James M. Statzer II

Greater Atlanta Area 678-***-**** abidas@r.postjobfree.com

www.linkedin.com/in/jstatzer

Business Analyst / Project Manager

Innovative, process-savvy business analyst and project manager. Able to

work with minute details without losing sight of the big picture. Hired and

led a team of as many as 19 people who managed commercial accounts

representing 60% of $80M in monthly collectibles. Member of the Healthcare

Financial Management Association (HFMA) for eight years. Bachelor's degree

and PMP certification expected December 2010. Core competencies include:

. Business analysis. Known for transforming boatloads of data into revenue-

generating processes. At Piedmont Healthcare, for instance, analyzed and

influenced processes related to 3000 accounts (patient visits) per week;

reduced A/R agings from 99 days in 1999 to 48 days in 2005. Recently

reduced Medicare Advantage agings by 50% for a boost on a $12M monthly

volume.

. Process improvement. Demonstrated ability to "measure-to-improve"

utilizing metrics and baselines to gauge amount of improvement obtained

and remaining. Increased reimbursement $3M via data mining of high risk

accounts in 2005. Reprogrammed SQL data for redesigned workflow; reduced

billing backlogs from $9M to $300K per day. Applied similar application

to bad debt process and reduced processing time by more than 50%.

. Project management. PMP certification expected December 2010. Managed

dozens of projects that have saved or re-captured millions of dollars. In

2007, one of three members on a team that recouped $27M from our five

largest commercial payers; analyzed 500,000+ accounts (patient visits) in

huge Excel spreadsheets to prove business case. Also increased payment

variance staff by 100% and redesigned processes for $1M per month

collections.

Professional Experience

1999 - 2010 Piedmont Healthcare Atlanta, Georgia

Piedmont Healthcare (piedmont.org) is a not-for-profit four-hospital health

system in greater Atlanta area specializing in orthopedic, cardiac

(Piedmont Heart Institute) and solid-organ transplant care.

Commercial Accounts Supervisor 2001 to 2010

. Promoted from insurance specialist to lead a six-employee collections and

billing team. Increased staffing by 250% to better handle volumes and

reassigned underperforming staff for better skill set matches to improve

team performance while maintaining highest ratings our of eight peer

supervisors on internal employee opinion surveys.

. Redesigned billing workflow by reprogrammed SQL data reducing billing

backlogs from $9M to $300K daily. Increased collections for A/R agings

reductions from 99.7 in December 2001 to 45.7 by end of December 2006.

. Reduced days-to-collect by 50% for inpatient stop-loss claims (nearly

$100K or more per claim) by replacing paper-based fax or mailing with

same day electronic submit from hospital databases via report-generating

tools.

. Reduced account receivables days by 50% for Medicare Advantage claims

worth over $12M by implementing coding and corrective submission

identical to CMS Medicare claims requirements.

. Analyzed and collected over $3M in collaboration with managed care

department during 2005-2006 from accounts encountered in follow-up

oversights which lead to project assignment above.

. Reduced commercial billing errors from over $9M to less than $300K per

day. Improved database export of STAR failed claims and failed bill

reports data for analysis and workflow assignment to the appropriate

staff responsible to correct each error.

. Selected by CFO out of 70 PFS employees as analyst on three-person team

that reviewed contract modeling and payer underpayments from 2006 fiscal

year. Analyzed 500,000+ hospital visits and recouped $27M via this

initiative. Communicated with Piedmont staff necessary to collect the

outstanding reimbursements.

. Led project during 2006 and 2007 consisting of three analysts in a

payment variance team. Redesigned workflow, identified report

reprogramming issues, and doubled staffing of PCON payment variance unit.

Reorganized into separate teams of analysts with new capability to

recapture $1M per month.

. Managed Transplant Reimbursement project since April 2005. Coordinated

monthly meetings with transplant area, package billing vendor, Managed

Care Director, and physician group representatives. Created, trained and

maintained an internal team of PFS employees who analyzed trends,

identified high risk accounts or issues, and achieved 50% reductions in

A/R agings.

Insurance Specialist 1999 - 2001

. Reduced processing time by 60% from 7+ days (in excess of deadlines) to

three days by implementing database extraction tool and Microsoft Excel

analysis versus prior paper report process. Reorganized processes from

weekly paper reports and magnetic tape delivery of vendor reimbursement

and account data to EFT payments and FTP transfers of the data for

posting and improved analysis.

1997 - 1998 Baptist Health System of East Tennessee Knoxville,

Tennessee

Award-winning health system with 500+ bed primary acute care facility, two

associated hospitals and associated physicians practice network.

Patient Accounts Representative

. Increased collections from seven Contracted Medicaid Organizations (CMOs)

for outstanding hospital claims to the TennCare Medicaid system.

. Improved delivery of claims and correction to outstanding issues via

electronic claims transmits through Blue Cross Blue Shield of Tennessee

system to CMOs and BlueCross commercial claims.

1993 - 1997 Sylvan Learning Systems Oak Ridge, Tennessee

Sylvan Learning Systems (sylvanlearning.com) At-work division was a

workplace retraining operation with successful contracts / engagements

including Texas Instruments, Motorola and Lockheed-Martin.

. At Oak Ridge National Laboratory under Lockheed-Martin, developed and

implemented physics, chemistry and mathematics curriculum for retraining

of employees involved in manufacture of nuclear materials weapons

material in order to comply with new international treaties and safety

requirements. Exceeded contract expectations regarding timeliness of

project completion, successful learning and employee satisfaction with

training.

. Developed and implemented re-training program of educational and computer

skills in preparation for corporate downsizing and re-employment for

Lockheed-Martin.

1990 - 1993 University of Tennessee Knoxville, Tennessee

. Designed and performed immunology research experiments on programmed cell

death in K-562 leukemia cell line leading to the development of cancer

vaccine methodology. Performed statistical analysis of results and

prepared result results for presentation at Hospital and Oak Ridge

National lab

. Maintained animal research area; oversaw proposals as member of the UT

Animal Use and Care committee.

. Researched and maintained Teratology database entries at U.S. Department

of Energy at Oak Ridge National Lab.

. Taught immunoloy and microbiology classes for the UT biology department

and in the pre-nursing program.

Education and Professional Development

B.A., Biology and Chemistry University of Tennessee at Martin 99%

complete; expected December 2010

Professional Development

. Project Success Inc. (22 PDUs towards PMP Certification) - July 2010

. Project Management Institute - member August 2010

. Healthcare Financial Management Association (HFMA) - member 2001 to 2009

. Advanced Certified Patient Accounts Representative (ACPAR) - 2001

. Microsoft Certified Professional - 2000

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