ANTHONY E. COOPER, FHFMA, CFE
TOMAH, WISCONSIN 54660
To make a difference by coordinating diverse activities in manner that
makes it possible for an organization to effectively accomplish its
mission. . To draw upon lessons learned as a care advocate for others and a
patient in assuring that
the community of contributors to organization success work together. To
earn a reliable source of revenue. To make effective use of knowledge and
skills obtained through work and life experiences and a continuous
investment in education.
Turning setbacks into opportunities for growth. Responding to life's
challenges by improvising, adjusting and overcoming. Inspiring, motivating
and coaching others. Using documentation, auditing, evaluation and
interactive feedback to build pyramids for success. Investigating,
researching and applying best practices to elevate performance.
MY LIFE JOURNEY
Tomah and Sparta School Districts, Tomah and Sparta, Wisconsin
Substitute taught for Tomah and Sparta, Wisconsin school districts.
Successfully managed the classroom challenges of elementary, special
education, middle school physical education, mathematics and English ;
high school agriculture, biology, English, German, mathematics (algebra
and business mathematics), physical sciences, physics, science, social
studies and classes for the learning impaired.
Wisconsin Department of Health Services, Madison, Wisconsin
BUDGET AND POLICY ANALYST-ADVANCED
Produced Family Care budget package using Wisconsin Medicaid
Evaluation and Decision Support (WMEDS) warehouse,
Business Objects and Excel and made modifications to take into
account constantly changing and sporadically documented
business cases. Prepared financial impact analyses for transitioning
Medicaid recipients between institutional status and the
Family Care program using the WMEDS, Business Objects, Access and
Manpower at IBM Rochester, Minnesota
Competed with thirty five others for one of five final positions
while serving as financial help contact person for five IBM organi-
zations collectively employing over 600 employees. Learned and
applied innovative IBM methods for efficiently preparing
and explaining monthly forecasts through use of Brio and QMF queries
and Essbase tools. Assured proper set up, billing
and recoupment of hundreds of inter- company agreements and documents
of understanding. Received first hand introduction
to potential efficiencies offered by communications software like
Team Room, Second Life and Remote Access.
Contributed to care of elderly parents who were in their 80's.
including serving as caregiver for a mother who died of
Panceatic Cancer and suffered multiple dehabiliating eye strokes and
a father unable to walk without assistance, and suffering
from multiple life threatening conditions and progressive decline in
Organized volunteer team to recommend generic financial officer job
description for inclusion on HFMA-Wisconsin web site.
Created off the shelf HIPAA privacy and security presentations to
help Wisconsin HIPAA Collaborative workgroup members
preposition assets in advance of HIPAA compliance deadlines. Wrote
article and portions of requests for proposal in
support of a start up risk management company, The Masters Academy.
Pitched, organized and presented seminars on Internet
Marketing, Competitive Security and Leadership for Lorman Education
Services and UW-La Crosse Continuing Studies.
Reviewed books and articles for Healthcare Financial Management
Anthem Midwest, Inc., Mason, Ohio 45038
Produced analyses using the tera data warehouse, business objects, Excel
and Access that answered leadership questions about reasons for
unexpected increases in healthcare costs through production and
interpretation of drill down analyses.
Mastered and beta tested new niche software, accumulated and distributed
new software best practices to colleagues and monitored the impact of
colleague conversion to use of the new software.
Health Net of Arizona, Inc., Phoenix, Arizona
SENIOR FINANCIAL ANALYST,
Supported senior management of financially stressed organization
desperately seeking ways to avert collapse of division membership
from 350,000 to 50,000 members in the space of six months..
RSM McGladrey, Inc., Minneapolis, Minnesota
HEALTH CARE CONSULTANT,
Produced RSM McGladrey, Inc. American Medical Group Management (AMGA)
report for RSM Mc Gladrey, Inc. medical group clients..
Kansas Foundation For Medical Care, Inc. (KFMC), Topeka, Kansas 66614
HEDIS COMPLIANCE AUDITOR
Sold skeptical board and senior management on compliance auditing as
a possible line of business. Learned compliance auditing
by reviewing baseline surveys, developing audit work papers,
organizing audit agenda, rehearsing and performing onsite audits
and writing up and defending final audit reports. Prepared payment
integrity program portion of Medicare contract renewal.
Blue Cross Blue Shield of Minnesota, Eagan, Minnesota
Developed and implemented an Access tool for assessing effectiveness
of alternative strategies for controlling staffing, equipment
and administrative overhead expense. Role included developing
application in conjunction with Excel developer, serving as liaison
to division controllers and data base administrator, providing
technical specification documentation, training staff and arranging
application transfer from prototype to operational status.
University of Minnesota Clinical Associates, Minneapolis, Minnesota
Lived up to opportunity from UMCA transition leadership by producing
productivity benchmark comparison reports that were communicated to
stakeholders during a combination takeover by the Fairview Health System
and consolidation of nineteen physician businesses into one central
University Physicians, Inc., University of Maryland Medical System,
SHORT TERM HEALTHCARE ANALYST
Provided cardiology contract stakeholders with tools for deciding upon
conditions for continued cardiology contract participation. Report package
validated price effectiveness of cardiology code compression and accuracy
of contact capitation distributions and payment of Pediatric Cardiology
charges by a Third Party Administrator..
Missouri Department of Insurance, Jefferson City, Missouri
INSURANCE HEALTH INSURANCE ANALYST
Sought to build a position for myself by serving as go-to person for
assignments not performed by others: Researched autonomous provider
legislation, financial exam and market conduct data related to
proposed insurance company mergers and/acquisitions and issues
addressed at regulatory hearings.
Medical College of Wisconsin, Faculty Physicians and Surgeons, Milwaukee,
Facilitated actions of temporary charge compliance audit team that
anticipated the outcome and scope of probable Medicare related audits.
Carried out wishes of leadership in producing charge pick up analyses
to verify the accuracy and reliability of biller performance. Followed
expert guidance in scrutinizing remittance advices to identify
opportunities for revenue growth available from correction of billing
and claims payment errors and staunching of revenue leakages.
Owings Mills, Maryland
Blue Cross Blue Shield of Maryland,
PERFORMANCE SUPPORT, SYSTEMS AND FINANCIAL ANALYST POSITIONS,
04/ 1988- 07/28/1993
Prevented the adoption of unworkable information system conversion by
assertively communicating results of conversion
system acceptance tests to information system conversion committee.
Established a corporate Toastmasters club to facilitate interdepartmental
communication. Diminished possibility of unadministratable contracts
through championing pre-contract evaluation checklist. Reduced cost of
compliance with government mandates through cross walks that showed ways to
reduce duplication of effort. Researched operational costs of compliance
with proposed statutes, regulations and policy issuances. Managed
settlement process with physician groups and IPAs.
Blue Cross Blue Shield of Florida; Jacksonville, Florida.
DEVELOPMENT SPECIALIST, 07/1985-03/1988
Supported the development of state of Florida account standardized
subscriber agreement. Developed adequate provider networks for
coverage of Palm Beach county Medicare beneficiaries and commercial
enrollees by closing on financial terms for Palm Beach County hospital
agreements. Arrived at final settlements on hospital contracts by
resolving claims payment discrepancies between the health plan and
Forest Lake Doctors Clinic, Forest Lake, Minnesota
PHYSICIAN PRACTICE CONSULTANT/COMPTROLLER
Produced summary financial reports showing current status under Blue
Cross Blue Shield of Minnesota and Share agreements and forecasting
future performance absent changes in contract terms. Supported staff
cross training effort to promote greater flexibility in day to day
Missouri Medicaid, Jefferson City, Missouri
ASSISTANT DIRECTOR, PREPAID HEALTH SERVICES UNIT
Developed Physician sponsor program manual and bulletins and organized
orientation sessions for hospital and physician
office staff in Kansas City, Missouri. Arrived at pre-paid agreement
reporting package by incorporating draft reviews and
comments from effected prepaid health plans
St. Marys Hospital Medical Center, Madison, Wisconsin
SUPERVISOR, PATIENT ACCOUNTS
Supervised 15 person hospital billing and accounts receivable unit .
Capital Area Comprehensive Healthcare, Harrisburg, Pennyslvania
Performed all tasks necessary to convert the possibility of a community
based HMO into a viable candidate for start up
investment by the federal government, Commonwealth of Pennsylvania and/or
RESQU, Springfield, Missouri
Performed all tasks necessary to evaluate the feasibility of establishing
a Green County Medical Society sponsored
University of Massachusetts, Amherst, Massachusetts
M.S. in Public Health -5/1974
All requirements for degree completed except for thesis.
University of Wisconsin - Madison, Wisconsin
BACHELOR OF ARTS IN ECONOMICS - 8/1972
Graduated with special distinction
Accounting and finance coursework through the University
of Indiana School of Continuing Studies (July 2009- May 2010)
Computer Software courses in Microsoft Access through
Western Wisconsin Technical College (April 2010-M ay 2010)
Certified Fraud Examiner (CFE) (Now current through September 2011)
Fellow of the Health Care Financial Management Association (FHFMA)
specialization in the Financial Management of Physician Groups and
(Now current through 2013)
Able Toastmasters (ATM-Silver) - 2/2001