Manager Customer Service

**** ****** ******* ** ** apt **** marietta,georgia 30064

Phone 770-***-**** cell 205-***-**** . E-mail /abmpnm@r.postjobfree.com

LoiS A.wILSON

PROFESSIONAL SUMMARY

High-energy financial professional with experience in diverse areas of

healthcare revenue cycle management. Developed, trained and managed teams

of up to 65 managers and staff. Extensive history of process improvement in

maximizing revenues, increasing cash flow, and decreasing cost. Excellent

communication skill with a strong record of teaming effectively cross-

functioning with senior leadership.

PROFESSIONAL

EXPERIENCE

THE OUTSOURCE GROUP, Birmingham, Alabama

2008-Present

Senior Director Revenue Cycle, Operations

. Reporting to the Senior VP, responsible for the collections of

accounts receivables for multi-clients for 7 hospitals and physicians

groups. Manage 45 FTE's with 4 collections managers.

. Implemented new processes to increase cash by 10% and decrease denials

by 5% with using key indicators to monitor and analyze revenue along

with creating and developing a denial task team to execute an

aggressive follow-up with problem denials from payers with a focus on

timely and zero payments.

. Experience with implementing processes for decreasing denials from

government payers by utilizing streamline processes to obtain prompt

reimbursement with 30 days.

. Communicated and reported to clients the status of their inventory to

ensure that project deadlines were on target.

. Design staff productivity program to bring powerful results from 30to

60 accounts daily with implementing processes and tools to increase

cash collections.

. Implemented and executed processes to hold accountability and

productivity of staff to reach monthly cash goals for the department.

. Develop potential performance and quality metrics for staff to improve

workloads are worked, monitored, audited for resolution.

. Implemented and executed incentives for staff to promote positive

action for the organization.

. Compare capital budget concepts determine best practices for the

department.

. Coach, mentor, train staff on client patient accounting systems to

keep A/R workflow processes moving expeditely.

. Maintain and kept within budget with staffing & operations.

CORAM HEALTHCARE INFUSION SERVICES, Sacramento, California

2006-2008

Director, Patient Financial Services

. Reporting to the Senior VP, responsible for maintaining accounts

receivables for 25 sites with 43% of base business for a 500 million

infusion specialty services business.

. Maintain staff of 60+ employees along with (7) Supervisors, Billing

Manager, Collection Manager.

. Decrease denials by implementing strong pre-collections techniques

internally to expedite collecting cash within 20-35days which decrease

denials of timely filing. Reduce denial of claims from 1.2 million to

600k within six months and reached projected goal of $200k for

denials. Implemented processes for cash application team to expedite

payments being posted correctly to work denied claims timely for re-

submission to payers for reimbursement.

. Work closely/communicated with admission teams to put strategic plans

to improve registration processes for obtaining insurance information

from patients at time of shipment to customers.

. Work with IT team with new electronic claim submission to allow claims

to enter through claim scrubbing before going to the clearing house

for processing which improve claims not being on file.

. Implemented in-service training for staff quarterly to ensure

continual tools were provided for staff to complete daily job

functions.

. Worked with the various departments and insurance provider

representatives to maintain prompt payment reimbursement. Implemented

weekly team meetings to address aging accounts receivables.

. Worked closely with both Quest Diagnostics and LabCorp in managing

laboratory services billing.

WELL GROUP HEALTH PARTNERS, Chicago Heights, Illinois

2005-2006

Director, Patient Financial Services

. Reported to the CFO, responsible for collecting accounts receivables

for 55 physicians gross revenue $50million exceeded cash goals

monthly.

. Supervise staff of 45 FTE's with 3 Supervisors responsible for

collecting and monitoring accounts maintain all managed care contracts

held weekly meetings to discuss trends with problem payers.

. Responsible for the cash posting of accounts, self-pay, commercial,

Medicaid, Medicare payers. Knowledgeable of managed care contracts

also worked with the various departments to improve registration

processes implemented pre-pay for patients office visits/co-pay's on

line accounts which reduce bad debt down 8% to 6% within 6 months.

. Conducted training in-service training for the staff to keep up to

date skills and compliance with annual certification requirements.

. Acted as both internal & external liaison for department and the

payers held bi-weekly conference calls/meetings to discuss denial

trends with the payers to improve communication patterns to collect

reimbursement promptly per contract.

FRESENIUS MEDICAL CARE NORTH AMERICA, Westchester, Illinois

2003-2004

Regional A/R Manager

. Reported to the Controller, responsible for maintaining daily

operation & functions for a dialysis billing group of 40 with a 1

manager and 5 supervisors, auditing accounts and working closely with

payers to ensure prompt reimbursement.

. Implemented new staff structures to improve the billing &collections.

Reduce accounts receivables DSO from 149 to 93 within six months while

continually monitoring ATB to stay on target.

. Worked closely with the Director of Contracting to resolved contract

issues to increase cash collections with insurance payers.

. Responsible for $19 million in accounts receivables while continually

meeting goals for cash collections.

Work hands on with the various departments to improve quality

customer service for internal and external

customers.

. Implemented new procedures created strategic plans to improve cash

flows for the billing group. High

level of knowledge of working Medicare and Medicaid accounts

for obtaining difficult and timely

reimbursement from government payers.

ADVOCATE HEALTH CARE

1999-2003

Lutheran General Hospital - Park Ridge, Illinois

Manager, Patient Accounts

. Reported to the CFO, managed the day to day operations of 35 staff

and 4 supervisors engaged in billing and collections of managed care

accounts. Accountable for the auditing of the accounts receivables

for external collection agencies.

. Assessed staffing roles and responsibilities and redistributed tasks,

resulting in improved efficiency and better allocation of resources.

Partnered with IT department to create daily work activity reports

improved monitoring staff productivity.

. Assisted in recommendation strategies involving negotiation of

managed care contracts.

. Knowledgeable of managed care contracts along with experience in

working Medicare and Medicaid accounts receivables to obtain

reimbursement through aggressive financial counseling and strong

patient access processes to receive prompt payment within 45 days per

contracts.

. Work with the various departments to improve customer service for

internal and external customers which resulted in 5% increase in cash

revenue for inpatient and outpatient accounts.

ADVOCATE MEDICAL GROUP - Des Plaines, Illinois

1997-1999

Supervisor, Patients Accounts Managed Care - Physician

. Reported to the Director of Patient Financial Services managed staff

of 18 for third party emergency and specialty services with a focus on

Medicare and Medicaid accounts. Implemented billing and collections

procedures in order to maximize revenue for reimbursement.

. Trained, cross trained staff and closely monitored daily productivity

of assigned accounts receivables with timely follow-up to reduce aging

of accounts.

. Improved the internal mechanisms for emergency room registrations and

charge entry and coding which greatly enhanced the departmental

efficiency.

. Assisted departments in projects, and revenue projections, involving

business strategies and managing patient accounts with utilizing the

proper tools within the patient accounting system.

. Worked closely with outside agencies in the coordination of protocols

for billing and collections of bad debt placements.

. Reduced accounts receivables by implementing procedures for pre-

collection of fee for services on self-pay accounts.

DEPARTMENT OF HUMAN SERVICES,

1995-1997

Illinois Department of Medicaid Services, Chicago, Illinois

Case Manager

. Managed public assistance caseload aid to families with dependent

children.

. Reviewed client intake assessments to establish the program's

eligibility.

. Reconciled earned income with monthly allotment of clients benefits.

. Identified and developed new program initiatives to advance welfare

to work protocols in order to promote client's self- sufficiency in

occupational work related programs.

. Coordinated and facilitated self help-group sessions to support

welfare recipients entering and re-entering the work force, which

resulted in a reduction in public aid caseloads for the state.

. Managed medical assistance, no grant spend down (MANG) and federally

funded food stamp programs, establishing client eligibility

consistent with federal and state guidelines.

STATE OF ILLINOIS MEDICAL COMMISSION - Chicago, Illinois

1989-1993

Assistant Business Manager, Finance

. Reported to the Executive Director maintained effective and efficient

tenant relations, acted as liaison

between tenants and commissioners, assisted Business Manager in

implementing billing procedures and

invoicing statements through utilizing the system. Monitor and worked

past due accounts for reimbursement.

. Maintained complete bookkeeping and accounting records according to

the established state practice procedures.

. Prepared periodic financial statements reviewed budget reports for

the approval of the State of Illinois Medical Executive Board of

Directors to increase revenue for present and future projects for

land for medical research for the surrounding hospitals in the

Medical District.

EDUCATION

DePaul University - Chicago, Illinois

2000

Master of Arts Business Administration, Health Management

Bachelor of Arts, Business Administration

1978

SOFTWARE SKILLS

Hardware: PCS, IBM, and Network Applications.

Software: Microsoft Office, Works, Excel, Word and Power Point.

Systems: Allegra, IDX, Medical Manager, Siemens. Sorian, Care medic QSI,

Epremis, ( NEBO) Passport electronic billing systems.

ACCOMPLISHMENTS

& AFFILLIATIONS

Completing course in Six Sigma (green belt)

Member of HFMA Organization (2009)

VP, Operations & co-founder of

Wilson Healthcare Consultants Group (WHCG) established in 2005.

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