Training Medical

Toni DePass Baruti

**** *. ****** ***. **** Phone (720) 529-

0713

Denver, CO 80237 ********@*****.***

OBJECTIVE

To utilize my skills and expertise that will impact an organization to

operate in a professional and profitable manner.

PROFESSIONAL QUALIFICATIONS

Ten years experience that will enhance the success and profitability of an

organization by utilizing my strong analytical skills. I am highly

motivated, resourceful and a team builder. I am an innovative thinker who

has the ability to make decisions and dissect complex problems with

resolution as well as experienced to handle deadlines and pressure

situations.

PROFESSIONAL HISTORY

FRESENIUS MEDICAL SERVICES NORTH AMERICA

Strategic Business Operations Analyst 2007 -

Present

. Monthly review of Business Unit P&L accounts to identify loss and

marginal facilities tied to payer mix.

. Perform various financial analyses and recommend contract strategies

. Track, analyze and report managed care trends. Conduct analyses of

budgeted performance vs. actual, identify variances and report to sr.

management.

. Produce analytical reports to support managed care efforts and ad hoc

project analyses.

. Coordinate requests from Managed Care Organizations including collection

of data, evaluation of proposals and recommend course of action.

. Audit billing system and review billing accuracies to ensure that

projected revenue is being realized.

. Perform quarterly analysis of network data for growth.

. Build and maintain databases as well as reports

BKD, LLP

Senior Healthcare Consultant 2006 -

2007

. Hospital, Skilled Nursing Facility, Hospice, Critical Access and Home

Health Medicare and Medicaid cost report preparation and third-party

reimbursement

. Assists hospitals, chain organizations, federally qualified health

centers, school based clinics and other provider with reimbursement

issues such as Medicare bad debts, reimbursement analysis, appeals and

IME/GME.

. Correspond with Fiscal Intermediary as well as the State on audit and

reimbursement issues

Denver Health & Hospital Authority 2002 -

2006

Sr. Financial Analyst 2005 - 2006

Financial Analyst 2004 - 2005

Reimbursement Analyst 2002 - 2004

. Medicare and Medicaid Cost Report

. Graduate Medical Education

. Case Mix Index - Responsible for computing the hospitals Case Mix Index

for multiple payers.

. Provider Enrollment - Responsible for enrolling facilities into Medicare

and the Medicaid Assistance Program

. Correspond with Fiscal Intermediary on audit issues as well as the State

on FQHC (Federally Qualified Health Center) issues.

. Reimbursement Audit - Update and maintain information contained in

Siemens' Medicare and Medicaid DRG Scheme. Perform analytical review of

expected reimbursement versus actual reimbursement as well as calculate

hospital's Medicare base rate.

. Audit Patient Accounts

. UDS Grant Report - Determine the allocation of indirect NHP expenses for

use in grant proposals

. Indirect Cost Rate - Compile, analyze and put together proposal for

indirect cost rate negotiation used for grant programs.

. Calculate and Recover Capital and DME payments

. Sit on the Coding, Billing and Reimbursement Committee

PacifiCare Health Systems, Greenwood Village, CO 1999-

2002

Provider Appeals Supervisor 2001-2002

Provider Appeals Representative 1999-

2001

. Studied and standardized procedures to improve efficiency of subordinates

as well as turning an 8-month backlog to a 30-45 day turnaround time.

. Researched and resolved provider appeals such as retroactive referrals,

denied reimbursements and timely filing.

. Developed & maintained workflow processes for provider appeals that

increased productivity.

. Reviewed schedules to ascertain staff needs and goals.

. Assisted subordinates in resolving problems as well as coached and

counseled employees that improved employee morale.

. Interviewed and hired new employees, ensured appropriate training and

conducted performance reviews.

. Implemented and created Provider Appeal Training Manual to ensure quality

and consistencies in decisions of appeals.

EDUCATION & TRAINING

. BA, Business Administration, Clark Atlanta University, Atlanta, GA 1997

. St. Mary's Girl's Academy, Cherry Hills Village, CO 1992

. Certificate in Access I, II, III & IV, Aurora Community College, Aurora,

CO 2001

. Certificate for completing Siemens Patient Accounting Case Mix, Denver,

CO 2002

. Certificate for completing Beginners Medical Spanish, Denver, CO 2002

. Medicaid Billing Training, Denver, CO 2003

. FQHC (Federally Qualified Health Centers) Billing Training Denver, CO

2004

. ICD-9 and CPT Coding Training, Denver, CO 2004

. Medical Terminology Training, Denver, CO 2004

. Adhoc Reporting Training, Denver, CO 2006

. Hospital Medicare Cost Report Training, Lakewood, CO 2006

. HFS Medicare Cost Reporting Software Training, Las Vegas, NV 2006

. MedAssets Contract Modeling - 2009

. Proficient in: Windows, Word, Excel, Access, PowerPoint, IRISV3, New

Innovations, Monarch & Express Query, Siemens Patient Accounting

Invision & Signature, Winasap, Lawson, GoSystem, HFS, ACL, Crystal, BEX

and Hyperion

COMMUNITY SERVICE

. Junior Achievement Program, Denver, CO - Volunteer time teaching middle

school students Personal Economics, Enterprise in Action, The

International Marketplace and The Economics of Staying in School

. Denver Urban League Young Professionals, Denver, CO - Treasurer -2005

. Face to Face Ministries, Denver, CO - Mentor

. St. Mary's Academy - Alumni Board Member

ASSOCIATIONS

HFMA - Co-Chair Reimbursement Committee 2006-2007

Denver Women's Commission - Commissioner term 6/09

OTHER

Beautifully Blind Inc. Non-Profit - Founder/CEO

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