Medical Mental Health
Resume:
ALBERT M. JANKOWSKY
**.*********@*****.***
PROFESSIONAL EXPERIENCE
*/**** – Present Children’s Aid Society
Director of Billing & Revenue Cycle
Director for community-based clinic which provided Medical, Dental, Mental Health Article 28,31, Family Planning and Foster care. Overall management and contracting of all medical insurance and provider contracts. Intense claim analysis. Medicaid and Medicare billing, contracting, and coding. 3rd Party and Workers Compensation billing and coding. Slide scale fee set up and billing. Collections, Reporting, Cost Reports Medicaid and Medicare. All registration training and coding trainings. E-clinical Works, Accu-Med Systems, E-Paces,. Managed Billing Department and Front desk staff with large volume and turnaround.
1/2016-1/2017 MedDocs Consulting
Consultant
Responsibilities: Overall management and contracting of all medical insurance and provider contracts. Responsible for all revenue cycle management and redesign for clients. Management of value-based contracts and review of existing contracts. Medicaid and Medicare billing, contracting, and coding. Clients include Federally Qualified Health Centers, hospitals, and managed care organizations.
11/2014-1/2016 Housing Works Inc. /Medical Services III.
Vice President of Medical Billing and Revenue
Responsibilities: Implemented all billing and revenue services in house. Staffing of the billing and support staff. Contracted with 26 insurance plans. Services include: Medical Primary Care, OB/GYN, Mental Health, Dental, Article 28, Article 31, Article32, FQHC, OMH, ADHC, OASAS, HARP, Housing, Government Contracts and HBCS.
E-Clinical Works implementation: EMR, Billing, Registry, EBO and dash board reporting versions 9.0. Over 100 users trained by myself and staff. Attended the 2015 ECW Nashville national conference as a conference specialist.
Contracted the facilities and credentialed providers with all Medicaid Managed Care Plans.
Set up the supplemental payment program. (Wrap)
Set up the indigent care pool. (Charity Pool)
Medicaid and Medicare Cost reports.
Supervised All Voucher and State Billing.
Started an internship with Medical billing colleges for credit for their students.
Re-cooped almost $1,000,000 the first five months from prior billing company denials.
Direct management of 25 employees and indirect management of 4, including front desk staff, billers, coders, medical assistants and insurance enrollers.
7/2014-11/2014 New York Eye and Ear Infirmary/Mt. Sinai
Director of Medical Records/Director of Special Projects
Responsibilities: Directed the management of coding and patient accounts to enhance revenue and compliance. Special projects for the CEO/CFO regarding under payments and non-payments from all insurance carriers. Worked with and trained staff on authorizations, referrals and other revenue factors pertaining to revenue and compliance. Restructured contracts.
6/2009 – 5/2014 The Floating Hospital – (6 sites)
Director of Finance, Billing & Contracts
Responsibilities: Director for community-based clinic which provided Medical, Dental, Mental Health, and Cardiology Services. Overall management and contracting of all medical insurance and provider contracts. Intense claim analysis. Medicaid and Medicare billing, contracting, and coding. 3rd Party and Workers Compensation billing and coding. Slide scale fee set up and billing. Collections, Reporting, Cost Reports Medicaid and Medicare. All registration training and coding trainings. Accu-Med Systems, E-Paces, and Fund E-Z. Managed Billing Department and Front desk staff with large volume and turnaround. Implemented new EMR and Billing Systems.
E-clinical Works, became a certified ECW SUPERUSER 11/2009.
11/2007 – 3/2009 Community Cardiology/North shore/LIJ/ ST.FRANCIS HEART HOSPITAL
Senior Director
Responsibilities: Provided leadership in coordination of the medical and administrative Staff. Created policies for five physician practice, with full testing facility, managed staff of30+. ($5 Million Cardiology Practice. Managed all Finance areas (Accounts Receivable/Payable, Payroll) using Peachtree software. Conducted monthly staff meetings. Researched, selected, and coordinated implementation of new technologies in order to reduce overhead (EMR). Provided all office management duties which included ADP Payroll, 401k investments, scheduling and billing, all checkbook accounts. In charge of all billing, physician managed care contracts and coding.
5/2001 – 9/2007 Brooklyn Hospital
Director of Managed Care/Patient Accounts Director
Responsibilities: Responsible for leading and conducting all managed care activities for health system. Participated in the negotiation of all payer contracts on behalf of the organization and assisted in the implementation and administration of negotiated managed care contracts. Ensured compliance with all organizational, state, federal, and local regulatory laws, standards and practices. Coordinated the implementation and maintenance of all payer and provider contracts. Monitored and reported revenue and contract activity. Served as a liaison between Managed Care Department, Business Office and managed care payer to ensure that all parties are in compliance with agreements.
Apprised Senior Vice President, Revenue Cycle of all activities, pertinent changes in internal/external market, threats, and opportunities in a timely and anticipatory manner and presents action plans for immediate implementation and approval.
Worked in collaboration with the CFO, Finance Division, Executive Staff and Governing Board in the identification, development, evaluation and analysis of managed care contracts ensuring economic viability while supporting the long-term goals and objectives of the medical center.
Participated in annual and long-range policy, program and financial planning for the organization.
Channeled information to key decision makers to be responsive to the third-party payer.
Recommended manage care contracts for approval to CFO.
Directed the managed care program in compliance with organizational, governmental and third-party payer requirements and standards. Assisted in the development of policies, procedures and standards applicable to managed care.
Planned, organized, directed, and conducted negotiations with payer entities such as HMO’s, PPO’s, Workers’ Compensation carriers, government agencies, employers and other direct contracting entities.
Implemented managed care agreements with current and prospective payers.
Managed contract renewal timelines and negotiation timelines.
Requested amendments to or extensions of contracts.
Established, communicated, and achieved buy-in and implementation of organizational contracting standards.
Responsible for the coordination and communication between managed care and other key stakeholder departments.
Contributed to strategic planning and implementation.
Carried out supervisory responsibilities in accordance with policies and applicable laws.
IDX, Eagle, and E,Clinical Works billing and systems training.
10/2000 – 5/2001 UJA-Federation of New York
Special Project Coordinator
Responsibilities: Provided Administrative assistance in the planning and implementation of projects. Assisted with analysis and input as needed to meet changing technical demands of the business. Coordinated budget per project. Prepared Operations manual and did an overview of the project performance monitoring.
1/1986 – 9/2000 Voodoo Lounge Restaurant
Manager/Owner
Responsibilities: Provided Scheduling Activities of the Restaurant. Organized Stock, ordered food, supplies and equipment as needed. Handled finances as well as staff payroll.
COMPUTER SKILLS
Microsoft office97, Microsoft Outlook, Peachtree 07, QuickBooks, Vista (Word, PowerPoint, Excel), E- Clinical Works SUPER USER
PROFESSIONAL CERTIFICATIONS AND TRAINING
Former member of the board of directors for Healthfirst Insurance Company 2002-2006
NYSDOH Healthcare Counselor – Certification
Cardiology Coding and Billing Certification – McVee and Associates – 2009
General Practice – Internal Medicine Coding and Billing Certification - McVee and Associates – 2008
Practice Management Certification – AMA, 2008
Medical Software Training Eclinical Works-Accu-Med-(Micro MD Medical Manager-IDX-Eagle-Epaces,E-Icares)
Electronic Billing & Records – All Systems Adaptable
Contract Management and Revenue Review
SDOH Consultant on the Managed Care Homeless Carve In
Medicaid Redesign Team Consultant
Board member for the Medical Advisory Board ASA College
Steering committee member for the coalition of providers for The Homeless
Six Sigma Black Belt Certification, American Society of Quality Holding exam in October 2016
Consultant on many independent projects. ICL (Healthcare partners), Project renewal, Bright Point (Help PSI) among others.
Contact this candidate