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Revenue Cycle Management

Location:
Roswell, Georgia, United States
Posted:
April 16, 2018

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Resume:

Dynamic Revenue Cycle Leader with an expansive portfolio of success driving operational improvement and execution to support organizational growth. Instrumental in building new business units, implementing new technology and reducing operational expenses. Skilled in leading on-site and remote support teams. Dedicated to aligning resources, technology and strategies to achieve corporate objectives.

Expertise

Revenue Cycle • Client Service • Strategic Planning • Quality Assurance • Policy Development • RFP’s • Vendor Relations • Process/Performance Improvement •

PROFESSIONAL EXPERIENCE

U.S. HealthWorks, Valencia, CA Sept 1999 – Present U.S. HealthWorks, a subsidiary of Dignity Health, is one of the country’s largest operators of occupational healthcare centers with 250 medical and onsite clinics in 21 states, employing more than 4,000 people, including approximately 1,200 medical providers. Our centers collectively serve more than 14,000 patients each day, providing quality medical care to help employees return to work and allow employers to effectively manage claims and reduce lost work time. U.S. HealthWorks also offers special early return-to-work, injury prevention, and ergonomics programs. Senior Vice President, Revenue Cycle Management Sept 2015 – Present Lead and direct Revenue Cycle and Service Delivery division to include Coding, Contract Management, Referral and Authorizations, Appeals Management, Collections, Cash Posting, MRO Service, and Client Service Delivery activities for 250 clinics and onsite locations with $600 million in annual revenue and 300+ FTE’s. Work directly with operations, sales, and physician leaders to set and drive KPIs in line with financial objectives of the organization.

• Oversee processes to ensure effective optimization of revenue cycle design, evaluate current business offerings, and identify improvements, enhancements, and new service line opportunities.

• Provide leadership that drives the execution of USHW mission and values across all revenue cycle management departments.

• Responsible for the effective operation of 2 RBO/CBO’s engaged in Coding, Contracting, Credentialing, Collections, Cash Posting, Referrals and Authorizations, Appeals, and Database Management. RBO’s are located in Valencia, CA and Alpharetta, GA.

• Integral member of mergers and acquisition team involving integration of 51 individual transactions with 124 center locations requiring due diligence, process mapping, system integration, and training of personnel

• Monitor and report on revenue and expenses, and ensure variances are analyzed to determine corrective action as appropriate. Establish and communicate performance metrics, goals, and priorities.

• Ensure all revenue cycle management functions and activities follow all laws, regulations and requirements.

• Develop and lead initiatives to improve efficiencies and decrease costs. Savings to company of $2.3 million in 2017 alone.

• Implemented automatic cash posting process with direct feeds from bank into detail accounts receivable system. Able to reduce cash posting staff by 50%.

• Developed offsite coding program for certified coders increasing productivity and reducing office footprint.

• Revenue management expenses trending at 2.57 % of Net Revenue YTD 2017.

• Increased Cash Collections as a Percentage of Revenue from 87.5% in January 2016 to 88.6 % as of July 2017.

• Automate appeals management program for optimization of reimbursement for denied or short paid services.

• Coordinate revenue cycle management audits for payors, due diligence, credentialing, and year end audits.

• Collaborate with IT department to develop business solutions and processes. Integral in testing, training, and implementation.

• Recently consolidated one RBO in Anchorage, AK into Valencia, CA RBO. Currently working on relocation of Alpharetta RBO to new location to be concluded by December 2017. Michelle Linsley

795 Fairbrook Lane

Roswell, GA 30075

678-***-****

ac45rt@r.postjobfree.com

Michelle Linsley ac45rt@r.postjobfree.com

• Maintain database structure for 21 states with workers’ compensation, private, and federal fee schedules, provider setups, ICD10 database, employer maintenance.

• Currently working with finance to automate patient refund process to ensure timely and expedited payments when due.

• Restructure of Referral and Authorizations to develop synergies between software systems and operational departments in progress.

EARLY CAREER HISTORY

1988 - 2015

U.S. HealthWorks, Vice President, Business Process – Atlanta, GA, 2009 - 2015 U.S. HealthWorks, Director, Business Process - Atlanta, GA 2004 - 2009 U.S. HealthWorks, Business Analysis - Atlanta, GA 1999 – 2004 Healthfield, Inc. Business Analyst – Atlanta, GA 1996 - 1999 Mastoran Corporation – AP / Payroll, Analyst, Waltham, MA 1994 - 1996 Georgia Federal Bank – Head Teller – Atlanta, GA 1989 –1994 EDUCATION

Georgia State University, GA - Marketing



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