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Revenue Cycle Leader

Location:
Apopka, Florida, United States
Salary:
120000
Posted:
March 13, 2018

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Resume:

Professional Summary

Proven, high-energy Revenue Cycle Leader. Strategic problem solver who conducts root cause analysis and enacts efficient and effective solutions to maximize performance and increase team engagement/productivity. Hands on leader with extensive knowledge implementing front and back end processes designed to adequately capture all pertinent billing/reimbursement information for timely resolution, while keeping the team focused, engaged and productive. Skilled in negotiating partnerships both internally and externally with a keen ability to capture opportunities. Educated in multiple areas of technology, including Cerner, Sunport, Microsoft Office Suites and many others.

Experience

March 2002 – Present Florida Hospital Medical Center

2915 Bed Facility (Tri County Area)

Business Operations Lead (11/2015 – Present)

Provided direction and leadership to 5 professionals involved in concierge, intake, scheduling, registration, billing, payment posting and collection activates for the hospital and our partners. Conducted coaching, mentoring and feedback sessions designed to engage employee. Initiated progressive disciplinary actions as appropriate.

Accomplishments:

Developed, implemented and established standard operating procedures and processes for newly developed department focused on international patients experience to include all areas of revenue cycle (Patient Access, Patient Financial Services, Coding, Cash Posting, International Insurance Billing).

Developed, implemented and established key performance indicator metrics which included patient response times, turnover rates, gross and net revenue metrics and profitability goals.

Created and initiated job roles, responsibilities and description, along with implementing training program for new team members and establish accountabilities for performance based metrics.

Exceeded first year’s metric goals by 20% with a profitability after EBDIT of over $750k in the first year of operations.

Maintained assigned AR at minimum with a 26-day average resolution timeframe.

Developed finance strategies for Florida Hospital Destination Medicine.

Prepared written briefs on operation and finance decisions for the Senior Vice President and senior leadership team including analyzing the pros and cons of options and financial business impact (cost, profits, people, and culture) associated with DM Strategy initiatives.

Insurance Reimbursement Manager (PFS Billing) (12/2010 – 11/2015)

Provided direction and leadership to 17 professionals involved in hospital billing/patient accounting. Conducted coaching, mentoring and feedback sessions designed to engage employee. Initiated progressive disciplinary actions as appropriate.

Accomplishments:

Maintained Gallup World Class Status for employee engagement, scoring between a 4.87 – 4.94 out of 5 throughout tenure.

Oversaw diverse group of payers to include, Medicare/Medicaid replacements, commercial, workers comp, psych and international.

Provided education, training and oversight to team, while implementing standard expectations and processes making unit the top performing of the system.

Identified over $1.2 million in lost revenue due to payer incorrect denials, NDC and incorrect coding issues. Created interdepartmental partnership with impacting areas to address and resolve.

Developed extensive understanding CMS/AHCA compliance requirements/regulations.

Average AR days were 36 and implemented monitoring process for all payer account listing logs averaging from 30 million to 100 million, ensuring all accounts reaching days in AR over 60, 90 and 150 were processed and addressing barriers causing delays in payments timely and effectively.

Patient Access Manager (04/2005 – 12/2010)

Registration Representative, Senior Registration Representative (02/2002 – 04/2005)

Provided direction and leadership to 31 professionals involved in hospital registration for emergency room, outpatient and inpatient services. Provided coaching, mentoring and feedback sessions designed to engage employee. Initiate progressive disciplinary actions as appropriate.

Accomplishments:

Designed and implemented front end collection training/process in all points of services increasing campus collections from $75k to $350 per month.

Employee work performance and collections increased with the average audit score increasing from 88% to 99% monthly.

Maintained average employee engagement Gallup score between 4.93-4.97 score of a possible 5.0 on employee Gallup, ranking team world class performers.

Developed and maintained position relationships between Patient Access, clinical peers and administrative partners ensuring open communication and collaboration toward common goals were achieved.

Developed strategic planning and implementation of processes to increase accuracy and avoid denials and write offs due to employee error. \

Developed training module on insurance interpretation and upfront collection techniques; provided training to current staff and new hire employees for system.

Analyzed weekly/monthly rejection/denial and upfront potential collection report for 7-campus system; provided final approval on errors and comprehensive detailed report of trends and opportunities to campus managers.

Education & Training

Prosci Change Management Practitioner – 08/2017

Benedictine University/Major: Organizational Leadership BAOL

GPA 3.929

Skills

Language: Bi-Lingual (English/Spanish)

Teamwork: Work well with other team members and departments to accomplish any task

Computer: Windows XP, Microsoft Word, Excel, Power Point, Outlook, Internet Explorer



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