Objective: Twenty-five years’ experience as a healthcare leader with proven abilities in strategic planning, improving operational efficiencies, team building, increasing revenue and decreasing aging accounts receivable. Successful in identifying operational strengths and weaknesses to streamline processes that optimize productivity, increase quality and improve the bottom line. Demonstrated ability to motivate team to maximize productivity, control costs and optimize resources. Excellent communicator, with emphasis on building strong client relationships.
Career Summary: A growth-oriented and highly talented Director with a strong background in Medicare Home Health Agency. Expert Knowledge of Medicare’s Home Health PPS Reimbursement, Home Health Strategic Planning for Growth, Process Improvement Techniques, Team Mentoring, Building and Leadership, Project Management. I have 20 years of experience in this domain as well as excellent communication and leadership skills.
Job Skills/Knowledge: Axxess, Kinnser, QuickBooks, CareAnyware, Cerner Beyond Now software, Nextech software and many other Home Health Software Programs, Medicare PPS, Medicare, Medicare Advantage, HIPAA, Medicaid, Managed Care, Liability, Commercial Insurance, DDE, EDI, Home Solutions, HCPC, Revenue codes, UB-04, HCFA-1500, improvement and Management, Organization Development, Microsoft Access, Excel, Word, Outlook, and PowerPoint.
Pinnacle Home Care – Revenue Cycle Manager 9/2017 – 9/2018
Organizes, directs, and coordinates financial revenue cycle operations
Coordinates revenue cycle meetings with Operations and Marketing teams
Provides revenue cycle support and acts as a liaison between Financial, Operations and Marketing teams
Coordinated efforts across all departments to decrease billing errors and increased revenue, working closely with billing & collections to determine opportunities for improvement
Supports in the preparation of monthly management reports providing key revenue and operational metrics, KPIs and analysis to the CFO
Supports with accounting team to roll forward accounts receivables as part of the monthly and annual close process; cash management projections and forecasting activities
Develops and review trending revenue cycle reports including: accounts receivable aging, days outstanding, denials, payment variance analyses, claim holds reports and write-off trends
Resolves payer issues; Investigates compliance issues related to billing; Promotes and implements LEAN processes
Ensures compliance with applicable laws, regulations, policies, and procedures.
Dropped their rap cancellation from 48% to as low at 8% for all 7 locations.
Decreased there aging by 23% in a short period of time.
Ongoing recouping outstanding claims for Medicare and private insurance.
Recouped 150K from John Hancock long term care
Adjusting accounts receivable to posting to correct accounts and invoices.
Generating reports, analyzing trends, and making recommendations to senior management.
BrightStar Care – Administrator 8/2014 – 9/2017
Managed & operated private duty home health agency. Accredited by Joint Commission
Effectively managed the activities of team members.
Generated and distributed daily reports and order acknowledgments to proper team members.
Changes to existing methods to increase the accuracy, efficiency and responsiveness.
Established rapport with the clients, case managers.
Maintained billing and A/R for Sunshine, Molina, and VA
Updated policy and procedure manual on going
Monitored and evaluated office team and field caregivers.
Managed payroll and billing; Managed Scheduling Coordinators, skilled department and Human Resources department.
Providing detailed monthly departmental reports and updates to Owner.
Developed, implemented and monitored programs to maximize office work flow.
Greystone Health Network (Senior Solutions)- Administrator 2/2013 – 8/2014
Delivers strategic leadership, vision, and clear direction; defines key goals, develops, and implements methods to ensure adequate and appropriate services and profitably grow business; ensure the success of the organization’s strategic goals. Created new work flows.
Responsible for support with recruiting, employing and retaining qualified personnel to maintain appropriate teaming levels to ensure adequate and appropriate services and business growth.
Human Resources, orientation for team
Recouped $50K in manage care billing for 2013.
Managed 13 office team, and over seen 30 field team.
Payroll for private duty HHA’s, and billing for private duty patients. Work with Long term care policy.
Bay Dermatology & Cosmetic Surgery, P.A. - Office Manager 3/2011 – 2/2013
Managed work flow process for the medical assistant and office team and Managed 25 employees and five physicians.
Developed and implemented an improved front desk and check out process for two offices
Implemented Nextech EMR and trained team; organized training between the office team and Nextech EMR trainer.
Implementing a Call Center to centralize all incoming calls for all seven locations.
Hiring Medical Assistants, office teams, call center team. Evaluate all team
Maintained daily billing and deposit, Maintain Dr. Schedule for maximum efficiency
Weekly inventory for injectable, cosmetics, skin care products, sustained budget.
Works closely with the Director on any issues with the practice.
Ultimate Home Care, LLC - Regional Director of Operation/Administrator 7/2009 – 2/2011
Managed & operated Medicare and accredited home health agency, accredited by Accreditation Commission for Health Care
Recoup over $70k from back billing
Created and managed a Corp. billing department
Leadership and supervised field team, marketing team, and office team.
Developed and implemented processes and procedures to support requirements for transition from Home Solution software to a new system Care Anyware.
Involved with acquisition and inquiry other home health agency.
Responsible for Medicare application, with CMS, and State.
Responsible of administration of all local, state, and federal rules and regulations about the home health agency.
Hired, trained and supervised Director of Nursing, office team, and field team.
Compiled and filed annual Medicare cost report data in a correct and prompt manner and collected PS&R reports from CMS. Quarterly reports to Medicare and State.
Diamond Home Health – Administrator 2007 - 2009
Rebuilt and operated a successful home health agency for a Medicare certified home health agency. Billed old claims for 18 months back that were outstanding collected over $280k and collected $16k from the IRS.
Initiation and overall supervision of all major programs affecting health and welfare of patients, facility operation including budget, personnel, clinical practice and public/ community relations.
Obtained venders contracts for rehabilitation services, social services and HMO Humana contact through JSA medical group.
Developed and revised policies, clinical forms and business methods to ensure orderly and effective operation of the agency.
Pasco-Hernando Community College 1992
Hillsborough Community College 1993
National Career Institute 1990
Marchman Vocational 1989
Ridgewood High School 1989