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Operations, Billing and Revenue Manager

Location:
Havertown, PA
Salary:
$75-$80k
Posted:
September 30, 2018

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Resume:

TERRI R. GARDNER

OBJECTIVE

To obtain an operational position with a company that will utilize my existing skills while allowing for growth. I thrive in defining problems and planning appropriate solutions. I am a self-motivated individual that seizes opportunities to learn, implement and improve processes/procedures via training and support. Capable of performing effectively in high pressure situations, while conveying a professional image.

EXPERIENCE

3/15 - present Self Employed Upper Darby, PA

Operations, Billing and Revenue Mgmt. Consultant

■Provide initial review of business plan, productivity, revenue data and contracts, in order to provide an accurate assessment.

■Based on KPI’s, Root Cause & FTE Analysis, government regulations, 3rd party requirements, budget and revenue assessment, an action plan is put in place.

■Set weekly onsite meeting, conference calls and web meetings to provide status update, address problematic revenue and address STAT items. Provide 24/7 availability.

■Work with designated staff on high risk items, urgent compliance issues and accounts receivable risks. Update billing/revenue policy and procedures, job descriptions and ensure current training methods are in place and sufficient.

11/12 – 1/15 Mercy Philadelphia Hospital Philadelphia, PA

ER Patient Access Manager – Business Office

■Supervised staff processing patients presenting to the ER via walk in, police custody, EMS arrival and crisis center for medical clearance. Staff handled bed board/admissions, hospital to hospital admission, verified insurance and submitted for authorization to admit or perform radiology services scheduled outside of the ER.

■Responsibility for rejected claims, denials and appeals for services provided in the ER, Admissions, Crisis, Fast Track and Radiology.

■Responsibility for creating, monitoring and auditing processes for quality assurance. Ensured all policies, procedures and training adhered to government and payer regulations and guidelines.

■Weekly and monthly reporting of patient services received, billed, patient hold accounts needing supervisor assessment and error release approval. Met with employees as needed to discuss audit findings and required action if any.

■Served on ER Management, Patient Safety and Disaster STAT committees. Met monthly to discuss compliance issues, stats, patient falls, concerns, updates and drills.

■Staffing of 24/7/365 area, full cycle hiring, HR combined termination process, payroll, annual/performance reviews and ongoing training in order to ensure the success of the areas under my supervision.

10/08 – 3/11 RHD – Corporate Philadelphia, PA

Billing and Revenue Manager Remote Sites

■Managed Billers, Analyst and Data Entry Clerks in full cycle billing of services for outside programs with over $180 million in revenue. Supervised employees locally and at remote sites. Locations consisted of school services, family practice clinics, behavioral health, group homes, drug & alcohol inpatient and outpatient facilities.

■Revenue Cycle Management, worked with Budget Managers, A/R department and locations to decrease delays, errors, un-billable services, write-offs and unapplied cash.

■Implemented procedures to effectively bill/collect revenue. Traveled to remote sites in 15 states to assess support needs, review and set new billing systems, perform quality audits, credentialing/plan enrollment, implement/review processes, assist in recruitment/hiring and conducted initial and ongoing staff training.

■Worked with stakeholders to determine if FFS billing of new sites were brought in house or kept at location with my oversight. Set up and review of new and existing contracts before renewal. Key person for payer and government compliance audits.

■Provided demo/training for upper management and clinicians on billing systems.

12/07 – 10/08 RHD - Lower Merion Counseling Bryn Mawr, PA

Site Manager

■Assisted in budget preparation and responsible for final review, reviewed billing process with corporate and implemented change as needed. Worked with CBO to resolve issues.

■Performed weekly chart audits in compliance with regulations and company policy.

■Assisted Director with clinical staff interview process/selection and credentialing.

■Completed new hire paperwork, orientation, non-clinical employee reviews, weekly meetings, monitor/adjust employee and consultant schedules as needed, AR/AP, vendor contracts, private fee rates and other duties as needed.

6/06 – 05/11 Bayada Nurses Lawrenceville, NJ On Call Manager - Remote Home Office

■Manage after hour calls from clients, prospects and employees.

■Staffed last minute openings and prepared am activity report.

■Market and quote prices for services to first time after hour callers.

■Participate in strategic meetings centered on office performance goals.

01/03 – 07/05 Kids First - CHOP/Chestnut Hill Pediatrics Philadelphia, PA

Billing Manager

■Handled patient inquiries regarding private pay rates and insurance participation.

■Revenue Cycle Management managed full cycle billing of physician clinic and hospital charges.

■Generated statements, delinquent notices, A/R reports monthly and Account Ready report quarterly.

■Supervised and trained data entry, billing and accounts receivable staff.

08/02 – 9/07 Coastal Clinical Management Services Rosemont, PA

On Call Manager – East & West Coast - Remote Home Office

■Acted as company Liaison from home after hours 7 days a week. Emailed summary report by 9am EST to office staff detailing shift activity.

■Filled last minute shift openings, schedule changes and call outs.

■Updated Nursing and Allied Health schedules via company intranet for Military Hospitals.

EDUCATION

09/09 – 04/10 RHD Leadership Development Program Philadelphia, PA

Operational Leadership, Team Building, Conflict Resolution Certificate

09/86 – 06/90 George Washington High School Philadelphia, PA

Communications, Psychology and Sociology Diploma

SKILLS

Microsoft Applications, EMR/EHR implementation & training, ROI, CRM, AR/AP, QuickBooks, Concur, Therapist Helper, MEDENT, IDX, ECHO, Medical Terminology and Coding, Revenue Cycle Management, BEARS, Call Center Training, ADP, LAWSON, NEXTGEN, MEDITECH, KRONOS, PICIS, MIPS, credentialing, quality assurance and auditing, WebEx training, remote staff management & travel, vendor and payer contracts, team building, mediation & conflict resolution. Twenty years of Healthcare Operations Management experience, supervised up to 125 direct and remote employees, twelve years of On Call after-hour Homecare employee and client experience.

CONTACT ac68fs@r.postjobfree.com • 913-***-**** or 484-***-****



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