Scott P. Knowlson, CPC, CPCO
**** *. ** ***** ** Tempe, AZ 85282
813-***-**** *****.********@*****.***
Medical Business Professional
A Recognized Expert in Medical Administration; Experienced in All Aspects of Practice Management Comprehensive background in medical business administration and overall practice management. Expert blend of medical industry knowledge coupled with shrewd business acumen. Professional Administrator with demonstrated success in driving revenue, slashing bad-debt and establishing successful practices. Thrive in auditing, billing, collections, compliance, and full revenue cycle management. CORE COMPETENCIES
Administration Medical Assistant Phlebotomy Coding Compliance Billing Medical Record Management Transcription Revenue Integrity Practice Management Internal Auditing Credentialing Contracting Documentation Improvement Chargemaster Medicare Compliance HIPAA Collections Project Specialist Financial Service Management Revenue Cycle Maintenance Medical Software Due Diligence Coding Auditing Billing and Reimbursement Auditing EXPERIENCES AND ACHIEVEMENTS
Alliance Physical Therapy Partners 2017 – present
Director of Compliance Compliance Officer
The compliance director position is responsible for legislative affairs, policy development and legal compliance for the organization. This position participates in product development services to existing and potential customers and interacts with all corporate management and personnel.
Key responsibility in Due Diligence in acquiring practices, auditing, onsite visit, revenue analysis, compliance analysis, coding and billing analysis.
Serves as the corporate compliance officer as appointed by the board of directors.
Oversees, develops, maintains, and promotes APTP’s Corporate Compliance Program (the Program) consistent with best practices and industry standards
Oversees subsidiary implementation of their respective Corporate Compliance Programs
Promotes a culture of commitment to Operating with Integrity, working with subsidiary management to ensure this is a core company value
Revenue Integrity auditing and chargemaster reconciliation
Defines annual ethics and compliance goals and training strategies
Oversees, manages, and implements APTP’s Governance, Risk, and Compliance Software
Drafts, maintains, and revises policies and procedures, including the Code of Ethics to prevent illegal, unethical, or improper conduct
Regulatory and Compliance Analysis and Education o Provides education to departments on improving charging accuracy, addressing CCI edits, optimizing compliant charge capture and completing documentation in a way that allows for more accurate coding
Special Projects
Moffitt Cancer Center 2016-2017
To contribute to the prevention and cure of cancer Revenue Integrity Auditor
The Revenue Integrity Auditor defines areas of high risk for revenue integrity and performs charge capture audits. Promotes revenue enhancement and compliance with laws and regulation by performing charge reconciliation activities, applying industry best practice research and identifying charge capture improvement initiatives. Scott P. Knowlson, CPC, CPCO Resume, Page 2
Regulatory and Compliance Analysis and Education o Provides education to departments on improving charging accuracy, addressing CCI edits, optimizing compliant charge capture and completing documentation in a way that allows for more accurate coding
Charge Capture
o Identifies services that are reimbursable but not coded; reviews, assigns, and determines charge and charge attributes for new services and products
o Recommends and initiates documentation reviews to support accurate and thorough charge capture processes for assigned service lines. Works in collaboration with nursing education to disseminate findings and implement process improvement and corrective actions
o Chargemaster update and analysis of charge patterns
Special Projects
BioSpine Institute /GulfCoast Spine Institute, Tampa, FL 2015 Offering minimally invasive spinal surgery; bringing relief to over 35,000 patients and counting. Director, Patient Financial Services
Acting Compliance Office and Director of the technical and financial segments of the Patient Accounts Receivable Department to include the direct supervision of Patient Financial Services Staff and all daily activities performed. Facilitated all trainings, monetary transactions, accurate claim transmissions and the development, implementation, and enforcement of all policies and procedures. Educated employees and key personnel on any pertinent changes affecting incoming revenue; analyzed issues related to the patient revenue cycle and presented thorough solutions to management for implementation.
Accountable for full revenue cycle and sound fiscal management; oversaw revenue generation and all discount program write-offs o Resulted in overall expense reductions
o Slashed bad-debt and wasteful expenses
Ensured compliance with all regulatory requirements as it pertains to Medicaid, Medicare and other insurance providers; maintained accurate documentation for existing providers
Created and executed billing/collection policies and procedures for proper claim submission and billing to ensure accurate maintenance of patients’ financial accounts and payment cycles. Established Revenue Integrity auditing and updates.
Guaranteed compliance with Federal, State and all regulatory entities in regards to patient billing and complete adherence to guidelines mandated by HRSA, CMS, FL DOH and 3rd party payers
Partnered and communicated with multiple departments ensuring a cohesive work environment o Analyzed and monitored billing trends and statistical data with Financial Accounting team o Consulted with Human Resources to recruit, interview, hire, train, monitor, retain, and terminate staff in a manner consistent with company policies and procedures
Laser Spine Institute, Tampa, FL 2009 – 2015
Leading provider of the highest level of patient care providing minimally invasive spinal procedures. Compliance Audit Manager
The Corporate Compliance Audit Manager responsible for planning, designing, implementing, and maintaining LSI’s internal audit program, which includes implementation of a reporting mechanism on internal audit findings, policies and procedures, as well as staff education which promote a corporate culture that fosters ethical and compliant behavior. Additionally, ensure the basis for adequate internal controls which adheres to all state and federal laws, and regulatory requirements which are applicable to LSI’s physician practice and ambulatory surgery centers. Responsible for the development, dissemination, and implementation of reporting tools, policies, compliance and audit standards, and administrative systems in all areas of the enterprise which may include, but are not limited to: accreditation and licensure; prevention of fraud and illegal acts; unauthorized use of assets; improper or inadequate documentation and billing; and adherence to regulatory requirements. Responsible for the oversight of LSI’s internal audit team, and educating enterprise leaders and staff on the accuracy and completeness of medical documentation, coding and billing, as well as implementation/completion of all corrective plans of action that correlate to audit findings.
Developed and implemented a Compliance Auditing team with focus on revenue integrity and documentation Scott P. Knowlson, CPC, CPCO Resume, Page 3
Managed and oversaw Internal and Compliance Auditing; analyzed results and implemented corrective action plans o Performed 20-day account reviews for accuracy in posted patient visits to include coding, deposits, insurance updates, MRI’s, X-ray’s, and various medical procedures
o Revenue Integrity auditing and review
Project Specialist
Team Lead for roll-out and implementation of ICD-10 code updates Medical Documentation Specialist and Team Lead
Created employee scorecard metrics and managed multiple team members, payroll, evaluations, coaching and development
PFS Specialist responsible for Revenue Cycle, Patient Logs and Medical Policy research and NBD Appeals Specialist (Temp role via Account Temps/Robert Half) Liaison for practice and insurance carriers responsible for obtaining frequent status updates on all submitted appeals on a daily basis. Debate for fair and reasonable rights and timeframes in which an appeal should be processed and finalized.
Finalize open accounts with multi-level appeals ensuring our patients receive favorable outcomes o Resulted in additional reimbursements paid to patients Patient Support Representative (Temp role via Account Temps/Robert Half)
Support patients via phone, email and fax, within 24 hours, and assure a swift and fair resolution involving their medical bills with their unique insurance providers
Ran quality checks on submitted medical claims; verify patient and provider information to ensure proper billing
Partner with clients to assist with the appeal filing process for all higher reimbursement requests All Medical Service, Tampa, FL 2008 – 2009
Private health services company established in 2008. Phlebotomist
Temporary position providing excellent service and outstanding patient care in the field of Phlebotomy Professional Medical Concepts, Inc., Clearwater, FL 2001 – 2008 Providing professional Medical Office Consulting Services. President and Owner
Professional consulting operation specializing in Medical Administration, Practice Management, and new office set-up. New business development with a focus on client care and providing expertise for providers starting up or revamping their practices. .
Drove revenue by offering Billing and Collections to include posting, coding, appeals and Accounts Receivable collections
Added value by providing clients with Transcription services and facilitated continuous staff training and post training support and mentoring
Offered additional practice enhancing services which included, but not limited to
Practice Analysis
Insurance Verification and Contracting
Patient and Practice Support
Scott P. Knowlson, CPC, CPCO Resume, Page 4
Morton Plant Mease Primary Care, Inc., Clearwater, FL/Tarpon Springs, FL 1996 – 2002 Non-Profit group of 100+ Board Certified/Board eligible primary care physicians. Team Leader II
Managed daily operations, activities and office staff for leading Internal Medicine practice comprised of two physicians. Facilitated office budgets and oversaw supply management. Accountable for all monetary transactions to include, but not limited to Billing, Coding, Collections and Cash Management. Created and implemented office policies, procedures and served as Records and HIPPA Compliance office.
Provider of patient care as Chief Medical Assistant
Licensed to provide X-Ray Tech Support
Director of Lab Services and CLIA Certified with increasing responsibilities to include Phlebotomy and specimen handling
Supported office by hiring and training newly hired employees EDUCATION AND CERTIFICATIONS
Master of Healthcare Administration, MHA - Capella University currently pursuing Bachelor of Science, Business Management, Rasmussen College Associate of Science, Computer Networking and Security, St. Petersburg College, FL Associate of Science, Programming and Analysis, St. Petersburg College CPCO, Certified Professional Compliance Office, AAPC CPC, Certified Professional Coder, AAPC
ICD - 10 Proficiency Coder, AAPC
Paramedic II, Center for Emergency Medicine, Pittsburgh, PA MEDICAL SOFTWARE
Amkai Soarian Financials’ Cerner EncoderPro 3M NextGen WebPT AgileRPM ZirMed ePrimis Healthicity Compliance 360 ChartSafe