Revenue Cycle Management
Resume:
Donald Craig Graham
Lithonia, GA 30058 *************@*******.***
678-***-**** Mobile
DI R EC TO R RE VE N UE CY CL E / B USI N ESS O F F I CE D I R EC TO R / CO
NT RO LL E R
Healthcare Industry
Background includes 10+ years of healthcare management experience in both
for profit and not-for-profit environments. Built high performance teams in
patient financial services as well as healthcare consulting Extensive
experience in debt and asset management, accounts receivable, denial
management, fiscal and quarterly reporting, and operational, risk and
strategic management. I have a proven ability to work successfully with
diverse teams in a problem assessment and resolution environment. Past
Accomplishments include: lowering DSO 5% below national standards;
implementing various custom-fit divisional training programs; collecting
millions in denied and pre bad debt accounts within the projected time
frames; and multiple Employee of the Month awards. Additional
responsibilities encompass overall management of Corporate Business
Planning and Control functions that include:
Financial Planning and Analysis
> Forecasting/Evaluation of Operating Results
> Strategic Planning: Budget and Organizational Development
Experience
> Skilled in Healthcare Management and Market Growth
> Effective in Staff Training, Development and Retention
> Excellent Communication Skills
EMPLOYMENT HISTORY
UHS of Southern Crescent Health System
Anchor Hospital and Crescent Pines Hospital
Business Office Director
05/2013 - Present
. Complete Daily Census report
. Manage Credit Balance and Refund processing
. Responsible for MS4/AS400 and Emdeon payee and provider
maintenance and updates
. Responsible for Medicare Credit Balance Report preparation
. Responsible for Medicare Bad Debt Cost Report preparation
. Responsible for preparing and reconciling all Physicians billing
and collections
. Prepares and Reviews outside Vendor collection efforts and
payments
. Manage business office operations such as financial counseling,
billing, insurance verifications and collection efforts
. Responsible for cash application and outpatient charge entry
. Responsible for Indigent approval and charity funds monitoring
. Responsible for all vendor selection and support for outsourcing
A/R
. Responsible for implementation and training of all operational
workflow for business office staff
. Conduct and present weekly A/R status via weekly meeting with
CFO, CEO, Director of UR and Director of Assessment
UHS of SummitRidge Hospital
Assistant Controller/Business Office Director 06/2009- 5/2013
. Manage and approve all purchasing orders for administrative
supplies and monitor supply budget
. Complete weekly FTE report
. Complete Daily Census report
. Manage Credit Balance and Refund processing
. Responsible for MS4/AS400 and Emdeon payee and provider
maintenance and updates
. Participate in Treatment Team meetings
. Responsible for Medicare Credit Balance Report preparation
. Responsible for Medicare Bad Debt Cost Report preparation
. Responsible for preparing and reconciling all Physicians billing
and collections
. Prepares and Reviews outside Vendor collection efforts and
payments
. Responsible for Month End Accruals, assist CFO in preparing
journal entries and reporting
. Responsible for AP and Payroll processing as back up
. Manage business office operations such as financial counseling,
billing, insurance verifications and collection efforts
. Responsible for cash application and out patient charge entry
. Responsible for Indigent approval and charity funds monitoring
. Responsible for all vendor selection and support for outsourcing
A/R
. Responsible for implementation and training of all operational
workflow for business office staff
. Conduct and present weekly A/R status via weekly meeting with
CFO, CEO, Director of UR and Director of Assessment
Inventurus Knowledge Solution
On- Site Coordinator 07/2008 - 01/2009
. Managed daily client needs and initiatives for the client
. Advised global operations in India via conference calls, onsite
visit, and weekly WebEx
. Implemented and trained Nextgen Practice Solutions operational
workflows for client with over 6500 physicians
. Trained staff located in India that consisted of 140 employees on
NextGen Practice Solution and Revenue Cycle Management
. Responsible for business development to ensure future potential
projects after all best practices have been implemented
. Conducted and facilitated weekly client status meeting
. Created and presented weekly client status reports via teleconference
and site visits.
. Conducted all pre-sale due diligence and client presentation for the
transition process
Deloitte & Touche 03/2007 -07/2008
Senior Consultant
. Managed and developed workflow processes for outsourcing initiatives
for large healthcare facilities and hospitals
. Managed collection and billing efforts internationally by managing
staff in India
. Managed and implemented operational workflow processes that increase
profitability for clients by reducing inefficiencies
. Managed business processes in order to create an efficient financial
management environment to increase client revenue
. Maintained and created new ways to reduce budgetary restraints by
increasing profit and reducing loss
PDSHeart - Conyers, GA 2005 - 2007
Central Business Office Manager
. Responsible for the day to day operations of collection and billing
customer service, billing, enrollments, and collection departments
. Responsible for $43 million A/R
. Increased collection by 60% in the first fiscal year
. Surpass all departmental goals for 5 consecutive quarters
. Reduced bad debt by 28%
. Implemented an extensive on-going training program
. Increased department internal employee customer service review by 63%
Raytel Medical Corporation-Windsor, CT 2002 - 2004
Collection Manager
. Management of collections efforts for 5 divisions and all payers.
. Responsible for $120 million A/R.
. Implemented Denial Management System that reduced bad debt by 58%
. Streamlined the collection process and improve inefficiencies
Independent Consultant/ Interim A/R Manager 2002 - 2003
. Managed 80 employee multi-divisional A/R operation
. Streamlined annual budget while implementing bonus system
. Responsible for researching divisional specifications for newly
implemented A/R system
. In charge of the ongoing overall improvement of the A/R department
and revenue cycle analysis.
. Developed a comprehensive training and denial management program.
. Responsible for all authorization and referral updates to ensure
proper billing
. Responsible for all departmental training: billing, insurance
verification, enrollment, customer service, call center, collection
functions, and denial management team
. Reduced bad debt by 45% in the first quarter and continued to make
strides
. Created billing, insurance verification, and collection, enrollment,
and denial management policies
. Successfully overturned several denials such as: no authorization, no
referral, timely filing mis- quote of benefits, not medically
necessary and pre-existing conditions.
Coast to Coast Consulting, LLC
2000 - 2002
Director of Operations 2001 - 2002
R. Solutions, Fort Myers, FL
. Performed denial management and business development analysis.
. Business office assessment and revenue cycle analysis.
. Implemented denial management procedures for several hospital
utilization review department.
. Spear-headed the cash reconciliation projects for workers
compensation, governmental, managed
care contractual and commercial payers.
. Increased revenue from $5 million to $55 million in less than a year.
. Aggressively reduced A/R to average aging of 60 days for clients.
. Managed a variety of projects involving as many as 50 consultants.
Johnson & Associates, Atlanta, GA 2000-2001
Director of Operations
. Managed all A/R and revenue cycle analysis.
. Overturned over $3.2 million dollars in denials such as no
authorization, no referral, not medically necessary, timely filing,
misquote of benefits and pre-existing conditions.
. Responsible for all company requests, proposals, projects,
exhibitions and new clientele.
. Responsible for training hospitals business office and utilization
review department on denial management.
. Specialized in Medicare, Medicaid, home infusion therapy, mental
health providers, and physician appeals, billing and collections.
. Collected $1.7 million dollars in 120 day old denied and bad debt
accounts within 60 days.
Clark & Mascaro-Atlanta, GA 1998 - 2000
Denial Specialist
. Responsible for conducting seminars and conferences on decreasing
denials and bad debt write- offs.
. Participated in annual HFMA seminars
. Acted as training manager for CEO, CFO, and in-service business
office training.
. Evaluated and resolved denied claims such as wrongful suit accidents,
misquotes, timely filing, pre-existing conditions, non-covered
benefits, and no authorization.
Charter Peachford Hospital-Atlanta, GA 1994- 1998
Accounts Receivable Coordinator
. Acting business office manager in absence of the business office
manager.
. Communication facilitator between central business office and clients
which ultimately improved case collection and A/R aging.
. Reviewed self-pay collections efforts, insurance collection follow-
up, and admissions functions for quality assurance.
. Performed monthly review of A/R for budget accrual.
United States Army 1988 - 1992
Accountant Specialist
EDUCATION
Bachelor Degree, Business Administration, Healthcare Administration, AIU-
Dunwoody, Atlanta, GA Associate of Applied Science, Atlanta Metropolitan
College, Atlanta, GA
Medical Assistant Diploma, Gwinnett College of Business, Lilburn, GA
SYSTEMS EXPERIENCE
Microsoft Windows/Excel/Access/PowerPoint/ Lotus Notes/ SMS/ IDX/
Lastword/ HBOC/ Cerner ProFit/ SoftMed/ RX-Home/ Medic/ Dalcon/ AS400/
NextGen,/ Navicure/ Medseries 4, McKesson, Lawson, Emdeon, Kronos, Midas
and MedPac
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