Management Manager

Steven R. Smith

***** ******** *****

Lutz, Florida 33559

Home: 813-***-****

Cell: 678-***-****

**************@*****.***

EDUCATION

M.S.A., Health Services Administration

Central Michigan University, Mt. Pleasant, Michigan

CPC, Certified Professional Coder

American Academy for Professional Coders

PROFESSIONAL EXPERIENCE

V IRG IN IA COLLEGE

2012-Present

Online Program Director-Health Science

Responsible for the management of the administrative functions of the Associates Degree in Healthcare

Reimbursement, Medical Office Administration the Bachelor’s Degree in Health Service Management. Shared

responsibilities for the Master of Business Administration with a Healthcare concentration in conjunction with the

Business Program Director. Provide program Management, Faculty Management, Student Management, Enrollment

Management, Compliance as well as Career Service Partnership. Responsible for providing management oversight to

the Assistant Program Directors as well as Academic Coordinators.

U LTI MATE M ED ICAL ACADE MY

2010-2012

Program Chair-Medical Billing & Coding

Program Chair-Healthcare Management

Responsible for overseeing the administrative functions of the Medical Billing and Coding Diploma as well as the

Associate Degree in Medical Billing and Coding . Serves as the technical expert on program curriculum for students,

faculty and advisory committees. Supervise and mentor instructors to deliver superior student success throughout the

assigned program of study and maintain 100% compliance with all pertinent regulatory bodies. Provide subject matter

expertise, direction, training, and support for program.

2008-

H ERZING UN IVERSITY

2010

Healthcare Department Chairperson

Responsible for overseeing the administrative functions of the HealthCare Department; which includes Diplomas,

Associates Degrees as well as Bachelor’s Degrees. Serve as Academic Advisor to the Healthcare students, Review,

Create and Maintain Student Schedules. Hire, Train, and Develop New Adjunct Professors for the College. Ensure the

Healthcare Department follows The College and State Department of Education policies and procedures

2007-

PRECISION COD ING AND CONSULTING

Present

Executive Director

Responsible for managing the overall day-to -day administrative operations of the company. Primary responsibilities

are to establish and maintain an effective operating environment which ensures effective and efficient operations of the

company. Responsible for securing new consulting contracts with various physician groups, hospitals and other

healthcare organizations. Perform ICD-9 and CPT coding functions to assist Medical practices with enhancing and

maximizing their reimbursement. Perform Practice Management audits to in include physician’s documentation,

Evaluation and Management audits, Chart reviews, as well as developing, writing, and implementation of new policies

and procedures. Instruct adult learners in the areas of ICD-9, CPT and HCPCS coding, billing, managed care contracts,

claims management, medical terminology and reimbursement practices.

E MORY HEALTHCARE, I NC.

2003-2007

Sr Manager, Clinical Operations

Responsible for managing the overall day-to-day administrative and clinical activities of a multiple physician

psychiatry group practice, this includes six outpatient locations an 18 –bed adult inpatient unit and a 44-bed Geriatric

General Psychiatry and Neuropsychiatry unit. Primary responsibilities are to establish and maintain an effective

operating environment which ensures effective, efficient and safe operations of the practice. Ensure proper

implementation of policies and procedures. Promote cohesiveness in the practice. Ensure that that the practice follows

Clinic and Section policies and procedures; adhere to and enforce JCAHO and OSHA standards relating to the

physician office practice of medicine. Prepare operational and financial reports for the Responsible for the Supervision

of 10 direct reports located at the various locations. Act as liaison between physicians and employees to resolve

conflicts and Department’s Clinical Administrator. Financial viability includes being Responsible for the clinical

component of the department’s 4.5 million dollar budget. Monitor the submission of timely, accurate and complete

billing information to the Business Office to ensure the maximization of professional services reimbursement. Served

as the department’s coder and developed the reimbursement department. Also, performed audits for inpatient and

outpatient visits performed by the psychiatrists.

MATRIX REHABIL IT ION, I NC .

2000- 2003

Administrative Operations Manager

Responsible for overseeing the administrative functions of 31 facilities; 17 Physical Therapy Clinics in The Georgia

D istrict and 14 Physical Therapy Clinics in The South Carolina District. Served as the District’s auditor for clinics

located in Georgia and South Carolina. Responsible for managing office administrative procedures that generate $10

million plus in revenue; serves as the liaison between business office functions, the reimbursement service center, and

the payers; hire, train and orientate business office personnel. Responsible for Supervision of 57 employees within the

two Districts with 7 Supervisors as direct reports; monitor business office performance against company standards and

benchmarks related to quality, productivity, and service; troubleshoot reimbursement and payer denials related to

facility issues; compliance with coding and administrative initiatives and facilitating cash flow; identify best practices

as they relate to office and billing procedures; conduct routine as well as ad hoc focused audits of billing processes;

identify procedural breakdowns and opportunities for improvement; troubleshoot payer denials related to field issues,

including credentialing and clean claim submission; analyze and review reimbursement reports and trends for potential

reimbursement problems and investigate accordingly; manage the Managed care operations and negotiation of

Managed care and capitation contracts; assist District Manager with payer relations issues, including short pays vs.

contractual language, patient and payer billing complaint resolution, capital equipment purchases, budget preparation

and planning, and regulatory compliance with state and federal governing authorities.

1999-

H EALTH F IELD, I NC .

2000

Care Management Manager

Responsible for managing the Commercial/Government Department of Care Management, hiring and training six full-

time employees; tracking daily management of new patient care coordination process to include, timely and effective

communication to clinical operations of new patients and appropriate revenue qualification/authorization ensuring

t imely reimbursement; daily management of the care management process for active patients; ensuring necessary

communication between Clinical operations, Care management, external case managers and the patient in order to

facilitate the highest level of patient care coordination; ensuring necessary authorizations are obtained, protecting the

integrity of revenue and timely reimbursement; directing and monitoring compliance with company policy and

procedures, as well as compliance with Medicaid, Medicare and Commercial Insurance policy and procedures;

maintaining pre-invoice error codes for initial authorization, pre-authorization and pending patients; implementing

strategic plans and developing quality assurance indicators to show trends for needed improvements.

1998-1999

THE E MORY CLIN IC, I NC.

Referral Management Supervisor

Responsible for supervising the Referral Management Department of Patient Access; hiring and supervising ten full-

time referral management employees; supervising referral activities including, but not limited to, verification of

insurance coverage for Managed Care patients; contacting insurance carriers and/or Primary Care Providers to obtain

referral information, and ensuring appropriate access to providers and Managed Care networks; serving as a resource

interpretation of Referral Management functions and activities for physicians, section personnel and Central Business

Office personnel.

FAM ILY PLUS HEALTH PLANS OF GEORGIA, I NC.

1997-1998

Pre-Certification Supervisor

BLUECROSS & BLUE SHIELD OF GEORGIA

1995-1997

Utilization Management Analyst

KAISER PERMANENTE –GEORGIA REGION

1989-1995

Appointment/Receptionist

Medical Records

Referral Management

Contact this candidate