Acute Care Revenue Cycle Management

SUMMARY EXPERIENCE

. Twenty five years of diversified Facility and Professional Services

Billing, Accounts Receivables Management and Practice Management

experience in the healthcare arena including but not limited to DME.

. CPAT Certified.

. Self Starter, proven leadership skills, analytical, flexible, results-

oriented, organized, detail oriented and creative problem solver.

. Computer literate/AP Smart Stream, MS Office (Word, Excel, Access,

Power Point, Outlook), SQL database, Monarch, Crystal.

. Medical Delivery Systems Software/McKesson Paragon, Quadramed

Affinity, Meditech Client Server, IDX, Medical Manager, Medic, Med-

One, HIS, SMS, SIS, Dentech, Mestemed, GE Centricity.

. Interface Systems/ Harvest Contract Management; Relay Health ePremis

claims management, 3M, Allscripts.

. Phone and Call Center Systems, Siemen's and Open Scape

PROVEN ABILITY TO:

. Lead and develop staff.

. Strategize and develop goals.

. Work independently and contribute to a team effort.

. Assess patient/customer needs and provide services to meet those

needs.

. Interface effectively with diverse patient base and all levels of

hospital personnel

. Manage projects from initiation to completion.

. Work well in a fast paced, high-pressure environment.

. Manage Projects from initiation to completion.

PROFESSIONAL EXPERIENCE

09/13 - Present Huntzinger Management Group Privately Held

Healthcare Consulting Firm Project Manager

- Engaged as a Project Manager for the implementation of Meditech's

Medical Practice Management.

- System (MPM/PBR for Gaylord Specialty Healthcare a Premier long-term

acute and chronic care hospital in southern New England from kick off

to implementation.

- Worked closely with core team of hospital management executives,

software and other vendors.

- Developed project documents to include Project Charter, scope, work

plan, issues/ decision tracking and risk assessment.

- Assessed areas for optimization, process improvement and provided best

practice solutions.

- Documented timelines, progress and tasks and provided project status

to include areas of risk.

- Created and executed implementation test plan.

- Facilitated discussions with hospital executives and managers on

system functionality and decision tracking and worked with Client

Executives to understand their objectives and needs.

- Documented workflows as defined.

- Developed go-live plan.

- Transitioned application to support.

08/12 - 09/13 ST VINCENTS MEDICAL CENTER, Bridgeport, CT

Billing/Revenue Cycle Manager Patient Financial

Services

- Manage Billing and Charge Capture process for 200 plus physician's and

mid level providers.

- Responsible for writing and implanting policies and procedures for all

revenue cycle functions.

- Responsible for developing and implementing standardized encounter

forms.

- Managed, measured and monitored the performance of the out sourced

billing company.

- Responsible for the managing the payer credentialing process.

- Created Revenue Cycle Dashboards that include key performance

indicators in measuring against best practice.

- Created a Denials Management process that resulted in a 20% reduction

in denials in just six months.

4/11 - 8/12 HOSPITAL of SAINT RAPHAEL, New Haven, CT

Revenue Cycle Manager

. Revenue Cycle Manager of the Faculty Practice and

Affiliated Physician's of Saint Raphael which includes 60

outpatient primary care and specialty practices and

hospital based clinics with over 600 providers.

. Responsible for all Revenue Cycle functions for the

Facility and Professional Services, to include Scheduling

and Registration, Credentialing, Billing, Coding, Accounts

Receivable Management.

. Direct Supervision of 6 Supervisors and fifty FTEs.

. Managed Central Scheduling and Registration Call Center for

60 office locations handing 800-1000 incoming calls per day

with 8-10 call center FTE's.

. Managed Call Center ACD and Reporting and Statistics,

lowering abandon call rates from 28% to 6% within 3 months.

. Created Dashboards, set goals, monitor productivity and

monitor standards using best practices for both Hospital

Billing and Accounts Receivable and Physician Practice

Management.

. Created efficiencies to reduce denied claims, increase

cash, lower days in A/R.

. Work with corporate compliance to establish audit system to

improve charge capture, coding and documentation.

. Monitored Performance of two out sourced billing and

collection vendors.

. Created a central Scheduling and Registration department

which helped reduce front end denials.

. Project Manager for several large GE IDX system build's,

migrations and implementations.

8/08 - 8/10 WESTERLY HOSPITAL, Westerly, RI

Manager, Patient Accounts

. A member of the revenue cycle management team, directly

responsible for all day to day operations and workflow of

the billing, collections and financial services.

. Direct Supervision of fifteen FTEs in the patient accounts

department.

. Managed the services, standards and outcomes of outsourced

vendors (Medicaid eligibility appeals, self pay and

worker's comp billing) and collection agencies.

. Reviewed and renegotiated vendor contracts to reduce

overall Hospital expenditure for outsourced services.

. Monitored and developed tracking of the Hospital's free

care practices.

. Hire, educate and evaluate billing, follow-up, and customer

service staff.

. Troubleshoot and resolve all customer service, system,

claim form and process issues.

. Compile and analyze month end data. Monitor productivity

and report on progress

. Update and maintain applications dictionary perimeters

related to billing data.

. Ensure compliance with Medicare, Medicaid and all other

payer billing requirements and update

. Develop and implement policy and procedures for billing and

collection practices, cashier and front end intake

procedure and receivables management.

. Insure timely accurate and compliant billing practices.

. Monitor A/R and strategize on lowering A/R Days in managing

aged receivables.

5/04 - 8/08 WILLIAM W BACKUS HOSPITAL, Norwich, CT

Patient Accounts Supervisor

. Member of the management team, direct Supervision of eight

FTEs in the patient accounts department with a

concentration on the Government payers.

. Hire, educate and evaluate billing and follow-up staff.

. Manage daily operations and workflow.

. Troubleshoot and resolve system, claim form and process

issues.

. Compile and analyze month end data.

. Stay current with Medicare, Medicaid and other payer

requirements and updates.

. Monitor productivity and report on progress.

. Develop policy and procedures.

. Insure timely accurate and compliant billing practices.

. Strategize on lowering A/R Days and aged receivables.

2/02-4/04 NORTHEAST DENTAL, Wilbraham, MA

Practice Administrator

. Management of the daily operations of a multi-specialty

practice.

. Coordinate Patient Care, Treatment planning and financials.

. Developed Business and Marketing Strategy.

. Managed A/R by the timely and accurate filing of insurance

claims.

. Self pay collections.

. Provided and delivered staff evaluations and feedback on

performance.

3/00- 1/02 EASTERN REHABILATION NETWORK (Hartford Hosp. Affiliate),

Newington, CT

Manager of Patient Accounts

. Member of the management team responsible for the

operations of billing and collections for fifteen

outpatient rehab locations.

. Hired, trained and developed staff of twelve FTEs Central

Billing Office.

. Developed and implemented policy and procedures related to

billing and collections for both central business office

and outpatient locations.

. Assessed business needs and updated the medical delivery

billing system functionality to accommodate process and

regulatory changes.

. Collaborated with the Corporate Privacy Officer to develop

policy and procedure regarding HIPAA.

. Provided billing consult services to contracted outpatient

rehab facility clients.

. Developed and implemented productivity tracking for

collectors/follow-up staff.

1/99-9/99 PRACTICARE, Windsor, CT

Director of Business Operations

. Member of the Senior Management Team with responsibility

for Accounts Receivable and Information System

Implementation for two MSO groups, making up 70 plus

providers of primary care and ancillary services in more

than twenty practice locations

. Direct management responsibility of the billing staff of

twenty persons at the Regional Business Office and managed

the operations of billing and collections.

. Implementation of policy and procedures

. Fee schedule updates

. Analyzed and reported payment patterns

. Reported generation of month end and quarterly activity

from several systems

. Created and implemented a new medical Information System

(Medical Manager)

. Developed a Regional business office

. Established and implemented policy and procedures regarding

front desk control for 16 practice sites

6/98 -1/99 HEALTHWISE MEDICAL ASSOCIATES, Vernon, CT

Accounts Receivable Manager

. Member of the Management Team with responsibility for

accounts receivable and collections and Information

Systems Implementation and Administration

. Direct supervisory responsibilities for a staff of six

in the Central Business Office

. Provided in house support for all computer software and

hardware issues

. Presented monthly to a committee of Physicians

. Implemented a new Medical Delivery System to CBO and

Practice locations

. Successfully Implemented a new information system

(+Medic) as the project manager

. Developed fee schedules for approval by the management

committee

. Developed and operational Central Business Office

2/97 - 4/98 FIRST NEW ENGLAND DENTAL CENTERS, Hartford, CT

Practice Manager

. Budgeted and managed daily operations of the practice

. Hired and evaluated 12 clinical and clerical staff

. Developed and implemented effective office policies and procedures for

patient relations, front desk procedures, Billing, Collections and

Computer System Operations

. Coordinated business promotional and marketing activities

. The company had purchased a failing practice where revenues were

increased from $12K to more than $60K per month due to effective

marketing, implementation of effective patient booking procedures and

expansion of services, including hiring of two additional specialists.

5/96-2/97 HBP FINANCIAL SERVICES, North Haven, CT

Billing Supervisor

. Liaison of Billing operations for clients at Stamford Hospital, Lawrence

Memorial, Manchester Memorial and the Hospital for Special Surgery in New

York City

. Analyzed business performance and generated projections for budget

preparation

. Coordinated credentialing of physicians and completed provider

applications

. Implemented information system (SMS) to billing office staff

. Traveled to various facilities to review operations

. Provided monthly presentation of practice operation to physician clients

8/93-5/96 AMERICAN MEDIQUIP CORP, Windsor, CT

Accounts Receivable Analyst

. Responsible for supervising a staff of sixteen in the Claims

Management Department

. Overseeing the timely and accurate filing of electronic and paper

claims to third party, Managed Care, DMERC and Medicaid carriers

. Timely billing of private pay, contract billing and collections.

. Supervised cash posting and denial management

. Staff training and development of policy and procedures.

. Supervised the intake of Certificates of Medical Necessity and other

documentation.

. Analysis of receivables, month end and financial reporting

10/89 - 4/93 MANCHESTER ORTHOPAEDIC SURGERY & SPORTS MEDICINE,

Manchester, CT

Billing and Collections

. Posted insurance and self pay payments on patient accounts.

. Worked all A/R related correspondence including follow up on denied

claims.

. A/R Management working A.T.B and other A/R generated reports.

. All collection activity on outstanding self pay accounts and insurance

balances.

. Kept staff informed on payment trends, changes in policy and carrier

updates

Education:

Manchester Community College - Business Administration and Accounting

Special Training:

AAHAM- CPAT Certification 11/2006, Extensive billing, collections, coding,

practice management and system software courses, seminars and conferences

Professional Organizations:

AAHAM, STCC medical Curriculum and Coding Advisory Committee

Contact this candidate