Karla Pieters - Resume

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KARLA PIETERS

**** *. ******* *****, *** Bernardino, CA 92404

909-***-**** Cell or 909-***-**** Home

acz6oi@r.postjobfree.com

CAREER OBJECTIVE

I am seeking a position within a progressive practice in which the opportunity is given to apply my management and financial expertise, in an effective manner, where professional growth is available as well as supported. SUMMARY OF QUALIFICATIONS

More than twenty years of diversified health care background working for IPA's, single/multi-specialty medical practices, MSO's and Hospitals', with exposure to a broad range of functions including:

*Day-to-day Operations *Management *Marketing *Recruitment *Networking *Budgeting *Financial's (GAAP & Cash Methods) *Billing (HMO, PPO, PI, WC) *Human Resources *Strategic Planning *Practice Development *Contracting

(Provider, Capitated, Insurance, Full-Risk/Shared Risk, etc.) *A/R-A/P Management *Facility Management *Knowledge of CPT and ICD.9/10 *Shareholders Board Meetings *By-Laws *HEDIS/RAF & Star Rating *Acquisitions

*Credentialing *Claims Management *Case Management *Utilization Management *Quality Assurance *Delegation

*Department Managed Health Care *Capitation *Bargaining and working with SEIU-UHW Union (Service Employees International Union - United Healthcare Worker)

Well versed in Excel, Word, Lotus, Word Perfect, Microsoft Outlook, EMR (Prime Clinical, MicroMD, eCW, eClinical, OnStaff), Power Point, QuickBooks, Peachtree, Access and numerous other software Programs CAREER PROGRESSION

08/13 to 01/17 SERRA COMMUNITY MEDICAL CLINIC, Sun Valley, California Chief Operating Officer / Chief Financial Officer

This was an IPA practice which included 25+ Specialties which included Optometry, Ophthalmology, ENT, Pediatrics, Nephrology, Pulmonary, Anesthesiology, Cardiology, Gastroenterology, Orthopedics, Internal Medicine, Adult Medicine, Neurology, OB/GYN, General Practice, Urology, Podiatry, Radiology, Physical Therapy, Industrial Medicine, Nutritionist, General and Vascular Surgery. As the COO and the CFO, I was responsible for 100+ employees, multiple departments with annual revenue of 12.9 million. Some of my responsibilities consisted of the following:

Ø Overseeing and implementation for all operations, practice management, recruitment, marketing, referral networking, financial, HR, and strategic planning to ensure profitability while maintaining quality and positive outcomes

Ø Renegotiated health plan contracts increasing PMPM (per member per month) rates which increased the monthly revenue by $12k

Ø Streamlined and reduced staff by flexing hours, or reduction in staff which increased the monthly revenue by $5k Ø Negotiated with SEIU-UHW Union (Service Employees International Union - United Healthcare Worker) in changing health plan(s) to increase employee share of premium and out-of-pocket expense which increased the monthly revenue by $22k

Ø Increased Capitated membership more than 65%

Ø Regained contracts that former COO had previously lost which increased the monthly revenue by $55k Ø Outsourced billing department to billing company which increased the monthly revenue by $17k Ø Increased star rating from .5, 50th percentile to an average of 3.5, above the 75th percentile. This not only increased our revenue but more importantly, it improved the quality of care our patients were receiving Ø Implemented annual health fairs. This improved our assignment of patients, which increased our membership, thus increased our revenue

Ø Negotiated and ensuring contracts are in-place for other specialties not housed at Serra (IE; Acute Rehab, Alcohol/Substance, Endocrinology, Neurosurgery, Radiation Oncology, etc.) Ø Recruitment and hiring for all clinical and clerical staff including Physicians and Physician extenders Karla Pieters - Resume

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Ø Ensuring compliance is maintained for credentialing, contracting, claim processing, and education requirements are met with Pacifica Hospital, Surgery Center, Serra Community Medical Clinic, Insurance Carriers and State/Federal agencies

Ø Negotiated insurance contracts to expand our FFS and Capitated reimbursement rates Ø Overseeing and providing leadership to Managers and staff to ensure patient satisfaction Ø Ensuring all provider work-flows are maintained appropriately for maximum optimization Ø Initiated and implemented KPI's (key performance indicators) for staff and management to ensure appropriate threshold responsibilities are met appropriately, timely and effectively Ø Collaborate with Pacifica Hospital to ensure on-call Physician services are scheduled appropriately, as well as ensuring credentialing and contract guidelines are maintained Ø Ensuring company is in compliance with Department of Managed Health Care, Department of Health Care Services, Insurance Carriers, Federal and State Agencies Ø Worked closely and performed bargaining with staff and SEIU-UHW (Service Employees International Union - United Healthcare Worker)

Ø Reduced Accounts Receivable and Expenditures

Ø Maintain all monthly and budgetary financial's

Ø Initiated and implemented patient surveys responding to patients concerns, suggestions and/or inquiries 08/10 to 08/13 CARDIOLOGY SPECIALISTS OF ORANGE COUNTY, Santa Ana, California Medical Practice Administrator

This was a single Cardiology practice that is owned by five physicians. During my three years, I expanded the practice to seven Cardiologists with three locations (Santa Ana, Irvine and Newport Beach). As the Practice Administrator, I was responsible for 75+ employees, with annual revenue of 4 million. Some of my responsibilities consisted of the following:

Ø Day-to-day operations of multiple departments, and multiple locations Ø Implemented the financial and operational infrastructure necessary to ensure success Ø Marketing to include executing web-site

Ø Negotiated insurance contracts to expand our provider coverage Ø Ensuring company is in compliance with all necessary federal, state, and local laws Ø Implementation and completed phase I for Meaningful Use Ø Oversee personnel and operations of practice

Ø Reduced Accounts Receivable and Expenditures

Ø Trained billing staff on contracts, timely filings, A/R, etc. Ø Oversee Bookkeeper and reviewed all financial's for CPA 09/03 to 03/10 UNIVERSAL PAIN MANAGEMENT, Palmdale, California Director of Operations

This was a single Pain Management practice that was owned by three physicians. During my six+ years, I expanded the practice to (7) Anesthesiologists, (1) Chiropractor, (8) Nurse Practitioners, and (3) Clinicians (Physical Therapist, Occupational Therapist, and Acupuncturist), expanded to (3) locations, (Palmdale, Victorville and Valencia). As the Director of Operations, I was responsible for 65+ employees, with annual revenue of 5 million. Some of my responsibilities consisted of the following:

Ø Implemented the financial and operational infrastructure necessary to ensure success Ø Day-to-day operations of multiple departments and multiple locations Ø Created and implemented Medicare and Marketing compliance committees Ø Converted billing department into billing agency and brought-in other clients Ø Negotiated insurance contracts to expand our provider coverage Ø Ensuring company is in compliance with all necessary federal, state, and local laws Ø Implementation of Practice Management and EMR system Ø Set-up 10,000 sq. ft. ambulatory surgery center and office building Ø Reduced Accounts Receivable and Expenditures.

Ø Implemented all departmental policies, procedure and employee manuals Karla Pieters - Resume

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Ø Implemented and maintained budgets

Ø Implemented and maintained inventory controls

Ø Responsible for assessing and implementing strategies to ensure accomplishment of practice objectives and goals Ø Ad hoc training

1998 to 08/2003 ASSOCIATES IN DERMATOLOGY, Kissimmee, Florida Medical Practice Administrator

This was a single Dermatology practice that was owned by one physician. During my five+ years, I expanded the practice to (2) Dermatologists, (4) Physician Assistants, (1) Nurse Practitioner, (3) Estheticians, and expanded to (5) locations, covering three Counties (Orange, Osceola and Polk). As the Practice Administrator, I was responsible for 50+ employees, with annual revenue of 2 million. Some of my responsibilities consisted of the following: Ø Implemented the financial and operational infrastructure necessary to ensure success Ø Oversee financial, credentialing, provider relations, personnel and operations of practice Ø Reduced Accounts Receivable and Expenditures

Ø Recruited Physician(s), Physician Assistants, Nurse Practitioner Ø Purchased and remodeled multiple office buildings and set-up of procedure rooms Ø Implementation of selling skin care/cosmetic products “Anjou” Ø Implemented and maintained budgets

Ø Implemented and maintained inventory controls

Ø Responsible for acquiring and setting up multiple office sites Ø Negotiated and implemented 401k plan

Ø Negotiated insurance contracts to expand our FFS reimbursement rates. Ø Implemented HIPAA policies and procedures

AREAS OF EXPERIENCE

Business and Financial Planning

Implemented and supervised all billing, claims management, case management, A/R-A/P, budgetary, financial reporting and physician compensation formularies. I was responsible for implementation of all revenue analysis budgetary guidelines. I regained our delegation, passed all site-audits, renegotiated all insurance contracts, and implemented all operational policies and procedures. Developed internal cash controls for organization to ensure integrity of operations. Management and Operations

I developed infrastructure for our medical office that was inclusive of financial, operational, personnel and computer systems. I have 20+ years of experience in maintaining and enhancing physician productivity through detailed operational assessment. Troubleshooting and implementing productivity strategies to improve revenues and reduce costs. Current/Past Affiliations

MGMA (Medical Group Management Association), PIHRA (Professionals in Human Resources Association), Florida Notary / Bonded, Haines City Chamber of Commerce

Education

Health Administration Bachelor’s Degree - 2006

Kennedy Western University - Agoura Hills, California Certified Medical Office Manager - 2002

Practice Management Institute - Orlando, Florida (Certification #203596) Health Care Management Program - 1996

University of Central Florida - Orlando, Florida

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