Francine R. Kaley, CPC

**** **** *** **. ********, NY 11224

Email: ad1cwc@r.postjobfree.com

718-***-**** or 917-***-****

Objective

A Revenue Cycle Director with over 20+ years in a variety of positions with experience in Customer Servicing, Management, Revenue Enhancement, Quality Assurance, and Team Management. A hardworking professional with good teamwork who can reliably achieve desirable outcomes by following a structured approach to achieving business goals.

Skills

Excellent knowledge of revenue cycle and other healthcare financial performance metrics

Working knowledge of Microsoft Word, Excel (including pivot tables), PowerPoint and Outlook

Ability to foster open communication, team build, and more 1encourage and maintain team morale

Ability to actively participate in budget development and carry responsibility for achievement of budget targets

Extensive knowledge of the healthcare professional revenue cycle environment, application of strategic AR workflow and a strong understanding of medical billing principles

Ability to perform and complete projects in a timely manner with minimal supervision in a fast-paced environment

Extensive knowledge of AR billing systems and utility management as it relates to production and system reporting

Hospital information systems, including data stored and prominent functions which occur in the following departments (Admissions, Medical Records, Order Entry, Discharge Planning, Patient Accounting)

Ability to influence key stakeholders at various organizational levels

Strong leadership and commitment to a team approach

Experience

RADIOLOGY ADVANTAGE OF NEW JERSEY SEPT 2001 - PRESENT

SENIOR DIRECTOR OF BILLING AND COLLECTIONS

Implement Hospital and Professional Billing Revenue Cycle Systems

Optimization, auditing, and setup of work queues for charge capture reconciliation, denial management, clearinghouse, claims management, and payment posting

Establish and maintain open communications with contract facilities. Monitor key performance indicators and collections goals, resolve billing issues and ensure timely payments

Mentor employees, conduct performance evaluations, counsel and provide corrective actions to assigned personnel, and work to facilitate individual and team development that drives positive results. Champion affirmative action efforts in all aspects of employment, including but not limited to staffing, training, and promotions. Responsible for compliance with and enforcement of company/department policies and procedures

Work closely all Regional Directors (RD) and other members of Operations, as well as other departments within to convey issues and propose solutions that will improve efficiencies, and/or reduce costs

Establish an in-depth understanding with RCM functions and operations, including the flow of trip ticket inventory, cash receipts and write-off patterns. (By day/week of month, typical problems and issues)

Ensure the integrity of the Revenue Cycle Systems-database and Master File

Collaborate with other departments/senior leadership to identify and manage revenue performance improvement initiatives

A team player; a highly collaborative, team-oriented process. Leads development of opportunities and management of team resources to grow the business

Contribute to the compliance with, and development and updating of, department standard operation policies and procedures by PQRS

Perform other duties as assigned

IMAGING ADVANTAGE FEBRUARY 2017- PRESENT

DIRECTOR OF BILLING

Oversaw day to day activities in billing for over 400 radiologists including charge capture, collections and account receivables analysis

Manage and direct credentialing, licensing, and privileging for onsite and teleradiology.

Identify issues regarding data transfer to various billing vendors including CMS database, as well as an internal billing department

Review payer contracts to capture additional revenue across the united states

Worked with various billing vendors to manage and identify receivable issues

Oversaw day to day activities for 125 radiologists: including charge capture, collections and accounts receivable analysis

Managed and directed credentialing, contracting and billing staff

Identified issues regarding data transfers from HL7 and ADT feeds

Developed efficient process for responding to attorney requests

Review payer contracts to capture additional revenue

Enhanced statement production to avoid outside collection activity for patients

Decreased patient refunds at time of service from over 1 million to less than 75,000

Worked with Client Services to create solutions to problems identified

Enhanced follow-up for aging account receivables with 10% at 180 days and over

Monitored payment in relation to charges to identify payer issues

Direct management of 4 billing supervisors including a total of 45 employees who were responsible for all billing functions

Oversaw day to day activities in billing including charge posting, coding, customer service, denial management, and accounts receivables follow up

Monitored outstanding accounts receivable for several clients

Evaluated processes and implemented changes as needed

Developed policies and procedures to achieve a less than 10% outstanding A/R in 150 days and older

Worked with outside vendors to enhance current use of their products

Established contracts with payers for reimbursement

Identified issues and created solutions to enhance efficiency

Monitored outstanding accounts receivable for multiple clients

Worked with staff to review electronic transfer issues when identified

Enhanced follow-up for outstanding A/R by utilization of the work files

UNIVERSITY IMAGING ASOCIATES DOWNSTATE MEDICAL CENTER AUGUST 1991- 2001

DIRECTOR OF BUSINESS OFFICE SERVICES

Direct management of outpatient billing and scheduling departments for Hospital based radiology group. Oversee employees who were responsible for all aspects of the internal billing office including scheduling, medical records, transcription and coding

Managed all workers compensation and no fault billing and collections

Education and Certifications

Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC)

IASSC Certified Lean Six Sigma Green Belt

KINGSBOROUGH COMMUNITY COLLEGE MAY 1990

Bachelor in Sociology

Minor Psychology

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