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Revenue Cycle: Acute and Ambulatory

Location:
Brookfield, CT
Salary:
$275k - $300k
Posted:
November 27, 2023

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Resume:

Continued

Maureen Moreno, MBA Southbury, Connecticut 203-***-**** ad1hvu@r.postjobfree.com

www.linkedin.com/in/maureen-moreno-a8739451/

Healthcare Revenue Cycle Executive

Improving Patient Experience and Access with Predictable, High-Quality Revenue Cycle Processes Driven revenue cycle leader offering the benefits of an ever-expanding scope of experiences and a history of pacesetting results across all key performance indicators. Using a balanced approach of talent development, coaching, mentoring, and rigorous operational and financial management. Leverages strategic, holistic thinking concerning integrated delivery systems at the enterprise level. Motivated to develop people to excel. Seeking a new senior-level revenue cycle role. SKILLS

Leadership

Revenue Cycle Management

Strategic Planning

Finance & Accounts Receivable

Systems Integrations

Process & Procedure Design

Workflow Automation

Claim Processing & Reimbursement

Denial & Adjustment Decisions

Agreement & Regulatory Compliance

Quality Improvement Initiatives

Training, Mentoring & Coaching

Technology: OMR, Oracle Invision, Cerner Soarian Scheduling & Financial Systems, Sunrise EPSI, MS Office – Word, Excel, Outlook

EXPERIENCE

Nuvance Health Bethel & Danbury, CT 11/2020 – Present Executive Summary: Chosen as a go-forward revenue cycle executive upon the acquisition of WCHN by HealthQuest and rebranding to Nuvance Health, a multi-state health system. Made a strategic career decision to focus on outpatient /ambulatory practice support to stay current with the trend toward more care delivery in physician offices. Assistant Vice President, Ambulatory Revenue Cycle Nuvance Health 10/2021 - Present Lead a team of seven people – six Revenue Cycle Managers and one System Optimization Revenue Cycle Manager – and oversee a total of $55MM in accounts receivable for NY and CT-based Nuvance Health Medical Group. Execute denial management and third-party follow-up procedures. Continually improving revenue performance workflow and patient experience. Also accountable for cash posting, bad debt reduction, and customer service. Lead organization of 150 FTEs. Notable Accomplishments:

Financial Improvements: Boosted collections $6MM in first half of FY23 and ambulance revenue $350K. Reduced denials and related write-offs to less than 2%.

Integration: Brought West physicians into organization’s accounting system, allowing for all work to be done in one place.

Customer Service: Cut complaints 85% after bringing customer service back in-house from a third-party vendor. Also saved $2.3MM with the initiative and created a coaching and continuous quality improvement culture.

Executive Collaboration: Established standing committees and executive sessions to review denials and contract issues. This has led to rapid employee retraining, improved execution, and systems enhancements. Assistant Vice President, Revenue Cycle Nuvance East Nuvance Health 11/2020 – 9/2021 Managed A/R of $300MM for three hospitals, the medical group, and ambulance services with a team of six direct-report Revenue Cycle Managers and the entire Revenue Cycle department.

Financial Outcomes: Reduced AR over 90 days to 24% and denial write-offs to less than 2% throughout tenure.

Organization Design: Created two management positions, Revenue Cycle Regulator and Audit Manager, focused on improved compliance, and System Optimization Revenue Cycle Manager, bringing IT expertise into the department.

Talent Development: Promoted two employees to management positions during the short time in this role. Western Connecticut Health Network Bethel & Danbury, CT 6/2007 – 10/2020 Executive Summary: Advanced from contact center operations to revenue cycle specialization to maximize personal impact on financial results. Leveraged well-recognized leadership skills and advanced business education to generate impacts. Administrative Director, Revenue Cycle Western Connecticut Health Network 12/2017 – 10/2020 Promoted to manage revenue cycle for three hospitals and a medical group totaling $300MM in AR. Responsible for denial management and third-party follow-up, collections, billing issue resolutions, and timely payments across the portfolio. Maureen Moreno, MBA Page Two 203-***-**** ad1hvu@r.postjobfree.com Collaborated system-wide, especially at senior levels, to provide exceptional service to all stakeholders while improving customer service and all patient-facing financial processes. Notable Accomplishments:

Integration: Completed integration of an additional 800 physicians and four hospitals into a single financial system, an 18-month project ending in March 2018 executed with few issues and that led to vastly improved information flow.

Team Creation: Brought together business offices of WCHN Hospitals and Medical Group into one cohesive team that worked collaboratively to improve and accelerate workflows. Ultimately, realized far better morale and performance.

Talent Development: Created career ladders in partnership with Human Resources, an initiative that made advancement for supervisors and individual contributors clear and motivational.

Quality: Implemented a system-wide employee coaching process to address registration errors and denials, an effort that resulted in a consistent, timely feedback loop that improved quality through quick, effective coaching.

Pandemic Response: Built on already-begun WFH initiative to get all staff productive at home within 24 hours. Director, Contact Center Western Connecticut Health Network 12/2012 – 12/2017 Promoted to deliver strategic leadership for revenue cycle management within the account services contact center. Oversaw operations of three financial clearance departments executing insurance verification, authorizations, and upfront/self-pay services as well as three centralized scheduling departments. Led eight direct-reporting managers and a total organization of 90 people. Resolved network denial issues and liaised with Pre-Bill Department to guide claim scrubbing to promote efficient adjudication. Established, controlled, and administered department budgets, monitoring financial performance and ensuring sound management of fiscal resources.

KPI Results: Achieved 98% financially cleared rate prior to patient service, 2% abandon rate for scheduling calls, and less than 1% daily revenue on denials.

Systems: Chose and began Cerner implementation to integrate three hospitals into one revenue cycle platform.

Complexity: Managed $315MM annual community benefit, charity care, and financial assistance applications.

Innovation: Led implementation of estimator tools to improve ability to respond to requests for expected service costs.

Talent: Created cross-training initiative to maximize versatility of workforce and to improve customer service. Manager, Contact Center Western Connecticut Health Network 6/2007 – 12/2012 Collaborated with senior leadership to create WCHN’s contact center as part of its integrated delivery system. Established processes for scheduling, financial clearance, and denial management while maximizing patient experience. Built and supervised teams working across departments. Also oversaw hiring, training, and performance management.

Innovation: Built a new scheduling system for outpatient testing, reducing patient touchpoints and completing financial clearances prior to care delivery.

Scope Expansion: Grew from supporting one department to encompass all outpatient testing.

KPIs: Cut no-show rate from 30% to less than 5% through reminder automation, reduced abandon rate to less than 2% for all departments/entities, and achieved 98% financial pre-authorization with same-day add-on capacity. Earlier: Supervisor, Patient Financial Services, Danbury Hospital AFFILIATIONS

NAHAM Member 2007 – Present

HFM Association Member 2017 – Present

PROFESSIONAL DEVELOPMENT

Inspire Leadership Program Nuvance Health 2022 EDUCATION

Master of Business Administration (MBA), Leadership Post University Waterbury, CT 2015 Bachelor of Science (BS), Management and Human Resources Post University Waterbury, CT 2010 Certificate, Human Resources Management Post University Waterbury, CT 2009



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