SUMMARY

Highly motivated healthcare leader and educator with excellent project management, teaming skills, and the adaptability to work effectively with a wide range of stakeholders. Experienced in management, business development, marketing, recruitment, operations support, and compliance. Branded visionary utilizing effective problem-solving skills to maximize cost savings and drive innovation.

Systems Utilized

eClinical, Relay Health, Greenway, Visio, Tableau, SQL, Athena, Meditech, Cerner, Epic, Avatar, Emdeon/Change Healthcare, Waystar, Zirmed, Japari, Grant Writing, Slicer Dicer, MOR, Design of market reports and presentation to Market Executives along with Corporate, NextGen

HEALTHCARE EXPERIENCE

Guidepoint Remote Headquarters Based in New York, NY January 2019 – August 2023

RCM and CRM Consultant

Revenue Cycle consulting for billing for Multi Billion Multi-Specialty Corporations

Front end process improvement to minimize verification denials

Coding daily Op Reports: specifying unlisted codes and their potential reimbursement per payer contracts negotiated per the Corporations agreement, specialty and patient volume

Review of various EMR/EHR and Clearinghouse for reporting purposes to meet MOR numbers presented before the companies Executives, VP and CFO to gage corporate growth

Analytical trends of denial percentages and reimbursement review of outsourced billing and coding; with a goal of keeping AR below 25 percent

Provided business plan(s) for best practice strategies and process improvement ensuring appropriate growth

NextGen reviewed to discuss coding challenges, denials and trends to best improve AR aging

Slicer Dicer was often used for report out and benchmarks. During either monthly meetings or the ‘em weekly touch base meetings conducted.

Review of interface between Hospital and Physician Services systems

RCM/BI&A with several large medical groups and health systems; confidential contracts included Radiology Partners, HCA, Envision, LifePoint, Envision and CHS to name a few

Expert understanding of RCM processes both front/middle/back office decreasing denials by 30 percent eliminating front office errors

Depending on the client request often times Slicer Dicer we’re needed to breakdown AR trends

RCM-focused data warehouses; Mede Analytics, Tableau, VisiQuate

Patient collection programs & financial engagement platforms (Cedar & Simple/Flywire)

Experience with SQL queries, OLAP cubes, data warehouses, data modeling, visualizations

Report review of design and implementation

MOR in place to best show areas of improvement and areas of deficiency

With Epic EMR doing a deeper dive allowed for clarity and areas of improvement that often were overlooked in a clearinghouse system or was a tabled for a later date

Peidmont Healthcare Atlanta, GA. November 2021-August 2022

Hospital and Front Office Consultant

Designed planned and implemented front office best practices

Reviewed the impact of front office operations to best improve the front office back office loop

Review EPIC slicer dicer to identify trends and denials that needed improvement

Relayed findings in hospital and practice MOR

I the review of the workflow and provided feedback of areas needing improvement to relay back to billing to catch and correct and denials prior to adjudication minimizing denials and appeal on the front end

With this training and communication of the EPIC system AR began to see a 85 percent increase growing each month

While EPIC clearinghouse provided significant insight on claims often for reporting and improvement communication needed to best keep all stakeholders in the loop

Review of of front office and back office

The Surgical Clinic, PLLC Nashville, TN December 2 017 – July2019

Director of Revenue Cycle

Director of surgical revenue cycle providing oversight of 30 employees billing for 39 physicians and 14 mid-levels all in Middle Tennessee increasing AR from 16 Million to 46 Million in two years

Evaluated existing employee billing and coding workflow to best increase monthly revenue by 48 percent

Assessed areas for additional education to minimize claim denials and trends at patient intake; review yielded a 51 percent decrease of front office errors

Consistently increased monthly revenue by over half a million each month

Improved communication with front office allowing for continued education, clean claim submission increased monthly billed charges by 37 percent also reducing Provider documentation from 25 days to 5-7 business days decreasing timely filing denials

Partner with market CEO, CFO and Physician Board President to develope and communicate care team strategies and operational effectiveness

Communicated a shared vision for your organization org chart along with hiring a Compliance Officer and Coding Auditor to drive business results and health outcomes.

Serve as Grand Rounds care team representative on customer facing meetings

Cerner documentation was provided to both billers, coders and providers

Partner with front office, back office to improve verification, precertification and benefit eligibility

Implement compliance committee

COO process improvement to drive efficiency, clinical quality, and high member satisfaction

Assure that staffing is appropriate for demand and track FTE cost to budget

Partner with training and Customer Success Managers to provide feedback and/or guidance on training needs

Support staff relations

Implemented front office policy and procedures.

Reviewed and communicated operative reports from Cerner to coding team to review code and release to the clearinghouse for submission.

Designed billing workflow for Cerner review and research of path reports.

Communicated with hospital ops teams to send op reports and provider sign-off timely.

Review of each biller coder and compliance improvements to best show needed areas of improvement and design of staffing.

Work presented to show each month for the Board is the nominal value of improvements and a decrease in aging days.

LIFEPOINT HOSPITALS Brentwood, TN March 2014 – December 2017

Director, Tennessee Central Billing Office

Director of Physician Services revenue cycle Central Billing Office for 315 providers across 14 specialties

Provided oversight of 21 billing staff, consisting of three coders, two payments posting, financial advisor, payer enrollment and 14 billers

Partnering front office to improve verification, collections, and call center

Maintained AR per provider at less than 20 percent > 90 days.

Provided real-time report out of charge capture, patient volume, reimbursement and denial trends with market executives, healthcare providers, and stakeholders.

Provided monthly wRVU per each employed provider.

Held weekly meetings with market VP, controller, CFO, and CEO providing numbers on expected reimbursement, AR and outstanding denials an rational as to improve each.

Manager, Revenue Cycle Applications March 2013 – March 2014

Manager for eClinical Works and Athena Revenue Cycle functions for over 200 billers across 52 markets ranging from Rural Health Clinics (RHC) to multispecialty practices.

Facilitated design and setup of monthly billing system and process update calls for 200+ billers

across 52 markets

Perform and promote interdepartmental collaboration to enhance the continuity of care

Direct supervisor for 9 FTE billing staff for Tennessee and Alabama markets with gross AR ranging from 200 to 1.2 M

Conducted initial market AR audits identifying deficiencies between front and back-office loop

Implemented Revenue Cycle best practice standardization in each physician practice and billing

office

Spearheaded Central Billing Office setup to house thirty billers assisting with deficient A from across multiple markets

Researched, trained and implemented RHC billing components

NextGen was part of the Acquisitions that required a data migration to the current EMR, EClinical

Structured and implemented biller training of eClinical Works (eCW) in both a classroom and remote setting

HOSPITAL CORPORATION OF AMERICA (HCA) Brentwood, TN June 12 – March 2013

Implementation and Training Consultant

Project Lead consulting over 35 physician practices ranging from start-ups, new acquisitions, migrations, and/or Hospital Based Practices (HBP) providing training, completion of build items, and onsite support. Working directly with market management, Division VP, and practice management implementing Physician Practice Management Systems (PPMS) and staff training of revenue cycle processes closing the loop between the front and back-office operations.

Structured and implemented student training of eClinical Works (eCW) in both a classroom and remote setting for internal and external clients

Created and uploaded practice encounter forms, fee schedules, working hours and resource availability and visit types

Advised practice management and staff on best practices in compliance with CMS and HIPAA guidelines

Organized and facilitated migration of patient data from practice legacy systems, CORE, Mysis, and NextGen, into eCW

Instructed charge entry staff on how to key claims within eCW in compliance with CMS regulations allowing for result to be reported monthly

Liaison for clients in driving proprietary software product changes

Assessed front and back-office practice workflow, documents and procedures for implementation and customized training

Assisted in creating system end user documentation and maintaining strong interactions with end users to review and revise materials

Monitored individual practice response time matrices for continued efficient productivity

Utilized Meditech to research patient demographics, physician orders, and discharge orders

Demonstrated Dashboard and adhoc reporting to meet month end closing

Facilitated, developed, and implemented pilot of inbound and outbound referral tracking between

Northbound Train and eClinical Works for HCA Beta sites

Project Lead conducting startup of a 30-physician practice, 72 end users in conjunction with a

Central Billing Office staffing 8-10 billing staff and two upper management Financial Analyst and Account Manager providing revenue cycle oversight

Revised the Implementation Department OnBoarding document for newly hired employees

Spearheaded the Implementation Department Optimization Project

Conducted student training and Q/A of Information Exchange Tool in preparation for

RelayHealth

Investigated and analyzed physician salaries over the next six years in regard to Medicare and Medicaid cuts

Researched an Evansville pain management physician and constructed a marketing plan to further his practice

RELATED EXPERIENCE

DAYMAR COLLEGE Nashville, TN January 2019 – August 2022

Adjunct Professor

Taught courses for the Healthcare Administration, billing and coding, curriculum along with general education courses for pharmacology and medical assistant track

Expert understanding of RCM processes both front/middle/back end

RCM-focused data warehouses such as VisiQuate

Patient collection programs & financial engagement platforms (Flywire)

Educated Epic EMP builds and processes

Grant Writing

Educated Healthcare Compliance

EDUCATION

PhD in Human and Organizational Development

NATIONAL UNIVERSITY, SanDiego, CA Expected completion 2025

M.S. in Health Service Administration

UNIVERSITY OF EVANSVILLE, Evansville, IN

M.S. Health Service

HARLAXTON COLLEGE, GRANTHOM ENGLAND

B.S. in Health Science

UNIVERSITY OF EVANSVILLE, Evansville, IN

CONTINUING EDUCATION

Studied abroad to analyze the English, Hungarian, and Slovakian healthcare system in comparison to the United States

YOUNG LEADERS’ COUNCIL January 2012 – April 2012

oBoard of Directors leadership training

AFFILIATIONS

JUNIOR LEAGUE OF NASHVILLE – Member 2008 – Present

AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES – Member 2012 – Present

NOTARY REPUBLIC – Member 2018 – Present

VANDERBILT ADVISORY BOARD 2021 – Present

PROJECT MANAGEMENT INSTITUTE – Member 2012 – Present

HOPE CLINIC FOR WOMEN – Board Member 2012 – 2014

BIG BROTHER BIG SISTERS – Volunteer 2009 – 2014

HABITAT FOR HUMANITY – Volunteer 2000 – 2010

NATIONAL MS SOCIETY – Volunteer Committee Chair 2007 –2009

oOrganize and implement an extensive plan to recruit and utilize 58 volunteers for the annual River Valley

Multiple Sclerosis walk sponsored by the National MS Society IN ch

Pharma grant writing

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