Albert Berry, Jr.

**** ******** *****, ** *******, GA 30101

678-***-****

ad2lzl@r.postjobfree.com

QUALIFICATIONS AND SKILLS SUMMARY

Hospital and Healthcare Professional Consultant with more than 22 years of financial experience, leading business operations in acute care settings as a Director, Consultant and Interim Advisor; and 10 years’ experience working remotely. Successful change-agent with the ability to assess and implement positive fiscal functioning including revenue cycle processes, EMR conversions, Health Information Management (HIM), assist healthcare organizations in HIPAA 5010 compliance. Establishing appropriate safeguards, ensuring that the business associate will prevent PHI disclosure outside of what is permitted in the contract.

Offers hands-on strategic, financial and technology solutions, and thrives in helping companies navigate critical points throughout the business life cycle, amplifying their resources, efforts and productivity. Revenue cycle optimization through successful healthcare enterprise resource planning (ERP) implementations. Skilled in assessment of clients’ revenue cycle processes and has over 20 years’ experience provided systems training, implementation, optimization, testing, conversion, and clean-up of: EPIC, Meditech 6.1, Cerner, eClinicalWorks, Athena, Allscripts, McKesson STAR, McKesson AS400, CPSI, OAS Gold, ePremis, SSI, Caremedic, Webcare

EPIC Certification: Resolute Hospital Billing, and Resolute Hospital Billing Administration. Proficient with the use of the EPIC system, build, and testing. Analysis of EPIC data with the use of Clarity reporting and the Slicer and Dicer tool, to provide detail and summary reporting the financials.

Available immediately to interview and start a new assignment.

PROFESSIONAL EXPERIENCE

Velocity Made Good/Pensacola, FL (February 2018 – Present)

Engaging in Revenue Cycle Improvement Projects; including but not limited to RAC / MAC Audits; Implementation of SCI Solutions; Implementation of Passport (eNextBar & In Process Scripting); Redesign of PAS Workflows with Utilization Review of current Resource Technology Tools and with evaluating Patient Flows plus current Financial Clearance processes

Projects for Velocity Made Good:

(Hamilton Medical Center, Dalton, GA) November 2022 – December 2023 EPIC Analyst

Design, build and test Epic’s applications for implementation.

Work with an analyst team and end users, as an analyst to design and maintain the

system with the other teams.

Interview users, stakeholders, and sponsors to assess departmental needs to create Business,

functional and technical requirements documents.

Develop documentation of test plans, technical documentation, release notes, end-user guides,

training programs and/or other materials as necessary.

Decompose information gathered into details including sources of data, data types, users, user

types, interface components, interface navigation needs, reporting needs, and administrative

system needs.

Research industry practices; collect and analyze data; draw appropriate conclusions and

recommendations; present results in written reports or through oral presentations using visual

aids.

Coordinate user groups and project teams, convening conference calls and meetings and

maintaining minutes and follow-up logs.

Work collaboratively with Systems Analyst to develop designs, mockups and prototypes

Communicate technical design issues to non-technical people

Ability to work independently and as part of a fast moving team.

Work within timeline and resource constraints provided by the Project Manager

Provide ongoing communication with users, managers, corporate directors and vendors to assure

support and current initiatives.

(Estes Medical Center, Estes, CO) January 2022 – September 2022 EPIC Analyst

(Advocate Aurora Health System, Milwaukee, WI and University Hospitals Health System, Cleveland, OH)

Remote Work due to COVID, September 2020 – November 2021 EPIC Analyst

EPIC clients. Utilizing the Clarity and Slicer and Dicer reporting tools. Extracting specific data elements to provide reports such as detailed AR, Denial trending, Transactions, Bad-debt, Late charges, Charge captured, Collections, etc.

Review facility daily gross revenue reports for variances. Collaborate with department directors/managers to review variances. Escalate variances related to charge capture and collaborate with Revenue Cycle team for process improvements as indicated.

Provide concurrent and retrospective charge reviews, comparing clinical documentation to billed charges as directed by Revenue Integrity Manager, Compliance, and facility requests. Identify charge capture opportunities, proactively identifying revenue opportunity and suggests improvements.

Policies review such as Charity, Bad-debt, Red Flags and No Surprises Act

Monitor/Resolve charge capture work queues to identify opportunities for improvement in charge capture.

Collaborate with Revenue Integrity Senior Manager to develop and generate standardized reporting templates for revenue integrity KPI dashboard and daily/weekly analytics.

Analyze and quantify all charge capture review results for reporting to departments, CFO and Revenue Integrity Continuous Improvement Forums.

Thomas Jefferson University Hospital/Philadelphia, PA (February 2018 – November 2019) EPIC Client

Thomas Jefferson University Hospitals has 951 licensed acute care beds, with major programs in a wide range of clinical specialties. Services are provided at five primary locations — Thomas Jefferson University Hospital (the main hospital facility, which was established in 1825) and Jefferson Hospital for Neuroscience, both in Center City Philadelphia; Jefferson Methodist Hospital and Jefferson at the Navy Yard, both in South Philadelphia; and Jefferson at Voorhees in South Jersey.

EPIC Analyst /Denials/Systems Support

Daily support of the Revenue Cycle Management Team and associated teams through the application of data analysis to monitor current performance.

Assist with special projects within the RCM department and also throughout the entire organization when required.

Reviewed and analyzed claim denials in order to perform the appropriate appeals necessary for reimbursement.

Communicated directly with the payor, resubmitted denied claims, underpaid claims and claims that are inaccurately processed by auditing accounts to check on proper payments, coding, balances, adjustments, etc. and also using appropriate reports and working queues

Tracked and documented all denials by payor, visit type and denial category

Identified, documented, and communicated trends in recurring denials and recommends process improvements or system edits to eliminate future denials

Under the direction of leadership worked with necessary departments (e.g., Case Management, Medical Records, Patient Access, PFS Resolution Team, etc.) in order to drive process improvement and system edits.

Worked with the payors to understand specific reasons for denials and preventable measures available to prohibit future denials.

Compile and maintain detailed cash, billing and reimbursement metrics that can be used for daily operational management and to identify trends.

Utilizing the Clarity and Slicer and Dicer tool; to extract and generate data and reports on a regular schedule, as directed by the Management team as well as any ad hoc reporting as needed. Based on the generated reports, provide analysis and insight to the data generated and presented to Management and others as needed.

American Consultants/Overland Park, KS (October 2019 – February 2020)

At American Consultants, we truly understand the pulse of healthcare and are committed to providing a wide range of healthcare staff, executive search, interim leadership and consulting services with a personal touch.

Projects at American Consultants:

Lourdes Medical Center/LifePoint Pasco, WA (October 2019 – February 2020)

Critical Access Hospital, Behavioral Health Facility, and more than 20 Physicians Clinics

Interim, Director of Revenue Cycle

Act as a liaison between assigned center and hospital Registration, HIM, Coding, Charge Capture, Patient Accounts, and other Finance Departments as the revenue cycle consultant/expert.

Utilization of Cerner and Allscripts EHR, and billing through Availity

Responsible for overseeing visits/accounts and helping assigned hospital clients resolve their revenue cycle issues to identify, analyze and propose resolutions for problems resulting in ADRs, denials or changes that impede timely and accurate billing of services and timely reimbursement for those services.

Through regular analysis, ensure each assigned center is compliant with revenue cycle policies and procedures.

Supports and facilitates process and procedural improvements to the revenue cycle that contribute to favorable financial results and operational efficiencies; and communicate infractions with the appropriate parties.

Manage, train, and monitor performance of assigned Revenue Cycle Representatives (RCRs) to include timely A/R follow up and collections, problem solving, communications with insurances, clinics and hospital clients, payment analysis/billing worksheets for write offs.

Responsible for monitoring of unbilled A/R and assuring POR aging remains current (not to exceed 25% of total A/R > 90 days outstanding).

Evaluation and analysis of unresolved third-party accounts, unresolved accounts include unbillable, unauthorized, rejected, denied, underpaid and recouped accounts receivable.

Develop procedures to track trends, minimize disruptions, improve workflows, and increase collections.

Healthcare IT Leaders/Alpharetta, GA (May 2019 – September 2019)

We offer expert consulting and workforce solutions for all your critical enterprise IT needs. Every step of the way, our talented team is here to support your clinical, financial, business and operational systems. Implementation,

Advisory Services, Integration, Optimization, Project Management, Staffing and Hiring, Custom Development,

Go Live & Training, and Solution Expertise

Projects at Healthcare IT:

Huron/CCS Medical Clearwater, FL (May 2019 – September 2019)

CCS Medical, Inc., a mail order pharmacy, provides medical supplies home delivery services. The company offers insulin pumps and related supplies, including infusion sets, reservoir syringes and cartridges, batteries, prep wipes, tapes, and liquid adhesives; continuous glucose monitoring systems as a companion tool for diabetes management; diabetes testing supplies for patients and their families; prescription medications; wound care supplies for any size wound, including advanced dressings, compression therapy products, and negative pressure wound therapy products; and urology supplies for use at home, including intermittent, external, and Foley catheters, as well as leg bags.

Revenue Cycle Analyst

Provide expert guidance for the analysis, design and implementation of System updates, Work-flow & Work queues, Process, and Policies

Review customer requirements, perform analysis, design and documentation of current state and future state workflows

Maintain regular communication with client, vendor, team members and team leaders regarding project issues, risks, and needs

Classify problems as system, training, or process and recommend appropriate corrections

Proactively conducts local and national client branch discovery calls to understand and validate current issues, current processes, technical tools, etc. and ascertain potential risks.

Takes early action to identify potential issues and mediate, which may include escalating to the appropriate internal stakeholder.

Healthlink Advisors/Pinellas Park, FL (August 2018 – Jan 2019)

With direct experience in healthcare operations and management consulting, our exceptional talent brings an expansive understanding of complex health IT challenges. Our advisors apply bold IT operations strategies, technology, planning, and policy solutions to drive needed change.

Projects at Healthlink:

Jupiter Medical Center/Jupiter, FL (August 2018 – January 2019)

Jupiter Medical Center is a not-for-profit 327-bed regional medical center consisting of 207 private acute-care hospital beds and 120 long-term care, sub-acute rehabilitation and Hospice beds. Jupiter Medical Center provides a broad range of services with specialty concentrations in cardiology, oncology, orthopedics and spine, pediatrics, neurosciences and emergency care. Additionally, now offer urgent care services in five locations.

Cerner Revenue Cycle Consultant

Conversion of system from McKesson AS400 to Cerner Millenium

Provide day-to-day management of projects including risk management and interdependencies between projects or programs.

Facilitate project implementation, overcome project barriers, obtain requirements, evaluate and determine objectives, goals, and scope of multiple projects.

Responsible for networking within the organization to drive initiatives, strategies, issue resolutions, and alignment.

Support the team by growing their capabilities to organize, manage, and make decisions.

Report risk areas and partnering with leadership on strategies to address concerns.

Responsible for developing detailed project plans and manage project process documentation.

Warbird Consulting/Atlanta, GA (September 2017 – January 2018)

Exists to help hospitals, physician practices and other healthcare providers identify and solve their most urgent financial and operational challenges. Warbird Healthcare consulting deploys customized teams of subject matter experts through our proven OnDemand business model in the areas of finance, revenue cycle and IT.

Projects at Warbird:

Palmetto Medical Group/Columbia, SC (August 2017 – January 2018)

87 physician practices in 100 locations. More than 600 physicians and advanced care providers (including nurse practitioners, physician assistants and other providers who will care for patients)

Revenue Cycle Analyst

Cerner Millennium, One Chart, Power Works, eClinicalWorks, and Horizon Plus systems; Billing through Relay Health

Analysis of entire revenue cycle process, systems, and policies and identifying bad-debt reserves

Assigned 12 physician practices, 6 different specialties, billing on HCFA 1500 forms

Billing, Re-bills, Follow-up, and Appeals

Assigned Medicaid and Medicaid CMO accounts aged 181 and greater

Increase Medicaid and Medicaid CMO collections by 30%

Decrease of 10 days in AR days, from 51 - 41 Medicaid and Medicaid CMO

Maintain HIPAA compliance, and PHI policy and guidelines

Piedmont Healthcare/Atlanta, GA (April 2017 – August 2017)

A private, not-for-profit organization serving nearly 2 million patients across Georgia, Piedmont is transforming healthcare, creating a destination for the best clinicians and a one-of-a-kind experience that always puts patients first. Piedmont is known as a leading health system in cancer care, treatment of heart disease and organ transplantation with 7 hospitals, 19 urgent care centers, 94 physician practice locations and 1615 Piedmont Clinic members.

Specialty Biller

Research and Transplant Billing, Government, Non-government, and Sponsored payers

EPIC system, Emdeon Billing system

Increase in cash collection, from $3 million to $8 million per month

Managing 8 work queues in EPIC and all error claims in Emdeon

Managing and resolving all unbilled claims

Review of clinical trials and implementing billing process for all payers, applying NCT and IDE numbers for devices.

Identifying and trending $0 pay remits. Appropriately applying contractual adjustments, write-offs, non-covered and patient liability.

Maintain HIPAA compliance, and PHI policy and guidelines

Tatum Consulting/Atlanta, GA (February 2014 – August 2017)

Offer hands-on strategic, financial and technology solutions, delivered by proven executive leaders and consultants. Thriving in helping companies navigate critical points throughout the business life cycle, and do so while plugged into an organization, amplifying their resources, efforts and productivity.

Projects at Tatum:

South Georgia Medical Center/Valdosta, GA (February 2014-January 2017) EPIC Client

A 330-bed acute care hospital, SGMC provides area residents with broad services through our growing medical staff of more than 300 physicians and 2700 staff. It is a growing healthcare enterprise, SGMC, encompasses four hospitals, South Georgia Medical Center (Valdosta, GA), SGMC Smith Northview Campus (North Valdosta, GA) SGMC Lanier Campus (Lakeland, GA) and the SGMC Berrien Campus (Nashville, GA). These facilities serve a large, diverse population with a wide variety of inpatient and outpatient services.

Revenue Cycle Consultant (Project Manager)

Guaranteed increase in cash collection 20%

Decrease in Net AR days, 68 to 43 days

Improve clean claim rate from 53% to 84%

Assessment of clients’ revenue cycle process

Systems (implementation, optimization, testing, conversion, and clean-up): McKesson to EPIC

Athena EHR for professional billing

EPIC (Build and implementation team) Certification class EPIC Resolute Hospital Billing

Performing a complete analysis of the entire revenue cycle process, systems, and policies

Identify bad-debt reserves

Oversee EBO vendors, for outsourcing of self-pay accounts

Oversee Bad-debt placement, recalls, and Medicare Bad-debt Report

Review and resolve of credit balances

Maintain HIPAA compliance, and PHI policy and guidelines

Charge Master Review: CDM review for all departments that generate revenue.

Implementation of ICD-10 for patient accounting systems and billing software

Billing and Collection: Assessment of patient accounting systems and billing systems (clearing house), valid claim edits are in place (based on patient type, service, and payer), clean claim rate, DNFB, unbilled claims, denial management, payer contract review, quality analysis of collectors and follow-up, appeals, Medicare RAC, etc.

Frasier Healthcare Consulting/Arlington, TX (February 2012 – September 2013)

National healthcare revenue cycle receivables, management company specializing in business office operations, cash application, accounts receivable, billing, collections, and registration for healthcare providers (Acute hospitals, CAH, Skilled Nursing Facilities, DME vendors, and Physician/Professional services).

Projects at Frasier:

Our Lady of the Lake Medical Center/Baton Rouge, LA (November 2012-September 2013)

Our Lady of the Lake is one of the largest private medical centers in Louisiana, with more than 700 licensed beds. It has been approved by the America College of Surgeons and the state of Louisiana as a Level II trauma center, along with being an education institution. The Lake treats more than 35,000 patients in the hospital and serves more than 350,000 persons through outpatient locations, with the assistance of more than 1,000 physicians and 4,000 team members.

Interim Business Office Manager

Performing a complete analysis of the entire revenue cycle process, systems, and policies

Billing and Collection: Assessment of patient accounting systems and billing systems, (clearing house), valid claim edits are in place (based on patient type, service, and payer), clean claim rate, DNFB, unbilled claims, denial management, payer contract review, quality analysis of collectors and follow-up, appeals, Medicare RAC, etc.

Patient Access Process: (scheduling, registration, admission, insurance verification, POS collection, ABN policy, physician order verification, pre-certs and authorizations)

Implementation and overseeing Centralized Scheduling for all outpatient procedures and departments.

Verifying that a written order is obtained for all procedures.

Minimize scheduling errors.

Review scheduling staff productivity; identify any break-downs within a location, department, or physician’s office.

HIM: Identifying deficiencies for medical records, charts that are incomplete, invalid orders, ICD-9 and CPT coding issues, and auditing of charts along with bills.

Maintain HIPAA compliance, and PHI policy and guidelines

Scott & White Healthcare/Temple, TX (February 2012-November 2012)

A non-profit collaborative health care system which encompasses one of the nation's largest multi-specialty group practices. It is a medical education and research organization based out of Central Texas in a 29,000-square-mile service area. The system owns, partners, or manages 12 acute care hospital sites.

Revenue Cycle Consultant (Project Manager)

Clean up project, all accounts 181 days and older, except for self-pay

Increase in cash collection

Identifying write-offs and adjustments needed

Delegating assignments and creating work queues for project team members

Reporting KPI and results to client

Managing project team of 11

Coordinate training and identified training resources for team members

Served as liaison between Vendor and Client

Maintain HIPAA compliance, and PHI policy and guidelines

Southern Regional Medical Center/Riverdale, GA (July 2011 – February 2012)

Acute Care facility with 331 beds, inpatient rehabilitation unit, and an oncology department.

Denial Prevention and Recovery Specialist, Temp

Review EOB, validate and ensure patient accounting system reflects correct dispute disposition, Appealable, Un-appealable, Contractual issues, etc.

Write first, second, third, etc. level of appeal letters to ensure all efforts for recovery are exhausted.

Attained expert level understanding and knowledge of contractual/reimbursement assigned payers.

Track and trend dispute data, and inform management of findings

Lead meetings with Billing Integrity Specialist and EOB Analyst for resolution

of payer issues.

Root cause denials to prevent future denials

Provide guidance to the staff, of understanding of reimbursement issues that have been identified.

Assists Revenue Cycle leadership with day to day follow up and collection activities as well as any special

projects assigned

Work Medicare RTP (Return to Provider) via DDE system

Operating patient accounting system McKesson HBOC STAR

Optimization of McKesson STAR

Operating billing system ePremis

Complete Medicare Credit Balance Report

Advise on HIPAA 5010 implementation

Ivinson Memorial Hospital, Acute Hospital/Laramie, WY (October 2007 – November 2010)

Acute Care facility with 99 beds, 50 active physicians, dialysis unit, and an oncology facility.

Patient Financial Services Director

Oversee a business office staff of 13 employees and 1 supervisor

Patient access, (registration, scheduling, insurance verification and authorization)

HIM department (ICD-9 and CPT coding, completion of medical charts, auditing for charge integrity)

Periodic training and education of staff

Conversion of systems, McKesson Star to Meditech

Operating patient accounting system Meditech

Operating billing system Caremedic and MedAssets XClaims

Implement revenue cycle policies and procedures

Implement billers and collectors QA

Billing system conversion

Implemented KPI report

Monthly In-service with hospitalists

Credentialing physicians for Professional Billing

Set up and maintain Surgery Clinic and Internal Medicine fee schedule

Increased monthly cash collections from $2.5 to $5.8 million per month

Decrease of days outstanding from 114 to 51

Clean claim rate from 0% to 80%

Create work queues for billers and collectors

CDM monitoring, Update charge dictionary

Review daily billing, UB04 and HCFA 1500

Medicare billing and follow-up, appeals, and denial recovery/prevention

Review and analyze the unbilled report and late charge report

Implement additional edits or delete edits to help bill claims efficiently

Complete the Medicare Credit Balance report, Bad Debt Report, and Cost Report

Review all RAC inquiries, and inform Administration of all RAC updates

Developing and implementing Security Rule compliant safeguards, review and modify security measures to continue protecting PHI and ePHI in a changing environment.

D-Med Corporation, Consulting Firm/Dallas, TX (April 2001 - October 2007)

D-MED Corporation is a highly respected company in the area of Accounts Receivable, Business Office, and Physician Practice Management. Our consulting practice assists healthcare providers in the areas of Operational Reviews, Implementations, Interim Managers, Turnarounds, Process Improvements, Staff Training, Implementing Key Indicator Performance Reporting, Quantifiable Registration Quality Assurance Programs, and Policies and Procedures.

Projects at D-Med Corporation:

St. Francis Medical Center, CAH/Breckenridge, MN (January 2007-October 2007)

Business Office Director, Interim

Consulting assignment through D-Med Consulting Corporation. Critical Access Hospital with 120 beds and a long-term care facility.

Mariner Healthcare, Corporate Office/ Houston, TX (March 2004 - January 2007)

Project Consultant

Consulting assignment through D-Med Consulting Corporation.This is one of the largest providers of long-term health care services in the United States. Mariner has 291 skilled nursing facilities in 23 states with an estimate of 36,000 licensed beds.

Mariner Healthcare, Skilled Nursing Facility/ Atlanta, GA (January 2002 - January 2004)

Business Office Manager, Interim

Consulting assignment through D-Med Consulting Corporation.This facility has 114 licensed beds,

generates a revenue of about $1.2 million per month, and an estimate of 75 employees.

Sierra View Hospital/ Porterville, CA (November 2001 - December 2001)

A/R Specialist, Consultant

Consulting assignment through D-Med Consulting Corporation. Sierra’s Cancer facility needed assistance with Medicare billing and collection.

Providence Hospital/ Columbia, S.C. (April 2001 - October 2001)

Billing Supervisor, Interim

Consulting assignment through D-Med Consulting Corporation. Providence is a non-profit organization that is licensed for 322 beds, comprised of four entities, and has about 1,800 employees.

Centerpoint Healthcare, Consultant / Tampa Bay, FL (October 2000 - March 2001)

Coast to Coast Consulting, Inc., Consultant /Austin, TX (April 1999 - August 2000)

GA Baptist Medical Center, Medical Biller and Coder / Atlanta, GA (February 1995 -April 1999)

EDUCATION

EPIC Certification Resolute Hospital Billing: Billing Readiness

HFMA (Healthcare Financial Management Association) member

CPAM (Certified Patient Account Management) Certification through HFMA

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