Revenue Cycle Project Manager

DAVID VAUGHN LANE, BS, FHFMA, CHFP

**** ********** ****

Hixson, TN 37343-3029 423-***-****

linkedin.com/in/davidvlane *****.*.****@***.***

Revenue Cycle professional with well-rounded turnaround management experience in academic medical centers, acute care community hospitals, critical access, and psychiatric facilities. Extensive expertise in cash acceleration, compliance with various Medicare, Medicaid, and other third-party regulations, establishing and meeting client service level agreements (SLAs) and EBITA goals, staff development, hospital and physician-patient accounts management, charge master development, review and maintenance, process redesign, and improvement, project management, strategic and budget planning plus exposure to a wide variety of EDP systems. Exceptional communicator (written and oral) and leader who motivates staff to identify and resolve complex issues while managing multiple projects.

CONSULTING/INTERIM MANAGEMENT

INDEPENDENT INTERIM REVENUE CYCLE CONSULTANT & DIRECTOR 1997-Present

Provide senior-level operations management and revenue cycle consulting services to hospitals and health systems as an interim revenue cycle director, director of business services, project manager, facilitator, and consultant, focusing on all areas of revenue cycle and accounts receivables-related activities. Client facility sizes range from 25 to 2,600 beds.

SPECIALITIES

Revenue Cycle/Patient Accounting Operations

Accounts Receivable Analysis

Patient Access, Credit, and Collections

Operational Assessments

Cash Acceleration/Third Party Recovery

Change Management

Inter/Intra Departmental Communications

Managed Care Contracting & Denial Management

EHR implementations, file builds, and optimizations (both pre-and post-go-live)

Outsourcing (Alternative Patient Financial Services) assessments, evaluations, and recommendations

Establishing, monitoring, and achieving Service Level Agreements and profitability goals

Ensuring the client complies with Medicare, Medicaid, and other Federal and State healthcare programs.

Productivity, Training and Education Development, TJC, HIPAA, and billing compliance.

MASSACHUSETTS GENERAL BRIGHAM HEALTH SYSTEM THRU RANDSTADT

Boston, MS

(09/2023-Present)

Revenue Cycle Consultant – Epic and Insight

Implementing KPIs, policies, procedures, and processes for the Innovation and Research Revenue Cycle.

Reviewing contracts, billing, and collections with research partners to ensure compliance and maximize collections/return on investment.

HUNT REGIONAL HEALTHCARE THRU THAXTON INTERIM LEADERSHIP, Greenville, TX

(06/2023-08/2023)

Revenue Cycle Consultant – Meditech & Cerner Community Works

Performed a comprehensive revenue cycle assessment, identifying opportunities for improvement with specific solutions and a comprehensive action plan to realize the improvements for a two-hospital health system with three urgent care centers and 23 clinics.

ORACLE/CERNER THRU ALKU (HOLLAND SQUARE GROUP) & AMERICAN CONSULTANTS, Kansas City, MO

(06/2022-05/2023)

Revenue Cycle Architect – Cerner Soarian and Millennium

Led successful Revenue Cycle project implementations.

Managed revenue cycle integration workflow, policies and procedures development, and technical design across all revenue cycle solutions and venues.

Articulated operational and financial impacts of workflow and technical decisions to client and Cerner project teams.

Represented leadership expectations for testing strategy issue management conversion readiness and post-conversion responsibilities to Cerner and client stakeholders.

Managed project escalations, tracking status and client expectations as the point of contact for revenue cycle leadership.

Led clinically driven revenue cycle CDRC conversations across venues.

Worked closely with CIO, CFO, and revenue cycle leadership as a trusted advisor to define financial metrics, key performance indicators, KPIs, and reporting before conversion.

Participated in planning conversations and decisions on legacy accounts receivable.

Provided support and guidance on third-party system workflows.

Provide support and guidance to the client to ensure integrated workflows, policies and procedures development, revenue cycle testing, integration, and implementation, third-party system workflows, and trusted advisor to the client.

MIDWEST MEDICAL ASSOCIATES THRU HURON CONSULTING, Omaha, NE (03/2022-05/2022)

14-location Ambulance Service – Waystar

Assessed system reporting capabilities and built reports to support daily business office operations, month-end reporting, and productivity management and also established key performance indicators and benchmarks to monitor performance.

YAKIMA VALLEY MEMORIAL HEALTH THRU FRASIER CONSULTING, Yakima, WA (10/2021-02/2022)

275-bed Acute Care Health System – Cerner Soarian

Revenue Cycle Consultant / Interim Revenue Cycle Director

Assessed current state processes, policies, procedures, staffing, and structure and developed an action plan to transition the revenue cycle to a recent state that follows best practices.

Improved cash collections by $3.5 million per month (10%) during my tenure.

Improved clean claims rate by 13% during my tenure.

Revised charity care policy to ensure compliance.

Developed productivity standards for staff.

Improved staff morale by setting clear expectations and improving communication by establishing weekly 1:1 touch-base meetings with staff and supervisors, daily huddles, and monthly town hall meetings to improve communication.

CITIZENS HEALTH SYSTEM THRU AMERICAN CONSULTANTS, Colby, KS (2021)

25-bed Critical Access Hospital, SNF, and Rural Health Clinic – Evident/CPSI

Revenue Cycle Consultant

Established KPIs for the revenue cycle.

Assessed current policies and procedures and made additions and revisions.

Reviewed current contracts to ensure compliance.

Implemented a new process for accurately capturing and reporting Medicare Bad Debts.

Identified and recovered an additional $730,000 in Medicare Bad Debt that was not reported in fiscal years 2019 and 2020.

Developed productivity standards for staff.

Identified charge capture opportunities totaling approximately $2.5 million in gross revenue and $1.075 million in net revenue.

ST. DOMINIC HEALTH SYSTEM THRU nTHRIVE, Jackson, MS (2020-2021)

545-bed Acute Care Health System – Cerner Millennium

Interim Revenue Cycle Director

Responsible for daily revenue cycle operations and process improvement that include:

Working with Cerner to optimize the use of the system, workflow/process redesign, work queue setup, and assignments with particular emphasis on the self-pay, agency, and denial work queues and workflows.

Cash acceleration and accounts receivable clean-up.

Implementation of a denials management program.

Reducing initial claim rejections and discharges not final Bills.

Working with vendors to establish clear expectations, work assignments, and communication.

REHOBOTH McKinley CHRISTIAN HEALTHCARE SERVICES THRU ACCORDIAS HEALTHCARE, Gallup, NM (2020)

60-bed Acute Care Hospital - Meditech

Interim Revenue Cycle Director

Worked with SSI to set up additional payors on automated remittance posting and secondary claims filing and reduce initial claim rejections.

Developed and implemented policies, procedures, and best practice standards.

Worked with HIM to reduce Discharged Not Final Billed accounts receivable and maintain the decreases via improved workflows and processes.

Results included cash collections equaling 116 percent of the 60-day prior net revenue in January and 114 percent in March and reducing and maintaining a reduction in discharged not final bills of $2.3 million in three weeks.

OPELOUSAS GENERAL HEALTH SYSTEM, Opelousas, LA (2019)

225-bed Acute Care Hospital – Cerner Millennium

Interim Revenue Cycle Director

Worked with Cerner to optimize the use of the system via identifying and resolving issues related to the initial system build, work queue setup and assignments, workflow/process redesign, and additional training/retraining of staff on the system.

Cleaned up accounts receivable.

Established Key Performance Indicators (KPIs), productivity standards, clear expectations, and departmental and individual employees' goals.

Initiated a succession plan and reorganization to address staff turnover due to future staff retirements/turnover.

Replaced bad debt and self-pay ‘early out’ vendors due to performance issues.

Established a denial management process.

Improved communication within the department and with internal & external customers.

Results included three record cash collection months for the health system and a 35 percent reduction in claim rejections.

MEE MEMORIAL HEALTHCARE SYSTEM, King City, CA (2019)

112-bed Acute Care Hospital - Meditech to Cerner Community Works

Interim Revenue Cycle Director

Reorganized the patient access function via stabilizing staff turnover, setting clear expectations and goals, and improving morale during a revenue cycle management transition.

Developed and implemented a training plan for patient access for the Cerner conversion.

Organized and implemented the patient access, billing, and collections staff’s participation in integrated testing of Cerner Community Works.

Evaluated the performance of receivables outsourcing vendors and held them accountable for substandard performance.

McPherson HOSPITAL, McPherson, KS (2019)

49-bed Acute Care Hospital - CPSI/Evident

Revenue Cycle Consultant

Established KPIs for the revenue cycle.

Assessed current policies and procedures and made additions and revisions.

Reviewed current contracts to ensure compliance.

Assessed current and future staffing needs as well as job descriptions.

Developed productivity standards for current and future staff.

Developed a transition plan from outsourcing to on-site hospital billing and collections.

RIDGECREST REGIONAL HOSPITAL, Ridgecrest, CA (2018)

25-bed Critical Access Hospital, 6 Clinics & 46 employed physicians – Allscripts Paragon - Interim Director of Revenue Cycle

Responsible for daily operations of the revenue cycle functions (registration, clinic coding, billing, third-party follow-up, financial posting, and denial management (2 managers, three supervisors, 56 FTEs).

Reduced denials by 45% by establishing a denial management program, identified reserve deficiencies, and realized four record cash collection months.

Realized improvements in employee satisfaction and morale via evaluating staffing needs, redeploying staff, and replacing a manager, supervisors, and line staff that had created a hostile work environment.

Provided education, training, clear expectations, and accountability for coworkers.

Established KPIs to benchmark revenue cycle performance for hospitals, clinics, and urgent care centers.

These actions improved internal and external customer satisfaction (22 and 27 percent, respectively).

COVENANT HEALTH, Knoxville, TN (2017)

Seven acute care and one psychiatric hospital, 1,650 beds

Interim Director of Patient Accounting-Knoxville Business Office Service

Responsible for daily operations of the patient accounting function (billing, follow-up, cash application, customer service call center, and internal collection agency (5 managers, two financial analysts, and 178 additional FTEs).

Record cash collection months in March and August 2017.

Increased cash collections by approximately $48 million over the prior year.

Updated charity care policies.

Streamlined daily billing processes, leading to a 10% reduction in timely filing denials compared to the prior year.

Realized a 13 percent reduction in employee turnover versus the prior year.

REVENUE CYCLE CONSULTANT, Multiple Engagements, and Locations (1997-2016)

Facility sizes ranged from 25-bed critical access to 15 hospital systems.

Key responsibilities varied from Interim Revenue Cycle Director to Project Manager/Subject Matter Expert

Managed 4 EHR implementations on the Revenue Cycle function (2 Cerner, 2 Evident) and two optimizations (Cerner and Evident) as a project manager/revenue cycle subject matter expert.

Reestablished/transitioned the back-end revenue cycle functions for a 175-bed hospital from a central business office to an onsite operation.

Set up a centralized business office for two hospitals and six residential treatment centers.

Established and managed a team to resolve the legacy accounts receivable for SSM Healthcare during their EHR conversion from McKesson Star to EPIC.

PERMANENT POSITIONS 1988-1997

Served as an Assistant Controller/Business Office Manager, Revenue Cycle Consultant/Assistant Project Director, Project Director, and Director of Business Services for HCA, Advanced Receivables Strategy (now Conifer), Ingram and Associates, and Paracelsus Healthcare Corporation.

EDUCATION/CERTIFICATIONS

BS, Business Administration, Finance & Accounting, University of Tennessee, Knoxville, TN

Six Sigma Certified Black Belt

HFMA - Fellow and Certified Healthcare Financial Professional - Patient Financial Services.

Awarded Medal of Honor from the TN Chapter in 2012, recognizing significant contributions to Healthcare Financial Management in the Revenue Cycle.

SYSTEMS EXPERTISE:

Cerner Millennium, Soarian, and Community Works

CPSI/Evident

Meditech

SMS Invision and MedSeries 4

Allscripts/McKesson Star and Paragon

MedHost (HMS)

Patcom, Healthland, Centriq, QuadraMed Affinity, CareMedic, and E-Clinical Works

Contact this candidate