OBJECTIVE

To obtain an operational position with a company that will utilize my existing skills while allowing for growth. I thrive in defining problems and planning appropriate solutions. I am a self-motivated individual that seizes opportunities to learn, implement and improve processes/procedures via training and support. Capable of performing effectively in high pressure situations, while conveying a professional image.

EXPERIENCE

Self Employed Upper Darby, PA 3/2015 – Present

Operations, Billing and Revenue Mgmt. Consultant

●Based on KPI’s, Root Cause & FTE Analysis, government regulations, 3rd party requirements, budget and revenue assessment, an action plan is put in place.

●Set weekly onsite meeting, conference calls and web meetings to provide status update, address problematic revenue and address STAT items. Provide 24/7 availability.

●Work with designated staff on high risk items, urgent compliance issues and accounts receivable risks. Update billing/revenue policy and procedures, job descriptions and ensure current training methods are efficient.

Mercy Philadelphia Hospital Philadelphia, PA 11/2012 – 1/2015

ER Patient Access Manager, Business Office

●Supervised staff processing patients presenting to the ER via walk in, police custody, EMS arrival and crisis center for medical clearance.

●Handled bed board/admissions, hospital to hospital admission, and verified insurance and submitted for authorization to admit and performed radiology services scheduled outside of the ER.

●Responsibility for rejected claims, denials and appeals for services provided in the ER, Admissions, Crisis, Fast Track and Radiology.

●Created, monitored and audited processes for quality assurance.

●Ensured all policies, procedures and trained adhered to government and payer regulations and guidelines.

●Weekly and monthly reporting of patient services received, billed, patient hold accounts needing supervisor assessment and error release approval.

●Met with employees as needed to discuss audit findings and required action if any.

●Served on ER Management, Patient Safety and Disaster STAT committees.

●Met monthly to discuss compliance issues, stats, patient falls, concerns, updates and drills.

●Staffing of 24/7/365 area, full cycle hiring, HR combined termination process, payroll, annual/performance reviews and ongoing training in order to ensure the success of the areas under my supervision.

RHD, Corporate, Philadelphia, PA 10/2008 – 3/2011

Billing and Revenue Manager Remote Sites

●Managed Billers, Analyst and Clerks in full cycle billing for outside programs with over $180 million in revenue.

●Supervised employees locally and at remote sites. Locations consisted of school services, family practice clinics, initial evaluation for various medical specialities, behavioral health, group homes, drug & alcohol inpatient and outpatient facilities.

●Revenue Cycle Management, worked with Budget Managers, A/R department and locations to decrease delays, errors, un-billable services, write-offs and unapplied cash.

●Implemented procedures to effectively bill/collect revenue.

●Traveled to remote sites in 15 states to assess support needs, review and set new billing systems, perform quality audits, credentialing/plan enrollment, implement/review processes, assist in recruitment/hiring and conducted initial and ongoing staff training.

●Worked with stakeholders to determine if FFS billing of new sites were brought in house or kept at location with my oversight.

●Set up and review of new and existing contracts before renewal. Key person for payer compliance audits.

●Provided demo/training for upper management and clinicians on billing systems.

RHD, Lower Merion Counseling, Bryn Mawr, PA 12/2007 – 10/2008

Site Manager

●Assisted in budget preparation and responsible for final review, reviewed billing process with corporate and implemented change as needed. Worked with CBO to resolve issues.

●Performed weekly chart audits in compliance with regulations and company policy.

●Assisted Director with clinical staff interview process/selection and credentialing.

●Completed new hire paperwork, orientation, non-clinical employee reviews, weekly meetings, monitor/adjust employee and consultant schedules as needed, AR/AP, vendor contracts, private fee rates and other duties as needed.

Bayada, Nurses, Lawrenceville, NJ 6/2006 – 5/2011

On Call Manager, Remote Home Office

●Managed after hour calls from clients, prospects and employees.

●Staffed last minute openings and prepared am activity report.

●Marketed and quoted prices for services to first time after hour callers.

●Participated in strategic meetings centered on office performance goals.

Kids First, CHOP/Chestnut Hill Pediatrics, Philadelphia, PA 1/2003 – 7/2005

Billing Manager

●Handled patient inquiries regarding private pay rates and insurance participation.

●Revenue Cycle Management - managed full cycle billing of physician clinic and hospital charges.

●Generated statements, delinquent notices, A/R reports monthly and Account Ready report quarterly.

●Supervised and trained data entry, billing and accounts receivable staff.

Coastal Clinical Management Services, Rosemont, PA 8/2002 – 9/2007

On Call Manager, East & West Coast, Remote Home Office

●Acted as company Liaison from home after hours 7 days a week. Emailed summary report by 9am EST to office staff detailing shift activity.

●Filled last minute shift openings, schedule changes and call outs.

●Updated Nursing and Allied Health schedules via company intranet for Military, Hospitals.

EDUCATION

RHD Leadership Development Program, Philadelphia, PA 9/2009 – 4/2010

Certificate

●Operational Leadership, Relationship Building, Conflict Resolution

George Washington High School, Philadelphia, PA 9/1986 – 6/1990

Diploma

●Communications

SKILLS

24 years of management experience in Behavioral Health & Healthcare, Microsoft Applications, EMR/EHR Implementation & Training, ROI, CRM, AR/AP, QuickBooks, Payroll, MEDENT, IDX, SALESFORCE, SHAREPOINT, Medical Terminology & Coding, Billing & Revenue Cycle Management, BEARS, Call Center Training, ADP, LAWSON, NEXTGEN, MEDITECH, CERNER, KRONOS, PICIS, Credentialing, Quality Assurance & Auditing, Web training, remote site and staff management, Contracts, Team Building, Mediation & Conflict resolution. Supervised up to 125 direct & remote employees. On-call after-hour employee & client experience.

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