RICHARD D. POSEY **** Grahams Port Lane, Snellville GA 30039
(Hm) 770-***-**** (Cell) 404-***-****
Email: *******.*****@*******.***
HEALTHCARE FINANCIAL EXECUTIVE
Dynamic, versatile, hands-on, results oriented healthcare financial executive with over 25 years of progressively increasing responsibilities. Primary focus is on improving Net Revenue/Cash Collections and reducing Cost to Collect, while maintain a sustainable margin for the companies I work with. Out-of-box thinker with visionary leadership strengths; resourceful team player characterized by an innovative entrepreneurial spirit; strategic thinker who develops, implements and achieves organizational goals.
CORE COMPETENCIES
Operational Efficiencies Productivity and Process improvement
Contract Negotiations Product implementation
Vendor Management System conversions
Revenue Cycle Consulting Mentoring and staff development
CAREER HISTORY
Independent Consultant – Atlanta, GA Feb 2020 - Present
Partner with hospital administrators or physician practices to provide long-term strategic process improvements for revenue cycle engagements which convert to sustainable margin enhancements. When necessary, provide interim management for leadership roles.
Jackson Revenue Management Company – Atlanta, GA
Vice President of Revenue Cycle May 2015 – Jan 2020
Responsible for the management of all Revenue Cycle activities, Managed Care Payor Contracting, and Provider Enrollment. Also responsible for the strategic implementation of processes to maximize recoveries associated with 35 various facilities across 12 states. FY 2018 Actual collections exceeded $65M for our partners where financial projections were set at $61M.
Responsibilities include:
Work with Organizational Medical Directors to ensure compliance guidelines are met. Identify deficiencies and develop, implement, and measure strategic improvement initiatives
Engage Facility C-Suite to discuss revenue opportunities
Establish and maintain Organizational Metrics. Determine target areas for improvement
Negotiated and administered anesthesia payor contracts for 12 states with $2M in increased revenue
Identify and implement technologic solutions to improve operational efficiencies and overall collections
Manage the P&L to ensure profitability
Oversee the activities of 60+ On-shore and Off-shore personnel within the Revenue Cycle arena
Manage and support Premier Consulting engagements with respect to Coding, Payor Contracting, and Denial Management reviews
Organizational Accomplishments:
Improved Net Income 36% from 2015 – 2018
Switched Clearinghouses improving Clean Claim Passage Rate from 90% to 96%
Utilized Clearinghouse data to isolate systemic Denials and created work queues for collectors.
oPerformed Root Cause Analysis and based on findings, put into place educational trainings for Anesthesia Providers
Established Organizational Metrics for Revenue Cycle –
oDays in AR – Reduced AR days by 15 within the first year of employment
oReduced claim submission times from DOS to Claim submission from 15 to 7
oClean Claim Passage Rate from Patient Accounting System – Improved from 92% to 96%
Implemented Offshoring solution for Anesthesia Coding and Charge Entry – Reduced employee related expenses 50% while increasing efficiency 32%
Established Anesthesia related metric comparisons to other Revenue Cycle companies via clearinghouse
Implemented an Automated Charge Entry Process via the use of ADT technology - reduced DOS to claim submission from 14 days to 5 days
HSI Financial Services – Atlanta, GA
Vice President of Collections/Senior Revenue Cycle Consultant July 2011 – May 2015
Responsible for the strategic implementation of processes to maximize recoveries associated with 21 various lines of business spanning the VBO and Bad Debt arena. FY 2014 collections exceeded $50M for our partners.
Responsibilities include:
Revenue Cycle engagements – Improve bottom line recoveries for clients via enhanced registration data capture and coding specificity resulting in increased revenue generation
Monitor and modify dialing strategies related to Bad Debt and Early Out call center operations
Manage staff in the Client Relations Center. This team supports placement imports, reconciliations, cash posting, and client related concerns
Oversee the preparation of training manuals for staff when new clients enlist with HSI for services
Ensure compliance with FDCPA, TCPA, FCRA, and all other regulatory requirements and guidelines
Organizational Accomplishments:
Improved collection recoveries for client’s year/year by 36%, reduced staffing by 34%
On-boarded new technology partner to perform account scoring. Realized a 104% increase in recoveries for one client with only a 1% increase in placements
Improved Net Income 66% from 2012 – 2014, even though placements declined 32%
Consulting – Created Consulting Division and improved monthly cash flow of Anesthesia firm from $5.1M to $7.9M during 4-month engagement.
MedAssets – OceanPort, NJ
Director of Non - Governmental Collections November 2010 – May 2011
Responsible for the Non-Federal billing and collections of a seven-hospital system. Revenues generated exceeded $1.2B.
Responsibilities included:
Ensure departmental goals for the unit were met. When deficiencies existed, took steps to identify and implement corrective action measures
Analyzed aging reports, sought out trends and patterns in payment discrepancies and denial capture. Modified billing processes when necessary and contacted payors to discuss systemic payment/rejection issues
Identified both payor/system issues and quantified financial impact. Responsible for facilitating the resolution of identified problems
Monitored staffing levels and claims movement. Ensured AR over 90 continued to decline to best practice standards (20% and below)
Identified and implemented systemic opportunities. Rolled out 276/277 statuses and incorporated responses into the collector’s queue.
Organizational Accomplishments:
Worked with IT department to develop and deploy a patient accounting system. Utilized ANSI Transaction sets (276/277) and ANSI 835’s to build work queues for Denials.
Redesigned the Collections Module for collector queues and realigned collections team which allowed for improved collections. Realized a $20M net increase in cash over a six (6) month period. $3M YTD deficit in November 2010 to a $17M surplus YTD ending April 2011.
Anesthesia Healthcare Partners – Duluth, GA
Director of Revenue Cycle Jan 2009 – October 2010
Responsible for all Revenue Cycle activities, including ensuring charges were forwarded timely and entered promptly, and claims were submitted accurately for 42 anesthesiology sites across 9 states. Also responsible for Managed Care Payor Contracting and managing site relationships with corporate.
Responsibilities include:
Created a collections unit. Consolidated the billing functions of two independent collection agencies to a single in-house collection’s division. Hired, Trained, and Mentored new staff on revenue capture and collection techniques
Redesigned the Patient Management system to capture and report on denials and subsequent recoveries
Implemented a three-tiered appeal process to recover underpaid claims
Core liaison between ASC, Hospital, GI management teams, the billing office, and the corporate headquarters operations staff
Immediately addressed site concerns involving cash collections and patient satisfaction
Created and monitored dashboard/key indicator reports to identify and correct reimbursement concerns
Organizational Accomplishments:
Redesigned the Collections Module for collector queues and realigned collections team which allowed for improved collections. Realized a $20M net increase in cash over a six (6) month period. $3M YTD deficit in November 2010 to a $17M surplus YTD ending April 2011.
Created Collections Division – Hired, Trained, and Mentored staff to submit and correct claims sent to GE clearinghouse.
Redesigned Patient Management System to function according to multi-tiered business model
Designed and implemented a web-based work-flow application between the US and India which identifies and allows for the documentation and notification of charge entry issues and subsequent issue resolution. Improved efficiencies by 60% thru redesign
Developed relationships with various payors for claim dispute and resolution. Improved recoveries by $1M by being able to present issues to payor representatives and obtain claim resolution
Implemented Call Center from ground up – hired, trained, and established protocols and processes for staff
Grady Health System – Atlanta, GA
PFS Director Sept 2005 – Dec 2008
Responsible for the overall billing and collections for a 953 bed Hospital with various outpatient clinics, both on campus and in the community. Carriers included: Medicare, Medicaid, Managed Medicaid, Self-Pay, Commercial and Managed Care.
Responsibilities included:
Identifying and implementing new technologies that improved overall effectiveness and efficiency
Ensuring staff was engaged in daily processes and producing at productivity levels
Identifying, developing, and implementing various automated EDI processes
Monitor CMS, DCH, and CMO notices to ensure compliance with governmental regulations
Create and monitor dashboard/key indicator reports to identify and correct reimbursement concerns
Organizational Accomplishments:
Identified collection inconsistencies with billing migration ($6M), worked to maximize revenue collections
Strategically implemented new software and hardware in billing unit at Grady Hospital. Improved clean claim passage rate from 70% to 95%
American Health Imaging – Decatur, GA
Director of Central Business Office Jun 2004 – Sept 2005
Managed the Central Business Office (CBO) for a 14 facility imaging company where the centers were located in six different states. Responsible for billing, collections, insurance follow up, contract negotiations, and resolution processes with a staff of 14. Maintained ongoing reviews of existing contracts and sought out new
opportunities to engage non-contracted carriers. Established new target receivable objectives at 15% over previous collection recoveries for FY 2004
Responsibilities included:
Training/retraining center employees on corporate policy and procedures
Monitoring CMS notices in multiple states, referencing multiple modalities, to ensure compliance with governmental regulations
Seeking out and establishing new vendor relationships that enhance corporate profitability, evaluate and monitor performance
Reviewing receivables data of potential acquisitions to determine accuracy and profitability
University of Chicago Hospitals – Chicago, IL
Director of Governmental Collections Jan 2003 – March 2004
Managed the collections recovery for receipts in excess of $704M for FY2003. Set new targets at 6% over previous collection recoveries for FY 2004
Identified opportunities and implemented strategies to maximize revenue cycle, reduced days in A/R and minimized the loss of revenue
Reengineered process flows to improve departmental efficiencies within the organizational structure
Reviewed monthly reports to analyze cash flows, identify anomalies, and develop solutions to situational issues
Formulated strategies to resolve problematic segments of accounts in the existing receivables base
Modified electronic billing process to eliminate 30% of rejected claims submissions
Manager of Non-Governmental Collections/Refunds/Cash Applications Sep 1993 – Dec 2002
Provided hands-on leadership in ensuring proper reimbursement to hospital based on previously negotiated contracts.
Responsible for the collection and application of Hospital patient related receivables
Responsible for setting departmental goals and mentoring staff to achieve established goals
Created productivity reports and established performance standards for the first time in the department
Responsible for quality assurance during the migration of system conversion from BHIS to LastWord/IDX
EDUCATION
Bachelors of Science (B.S.) - Finance, Northern Illinois University, De Kalb, Illinois
TECHNICAL KNOWLEDGE
Applications: Thorough understanding of Medsuite, Affinity, GE Centricity, STAR, SMS Invision, ePremis, Premis, MSI, Misys, TSI, LastWord/IDX
Software: Advanced knowledge of Microsoft Excel, Word, Access, Power Point, Visio