CAROLYN WHITE

**** ******* ******* ** ****** Garden, FL 34787

813-***-****

Contact: adjc90@r.postjobfree.com

Linkedin: www.linkedin.com/in/carolynjwhite/

PROFESSIONAL SUMMARY

Revenue Cycle Operations expert possessing over 25 years of successful Management and Consultant leadership. Prior experience as both Interim Manager and Interim Director of Revenue Cycle Management, Centralized Billing Office, and Patient Financial Services for a large multi-state hospital system and Multi-Specialty Physician group spanning 16 states.

Proven areas of focus include: Acute Care Hospitals (500 Beds), Critical Access Hospital (25 Beds), Teaching Hospital (250 beds), Community Hospital (450+), Multi-Specialty Physician groups with over 600+ clinicians, Federally Qualified Health Centers, Rural Health Centers, Ambulatory Surgery Centers and Urgent Cares. Leadership style respectfully aligns with a democratic / autocratic (collaborative – consultative and persuasive) and Objective/Goal Driven Management with a focus on talent building, staff education, and internal resourcing.

Proven abilities encompass aligning and leading cross-functional and segmented departments and teams to optimize strategic performance objectives and organizational goals to meet and exceed financial growth commitments, revenue loss reduction based off healthcare provider industry practice, and standards, exercising fiscal discipline by means of resource ramping, attrition, and allocation, platform capabilities and configuration to execute state and federal specific requirements and regulatory compliance and providing transparent oversight and reporting to executive leadership.

PROFESSIONAL EXPERIENCE

Independent Consultant – Fort Lauderdale, FL

Contracted: Director of Revenue Cycle Improvement and Management

01/2020 – Present

Responsible for performing a phased financial operations assessment of client practice sites by reviewing all procedures that are required to perform a E2E process for revenue cycle operations.

Developed and implemented a standardized list of site policies and procedures that reflect MGMA standards tailored for the client goals and capabilities.

Provided Business Cases for various areas of needed development and improvement in order to achieve executive management goals.

Developed performance metric dashboards that provide a detailed views and narratives of revenue cycle operations.

Implementing effective remediation plans that encompass each area revenue cycle workstream that include organization structure, roles and responsibility assignment, development of Policy and Procedures, Training and performance reviews of staff.

Managing the daily centralized billing operations and staff to ensure that clean claims submission, revenue integrity and appropriate backend processes are followed to ensure appropriate and predictable revenue is captured.

Working to strategize, solution implement and monitor executive leadership roadmaps and initiatives by partnering with key stakeholders.

Performing and managing RFP’s to various vendors for RCM platform migration to ensure growth, scalability and operational efficiency of the organization.

Warbird Consulting - Canton, OH

Interim Director of Revenue Cycle Improvement and Management

07/2019 – 11/2019

Contracted with Warbird Consulting to perform initial assessment review of Mercy Hospitals payer contracts by line of business to document and report to Mercy Hospital CFO payers that have lapsed contracts that need update, payers that are underpaying CMS reimbursement rates and payers that are contracted that are not reimbursing accordingly.

Developed and implemented a standardized standard operations practices and policy & procedures reflective of clients Hospital facility and physician practice groups.

Managed Oversight of third-party billing services contracted by Canton Mercy Hospital by reviewing current state operations and processes to identify and remediate existing service level agreements.

Managed the day-to-day revenue cycle operations inclusive to front-end patient verification, scheduling and registration and back-end claims submission and A/R denial follow up for over 125 Multi-Specialty physician group providers.

Implementation of new Service Level Agreement standards for BPO/BPAAS vendor with a focus on defining scope, processes and follow-thru with mandatory weekly reporting to hold accountability and remediation metrics.

Decreased denial write offs by over 30% by outlining and ensuring process adherence to procedural guidelines.

Increased Clean Claim rate from 66% to 92% by implementing a series of claims edits prior to clearinghouse submission from prior financial years.

Independent Consultant – Valdosta, GA

Interim Director of Revenue Cycle Management / Revenue Integrity

11/2018 – 07/2019

Responsible for the operations management of the Revenue Cycle and Health Information Management departments for a small rural area Critical Access Hospital with 25 swing beds.

Managed the Authorizing patient refunds and accounts write-offs/adjustments in accordance to established policies.

Oversight of departments patient scheduling, eligibility, billing, cash posting, accounts receivable and collections functions as it relates to reviewing claim encounters and payments.

Key accomplishments include: Increased revenue streams on all payer lines of business by <35% by end of Q2 of 2018 compared to Q4 of 2017, improved days of outstanding A/R from >180 days to under <50 days over a 2 quarter period which were achieved by corrected claims resubmission, audit review of unapplied payments, appeals for payment due to timely filing with exigent rational, adjustment of uncollectable claims due to previous management operations.

Developed standardized reporting and claim roster reports broken out by payer lines of business including Medicare, Medicaid, Commercial, Self-Pay and Worker’s Compensation claims that detail highest outstanding A/R by days and outstanding dollar amounts.

Lead client staff on daily operation goals by setting department expectations, goals, and performance guidelines to ensure productivity and competency, hiring, and onboarding new hires, creating corrective action plans and adherence inclusive to separation of employment.

Developed and strategized future state department infrastructure and staffing which included hybridization of BPO/BPAAS and in-house services to ensure reduction of operations costs and increase of revenue profitability.

Managed vendor oversight of partially outsourced services inclusive to Service Level Agreements adherence by means of schedule services and scope of work compliance.

Oversaw the training and education of client’s hospital staff on appropriate documentation medical coding requirement, ensuring that the security and confidentiality of the medical records are adhered and in compliance

Developed and implemented standard operation practices and policy and procedures that adhere to business industry and MGMA Standards for hospital facility and professional physician services.

Resolving identified gaps and critical issues impacting performance, compliance, and revenue production.

Near Term – Decatur, IL

Interim Director of Cash Application, Patient Financial Services, Patient Access Service and Revenue Cycle Management

07/2018 – 11/2018

Partnered with Nearterm to provide interim management services to Decatur Memorial Hospital for multiple areas of RCM that required stabilization for cash flow increase.

Responsible for day to day management of department staff inclusive to scheduling, performance evaluations, and work assignment issues related to Decatur Memorial Hospital cash posting and reporting.

Responsible for the daily monitoring of both electronic and manual posting activities, unapplied payments to patient accounts, patient / provider refunds of unidentified cash payments, application of credit balances, payment reconciliations and refunds.

Developing standard and ADHOC routine reports to executive leadership regarding cash on hand and payment posting activities, reconciliations, and refunds

Collaborated with client leadership to design and implement workflows and department guidelines/policies.

Responsible for monitoring and reporting all self-pay accounts receivable Key Performance Indicators to ensure billing and follow up activities are completed in a timely manner and appropriate resources are allocated to achieve goals, ensuring that client cash payments are posting are entered

Ensures that prompt, efficient financial service is provided to guarantors; and aids self-pay team in resolving problems relating to financial arrangements and other patient accounting matters.

Developed and implemented new Policy and Procedures to maintains effective processes and internal controls for posting payments and adjustments to patient accounts accurately and timely.

Authorizing patient refunds and accounts write offs/adjustments in accordance to established policies.

Identifies opportunities for improvement, communicates process issues to the appropriate stakeholders, and contributes to identifying solutions that address the source of the problem.

Participates on Revenue Cycle Committees and provides relevant information to Committee members that assists with identify issues and creation of solutions.

Developed and Implemented policies and procedures to improve the billing and collection processes.

Independent Consultant – Jacksonville, FL

Revenue Cycle Management Consultant

11/2017 – 06/2018

Contracted with various hospital / practice groups to perform revenue cycle operations assessments of current state operations and management to identify and document failure point by means of metric assessment of 12/24/36 month retrospective reviews.

Developed performance metric dashboards that provide a detailed views and narratives of revenue cycle operations.

Implementing effective remediation plans that encompass each area revenue cycle workstream that include organization structure, roles and responsibility assignment, development of Policy and Procedures, Training and performance reviews of staff.

Developed standardized policies and procedures to complete gap’s in process that significantly impact organizational revenue capture.

Developed 30/60/90/120-day remediation plans and stretch goals to force correct major systemic issues from an operations vantage point.

Recommend platform development or platform selection via Request for proposal process to various vendors albeit full BPO/BPAAS or Turnkey Platform model.

Tatum a Randstad Company – Atlanta, GA

Interim Director of Revenue Cycle Management / PFS / Patient Access Services

01/2017 – 10/2017

Partnered with Tatum to provide interim director services to Mercy Hospitals for alignment with their transformative roadmap by strategically developing and executing growth initiatives to increase profitability for General Ledger improvements during a health systems acquisition.

Responsible for providing operational analysis of current state business operations against industry standards to align with critical future state goals to ensure organization readiness.

Managed the revenue cycle department’s redesign and revenue methodology implementation techniques for: Hospital, Multi-Specialty Physician groups and Rural Health Centers across Mercy Health’s client portfolio by eliminating inefficiencies, creating / updating P&P’s and SOP’s that were inherently flawed and antiquated to standardized and tailored version leveraged after MGMA guidance.

Implemented initial and recurring training sessions with current staff to ensure proper quality metrics are adhered to from newly developed/revises Standard Operating Procedures and updated Policy & Procedures.

Directed the day-to-day operations and business management functions which are not limited to: Staff Management, vendor oversight and accountability of contracted vendor.

Responsible for resolving identified gaps and critical issues impacting performance, compliance, and revenue streams.

During tenure notable accomplishments include: Increased revenue streams on all payer lines of business by a minimum of 19% with a projection of 34% to 40% by end of FY 2017 from FY 2016 of implemented process is adhered to, drastic reduction in Outstanding A/R days from >120 days to <36 days over 3 quarters which was segmented into bi-weekly sprints starting from Q1 to present.

Developed a close and partnership relationship with executive leadership and steering committee to provider real-time problems with immediate and meaningful solutions and remediation plans.

Oversight of departments patient scheduling, eligibility, billing, cash posting, accounts receivable and collections functions as it relates to reviewing claim encounters and payments.

Independent Consultant – Myrtle Beach, SC

Revenue Cycle Management Consultant

09/2015 – 12/2016

Partnered with an up-start Revenue Cycle vendor for performing interim revenue cycle management leadership for performing organizational health assessment for over 14 Federally Qualified Health Centers across 8 states to operational status and reporting revenue performance and profitability to client leadership.

Responsible for decreasing the outstanding A/R Days from >120 to <45 within 6 months averaged for all site 14 site locations, increased revenue by average of $1.4 mill total for 5 underperforming sites on the verge of phasing out and stabilization and nominal increase on average of 840K for the remaining 9 sites by means of initiatives and mandatory benchmarks and ensuring staff and site adhere to metrics.

Provided up to date and widely accepted billing method training and education to centralized billing staff to increase productivity per individual assigned site location.

Developed standardized dashboard reports broken out by payer, provider, site, and line of business detailing highest outstanding A/R by days, dollar amounts, denial codes and filing deadlines.

Direct management and oversight of 14 on-sight billing resources and 16 off-site billing resources this includes coaching, one-on-one coaching and conducting of performance goals and reviews.

Performed monthly on-site operational audits on Physician Practices to target and resolve process deficiencies and provide educational assistance to staff to ensure maximum reimbursement of Patient Accounts.

Structured Central Billing Office to capture and increase revenue by targeting and eliminating ineffective billing, coding, A/R, Denial processes and replacing with efficient work processes.

Proactively worked with Coding and Payment Posting departments to analyze and decrease identified common error rates produced from the payer claims roster report

Divergent – Columbia, SC

Interim Accounts Receivable / Patient Financial Services Manager

01/2015 – 09/2015

Contracted with Divergent Consulting to provide revenue cycle leadership services to Palmetto Health “nka” Prism Health by mean of performing operational health and staff competency assessments to provide to client leadership for developing a remediation plan for CY 2015.

Managed a department of 6 supervisors and over 40 specialist/analysts by providing training and continuing education and effective Leadership within the departments by developing process improvement.

Managed the revenue cycle department’s redesign for: Hospital and Multi-Specialty Physician groups across Palmetto Health Health’s client portfolio by eliminating inefficiencies, creating / updating P&P’s and SOP’s that were inherently flawed and antiquated to standardized and tailored version leveraged after MGMA guidance.

Managed the Full end to end Revenue Cycle Management for Eligibility, PFS, Patient Access, Billing, Payment Posting, Coding and Denial Management by performing necessary audit reviews, tasking staff objective and projects and reporting effectiveness of client leadership roadmaps and agenda.

Responsible for developing short- and long-term initiatives in a sprint/passed approach to decrease the number of days outstanding from >50 to <32.2 days within, decrease of error/rejected claims by 39%, Increase revenue stream by performing revenue integrity checks prior to claim submittal and reduction of days from payment posting from 18 days to 4 days for receival from summary of remittance from payers

Spearheaded a configuration team by developing system requirements to be provided to the configuration team to ensure claims edits were in place by providers, site, service, payer etc. to prevent claim reject notifications and ensure 99% minimum clean claim submissions.

Developed the standardized requirements of robust panel of on demand and custom ADHOC reports by working extensively with the Data Warehousing and Business Intelligence department to provide financial health to leadership

Responsible for ensuring pertinent system updates and release notes are shared with leadership and staff as interpreted by the IT and Configuration department for MediTech, McKesson, Cerner, Greenway.

Independent Consultant – Myrtle Beach, SC

Revenue Cycle Management Consultant

7/2014 – 12/2014

Contracted with various hospital / practice groups to perform revenue cycle operations assessments of current state operations and management to identify and document failure point by means of metric assessment of 12/24/36 month retrospective reviews.

Developed standardized policies and procedures to complete gap’s in process that significantly impact organizational revenue capture.

Developed 30/60/90/120-day remediation plans and stretch goals to force correct major systemic issues from an operations vantage point.

Recommend platform development or platform selection via Request for proposal process to various vendors albeit full BPO/BPAAS or Turnkey Platform model.

Orleans Community Health / Medina Memorial Hospital - Medina, NY

Interim Director of Patient Financial Services

10/2013 – 06/2014

Partnered with Medina Memorial Hospital to perform an on-site operational assessment to address the CEO’s concern of incomplete/inadequate billing processes that impacted profitability and revenue growth.

Implemented various program initiatives to develop a standard compliant operations approaches to ensure maximum revenue and cash flow capture.

Directing all aspects of patient accounting, pre-registration, eligibility, pre-certification, admissions, registration, service pre-payment, post payment, accounts receivable, payment posting and payer appeals.

Responsible for performing deep dive analysis of Medina Memorial’s existing policy and procedures and billing practices that were absent/antiquated/obsolete/inadequate and developing standard and specific standard operating procedures and policy and procedures that reflect with Industry and MGMA Standards

Responsible for maintaining and evangelizing modern state billing standards and practices by ensuring vendor billing service systems reflect organizations requirements based on payer billing requirements per Lines of business.

Developed, monitored, and reported to executive leadership multiple key standard reports with a focus on provider performance, revenue integrity, and payer reimbursement.

Provided revenue cycle management oversight by reviewing current operations, conducting interviews for new hires, and reviewing the age trial balance to identify high value opportunities for improvement.

Provided high level management analysis, reorganization measures and revenue cycle maximization techniques for various Hospital sites and acquired Physician Practice groups

Education of staff on extensive revenue cycle methodologies to improve cash collections and decrease accounts receivable days from >120 to under <40 days, Increased net collection by 80% from prior fiscal years, improved claims reject and denial rates down to 15% of all claims submitted from prior 40% of all claims submitted.

Huntzinger Group – Broomfield, CO

Interim Director of Revenue Cycle Management

04/2013 – 10/2013

Partnered with Huntzinger Group to provide interim revenue cycle leadership and management services to Sisters of Charity Broomfield Hospital System by performing assigned facility and provider assessments to analyze their existing operational gaps and inefficiencies after a platform migration to EPIC’s full suite or EHR / Billing products.

Responsible for analyzing existing financial state against current operations management to identify areas of failure and non-compliance to remediate with staunch and immediate strategies to rectify gaps in operations and billing practices.

Developed and implemented system wide Standard Operating Procedures and Policies for 12 Hospital Systems and Multiple Physician practice groups with a combined total of over 600+ clinicians in 9 states.

Spearheaded revenue cycle education and training initiatives to all SCH billing staff to improve cash collections and front end edit controls for billing.

Performed all requirements gathering functions related to state and provider specific billing guidance to present to EPIC for configuration into the system ensure a clean claim submission to multiple payer lines of business.

Produced multiple payer and provider reports outlining standard reporting metrics inclusive to patient eligibility and registration accuracy, claims submission acceptance rate, claim rejects and denials rate, underpayment, non-payments, unapplied payments and misappropriated cash postings and payment recoupment and adjustment rates due timely filing errors additionally duties of tracking and trending per site, provider and payer to review any unreported errors to leadership.

Key accomplishments include strategizing and implementing new revenue cycle practices that lead to a reduction of outstanding days in A/R from >180 to <60 by middle of Q3 2013, revenue increase of 33%, reduction of operating costs by attrition and/or allocation of exiting staff to understaffed departments, Reduction of rejected claims from >30% to <12% per month by payer line of business across all 9 states.

Responsible for reporting and presenting weekly status reports to leadership of RCM department current state to proactively account for any upcoming or unforeseen changes in direction.

Developed and implemented new Central Billing Office (CBO), Policy and Procedures with goal and objective driven results based on Medical Group Management Association (MGMA) industry standards to successfully reduce outstanding A/R while reducing claim life expectancy as well as maximize revenue per physician encounter based on MGMA guidance.

Independent Consultant – Myrtle Beach, SC

Revenue Cycle Management Consultant

08/2011 – 03/2013

Contracted with various hospital / practice groups to perform revenue cycle operations assessments of current state operations and management to identify and document failure point by means of metric assessment of 12/24/36 month retrospective reviews.

Developed standardized policies and procedures to complete gap’s in process that significantly impact organizational revenue capture.

Developed 30/60/90/120-day remediation plans and stretch goals to force correct major systemic issues from an operations vantage point.

Recommend platform development or platform selection via Request for proposal process to various vendors albeit full BPO/BPAAS or Turnkey Platform model.

Guilford Adult and Pediatric Medical Group – Greensboro, NC

Interim Revenue Cycle Manager

01/2011 – 07/2011

Contracted with Guilford Adult and Pediatric Medical Group to perform revenue cycle leadership and management services to align with company goals of profitability and strategic growth by increasing number of facilities by new development or acquisition of existing physician locations.

Performed a current state assessment of the revenue cycle department to identify gaps in standard industry operations

Responsible for managing the front-end eligibility and verification staff to ensure members are insured and front-end collections occurs for co-pay’s and deductibles to apply to office visits and procedures.

Managed the daily operational activities of the Patient Access, Coding, Billing, and A/R follow departments by ensuring staff are meeting goals and metrics outlined by client policy and procedures.

Developed enhanced reporting capabilities to provide granular level of detail for each provider and site to ensure that maximum profitability and cash capture are implemented and adhered.

Implemented long-term and strategic goals that facilitated drastic improvement on financial bottom lines by reducing outstanding days in A/R from >90 to <45, Increase profit margins by 29% across all 4 sites, educated and trained staff on fundamental billing procedures.

Improved department productivity by improving workflow and staff competency by identifying segregation of duties and responsibilities in a Lean approach

Responsible for the interviewing, hiring, staffing, training, performance management and development of department staff members.

Performed monthly onsite operational audits on Physician Practices to target and resolve process deficiencies and provide educational assistance to staff to ensure maximum reimbursement of Patient Accounts.

Independent Consultant – Tampa, FL

Revenue Cycle Management Consultant

07/2010 – 12/2010

Contracted with various hospital / practice groups to perform revenue cycle operations assessments of current state operations and management to identify and document failure point by means of metric assessment of 12/24/36 month retrospective reviews.

Developed standardized policies and procedures to complete gap’s in process that significantly impact organizational revenue capture.

Developed 30/60/90/120-day remediation plans and stretch goals to force correct major systemic issues from an operations vantage point.

Recommend platform development or platform selection via Request for proposal process to various vendors albeit full BPO/BPAAS or Turnkey Platform model.

Auro S Management / Access Healthcare – Brooksville, FL

Director of Revenue Cycle Management / Centralized Billing Operations

02/2008 – 05/2010

Managed the day-to-day Revenue Cycle Operational processes for their assigned functions which encompassed daily stand-ups by management staff and leads to inform and glean of possible errors or issues that impact overall department production.

Identifying and counseling with IT department various bugs and system issues related to billing system issues and performance.

Monitored trends in relation to accounts receivable, cash payments, & aged billing reports segmented granularly.

Structured the Central Billing Office to capture and increase revenue by targeting and eliminating ineffective and antiquated operational practices and implementing effective and results driven protocols for 60 professional offices with over 100 providers

Evaluated effectiveness of billing and collection methods to ensure maximum reimbursement and performance are maintained.

Managed employees with regarding performance, attendance, and corrective action plans to ensure that department goals are met.

Developed and successfully carried out corporate policy and procedures to be implemented throughout Access Health

Produced and presented multiple reporting packages to show current and projected revenue growth as well as devised strategic real time operational solution to decrease outstanding days in accounts receivable to no more than 30 days and maximize revenue for various sites by up to 50% by streamlining the business process.

Managed and showed leadership to 4 direct reports and 30 FTEs to ensure assigned duties and goals were fulfilled to company expectations by performing weekly, monthly reviews focusing in on: quality metrics/error percentage rates.

Facilitated monthly onsite operational audits on physician practices to target and resolve process deficiencies and provide educational assistance to staff to ensure maximum reimbursement of patient accounts.

EDUCATION

Saint John’s River College – Saint Augustine, FL

Degree Healthcare Management/Administration – Part-Time

Currently Attending

SKILLS AND SYSTEMS

FUNDAMENTAL SKILLS

Revenue Cycle Management – Patient Financial Services – Accounts Receivable – Strategic Planning and Implementation – Operations Management – Training and Education – Health Information Management – Electronic Health - Medical Records – Medicare and Medicaid – Managed Care Operations – Claims Management – Eligibility and Verification – Regulations and Policy – Payer Reimbursement – Revenue Integrity – Coding and Billing – Hospital Billing – Physician Billing – Performance Improvement – Healthcare Administration – Policy Development – Procedure Development – Leadership and Management – Compliance and Auditing – Provider Credentialing – Call Center Operations – CBO

SYSTEMS EXPOSURE (EMR/EHR Billing Platforms)

EPIC IDX GE Athena Cerner AllScripts MediSoft Mckesson E-Clinical KAREO NueMD MediTech

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