Revenue Cycle Receivable Manager

ADRIAN J ENGLISH

Email: ***********@*****.***

Primary Contact Phone Number: 706-***-****

EXECUTIVE PROFILE

Executive Revenue Cycle Operation Leader with extensive experience in all areas of healthcare revenue cycle workflow, operations, finance, reporting, payer, client, vendor, financial reporting, sales analysis and partner relationships. Experience in all areas of Healthcare Revenue Cycle Operations in large, established, and small, start-up healthcare organizations. Extensive experience in Hands-on leader who enjoys training and developing staff to improve productivity and drive profit enhancements. A broad thinker and team player who works well with ambiguity and is able to transfer the vision/mission of the organization into a focused financial strategy and detailed practical plan for the future. Over Twenty years of healthcare experience leading and building teams of multi-disciplined healthcare professionals exceeding organizations margin profit and eliminating risk factors from an operations and billing standpoint. Meticulous, detail oriented, highly organized with expert analytical, customer services and problem-solving skills.

PROFESSIONAL ATTRIBUTES:

Solves problems by building consensus and support, working across functional lines to engage disparate resources to work together to achieve desired results. Think broadly and strategically; a team player who works well with ambiguity. Transferer the vision/mission of the organization into a focused strategy and a detailed practical plan for the future. Generates ideas and improved approaches. Ability to organize work with large amounts of information efficiently, manage multiple projects and deadlines simultaneously with attention to detail in a fast-paced and results-oriented environment. PERSONAL ATTRIBUTES:

Impeccable integrity, strong principles and deeply knowledgeable. Earns respect and support when making difficult decisions and choices. Establishes immediate credibility with peers, senior leadership, and medical staff. Active listener who encourages input from others. Provides clear directions. Maintains an ongoing dialogue with employees to ensure continual progress. Works collaboratively with individuals critical to the successful execution of financial tasks. Excellent oral and written presentation skills. Articulate conversationalist with a gracious demeanor. LEARNING & GROWTH MANAGEMENT:

● Communication – Actively listening, coaching, giving and receiving feedback, communication planning, disagreement/consensus building, effective written and verbal communication, meeting facilitation, and presenting information to executives.

● Develop Talent – Identify and recruit diverse talent, apply behavioral interviewing, develop retention and succession plans, evaluate performance, and set goals and standards. Professional Experience

Revenue Cycle and Managed Care Consulting, Atlanta Georgia Sr. Vice President of Revenue Cycle Management Consulting Division, 05/2019 to 09/2021

Reported to the CEO of the company. Provided revenue cycle consulting services to Hospitals, Physicians Practices, Healthcare CBO’s, Hospice, Palliative Care, Skilled Nursing Facilities and NP clients. Identified opportunities for improvement and provided recommendations for resolution. Developed process that enabled the facility to maximize reimbursement and increase cash flow of $257 million dollars with revenue of 3B. Successfully settled multi-claim denials for multiple payers resulting in multi-million-dollar recovery. Ensured revenue cycle strategy and operations worked in sync to maximize and exceed performance goals and metrics of the organization. Interface with external and internal stakeholders. Design and scale reporting that identifies risk, anticipate points of resistance and develop specific plans to mitigate the matter. Maintained programs and infra-structure to ensure a high level of customer satisfaction. Managed the departmental financial and operation reports, made recommendations on strategies for enhancing operating cost and increasing revenues; develop and maintain internal policies and procedures. Facilitate the implementation of a new and updated information system specific to the needs of the Revenue Cycle and Operations Department. Identified and communicated system problems, enhancements, upgrades to all relevant staff and departments. Outstanding integrity, adaptive, collaborative, expeditious, driven, with problem-solving skills. Accomplishments:

● Build, developed and maintained a robust deal pipeline that delivers new revenue annually as well as delivers accurate and dependable sales forecasts, and creates new and expanded business opportunities in excess of $15M.

● Defined market segmentation and strategic territory planning for the entire range of Revenue Cycle and Managed Care Consulting technology and services in the provider channel, ensuring that we are meeting customer’s needs and expectations.

● Worked to digitally streamline the patient’s financial experience, allowing patients to consolidate, view, and pay all their RCAMC Consulting bills from a single electronic location. Which brought the patient's financial satisfaction rate to 96%.

● Provided solutions to complex business problems for areas of responsibility where analysis of situations requires an in-depth knowledge of organizational objectives, provider revenue cycle management and the ability to bundle product and services to meet customer objectives which lead to $120m contract for organization.

● Experience in sales project management, including the ability to identify and resolve issues, manage risk, develop detailed plans and organize cross-functional efforts with operations improving error retention by 95%.

● Leverage contacts and experience closing multi-million-dollar Revenue Cycle Management deals to meet aggressive sale quotas.

● Worked collaboratively with individuals critical to the successful execution of financial tasks. Listening actively and accurately, encourages input from others. Provide clear directions. Maintain an ongoing dialogue with employees to ensure continual progress. HOMESTEAD HOSPICE - ROSWELL, GEORGIA

EXECUTIVE DIRECTOR REVENUE CYCLE, 06/2016 – 05/2019 Reported to the CFO of Homestead Hospice. Executive leading integration to tri-state regional revenue cycle representing a private multi-specialty medical practice spanning Georgia, Alabama, North Carolina, South Carolina, Arizona, and Ohio. Over 1100 providers with annual revenue in excess of $147 million. Responsibilities include providing support and direction to overall facility practice operations, accounts payable and revenue. Focusing on areas such as the development of standards and best practices for patient access, clinic operations, vendor relationship, revenue cycle efficiency metrics, productivity formulas, staffing standards, financial performance, and month end close out to exceed revenue financial goal. Provided subject matter expertise in all areas related to revenue cycle, accounts payable/vendor relationships and operations.

Accomplishments:

● Increased cash receipts an average of 10M annually in August of 2016. Utilizing a comprehensive revenue optimization project supports merger and integration to load all patient financial and demographic data from 2010 to 2016 inside EMR Brightree. Provided strategic and tactical direction to ensure that financial recordings were accurate throughout all financial and non financial systems.

● Directed and led large complex engagements focused on strategic and tactical business solutions that lead Homestead hospice from -1,000,000 of net revenue to 147M 2018-2019.

● Facilitated financial, operational, and clinical documentation reviews for Homestead Hospice resulting in revenue enhancements opportunities, coding improvements with a cash flow increase of 8M across all lines of business. Exceeding Revenue Goals consistency on a monthly basis.

● Demonstrated value to CEO, CFO, COO and Brightree Executive Leadership and IT Team on creating Palliative Care Line of business. Aligned Homestead Hospice services with national palliative care quality standards. Responsible for the development of coding, billing, pricing, and clinical documentation working diligently with Brightree IT Team. Performed continuous quality improvements and trained other Brightree hospice clients on how to set up their Palliative Care program inside EMR.

● Lead created supportive innovation environment, motivated and influence, manage a vision/goals and purpose, manage change, prioritize and delegate, made decisions, and lead revenue cycle, accounts payable and operations work teams.

● Responsible for monitoring and resolving past due Accounts Payable and vendor dispute issues and develop and coached the

● Manage Vendor/Client Relationships – Conflict management, negotiations, persuasion/soliciting ideas, and team building.

HEALTHCARE SOLUTIONS/ (OPTUM 360) A UNITEDHEALTHCARE COMPANY DULUTH, GEORGIA SENIOR REVENUE

CYCLE MANAGER, 08/2007 – 6/2016

Reported to SVP of Revenue Cycle at Healthcare Solutions Inc. Providing health cost management solutions and strategies for Medicare, Workers Compensation and Auto Insurance markets in the United States. Also providing pharmacy benefits programs, such as clinical management, utilization, network penetration, injured worker’s/policy holders compliance, claims administration productivity improvements; and ancillary health services, including provisions of durable medical equipment, supplies, orthotics and prosthetics, home healthcare, transportation, translation, diagnostic imaging, dental services and Sequoia, a technology that enables its customers to access Medicare set-aside management. Healthcare Solutions was successfully sold to Catamaran, Inc. in April 2015 $17B Net Revenue Annually. In August 2015 Catamaran, Inc. was successfully sold to United Health Group Inc. / Optum RX ($130B Net Revenue Annually).

Accomplishments:

Providing Price Transparency

● Created a price structure catalog which communicated the link between pricing and quality so patients can see the cost saving for each procedure conducted within the scope of the organization. Increased patient satisfaction rate by 98% as well as self pay rate.

● Engaged in revenue cycle analysis, planning, budgeting and reporting to Executive Leadership in evaluating financial productivity and avenues for enhancement, including business development and revenue enhancement initiatives which lead to an increase of 15B.

● Established a centralized revenue cycle department that generated accurate revenue cycle which maximized cashed flow by 30B.

● Presented ad hoc revenue cycle reporting for executive team to analyze current strategic direction and evaluate new business opportunities

● Responsible for ensuring accounts receivables / invoicing and Accounts Payable meet Corporate Key Performance Indicators (KPI’s).

● Work directly with Government audit teams to submit Provision rates submissions, accounting system accreditation, and contract closeout.

● Work directly with financial reports, financial KPI'

● Worked with and coordinated with third party revenue cycle vendors/ clients to ensure KPIs are met to maximize revenue cycle performance.

● Demonstrated support for corporate compliance program’s by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations and corporate policies and procedures policies that affect functions, responsibilities, and reporting compliance issues or concerns in a timely and appropriate manner.

APOLLO MD – ATLANTA, GEORGIA

SENIOR ACCOUNTS RECEIVABLE MANAGER, 01/2006 – 08/2007 Reported to the CFO of the company. ApolloMD is a privately held, multispecialty physician practice that focuses on Radiology, Emergency Medicine, Anesthesia, partners with surgery centers, health centers and provides professional services to over 60 Hospitals in 14 states. Annual receipts of approximately

$240M with visits that exceed 1.6 annually. AppolloMD delivers solutions to the many challenges confronting the healthcare industry through 100% value-based compensation structure for its physicians. A privately held organization servicing 12,981,675 patients served by AppolloMD physicians. Accomplishments:

Risk Pool Settlements and Incentives

Risk pool settlements and incentives revenue of $10M for the quarter ended 2006, an increase of 45% as compared to $ 4M for the quarterly ending primarily due to the timing of incentives revenue paid and recognized through processes improvements and credentialing physicians within the networks.

● Created a platform that combines artificial intelligence, machine learning and natural language processes with expertise to provide results-driven solutions and useful technologies which was incorporated into the daily revenue and operations practice to increase revenue $9M with Denial Management Prevention Recovery Escalation process. Vale-Base Care

● Moved away from what has been a predominantly fee-for-services healthcare model to empower the physicians to focus on the quality of care they provide to patients while lowering the overall cost of care and increasing profit margin over 45%. Technology and Data Analytics with Clinical Expertise

● Combed technology and data analytics with clinical expertise to obtain a deep understanding of value-based Healthcare from a clinical perspective with software engineering, machine learning and artificial intelligence methods increased revenue to $14M

● Platform has processed approximately 2 million claims with no human intervention across its 12 IPAs and all lines of business, saving nearly 20,000 hours of manual claims review. Utilization Management Automation

● Saved thousands of hours of examiner effort by processing authorizations request with no human intervention across all lines of business which was an increase of $6M TENET HEALTHCARE – NORCROSS, GEORGIA

CBO REVENUE CYCLE SUPERVISOR, 02/2001 - 01/2006

Reported to the VP of Revenue Cycle at Tenet Healthcare. A National Diversified Healthcare Services Company with 110K employees and more than 2,200 physicians and healthcare providers across the United States. Through an expansive care network that included 65 acute care and specialty hospitals, as well as other facilities within the hospital operations segment include primary and specialty care clinics, diagnostic imaging centers, micro-hospitals and off-campus emergency departments and a large physician CBO. Many of the local hospital networks also include facilities operated by USPI, such as ambulatory surgery centers and urgent care centers. Conifer processes more than $30B in Net Revenue with over 6.1 million people and supports clients across multiple healthcare industry segments including healthcare systems, physician groups, health plans and self-insured organizations. Accomplishments:

Results and Outcomes Management

● Use Support Standards – I applied benchmarking, collected and analyzed data, created a performance improvement environment, and applied LEAN principles.

● Plan and Execute – Applied analytical thinking, plan and prioritize, problem solve and innovate, manage projects, and hold self and others accountable in the CBO. Budget and Financial Management

● Financial Acumen – Analyze reports and data/take appropriate action, develop/monitor and adjust budget, manage staffing and scheduling based on productivity, develop and analyze requests for revenue cycle proposals.

Services Management

● Enhance Customer Satisfaction – Use complaint management and services recovery, apply clinical quality management, monitor and improve patient and customer satisfaction, and use stakeholder identification and communication.

● Plan Strategically – Utilize patient and customer satisfaction data, utilize employee engagement data, and assess population needs.

EDUCATION HISTORY

(BSHA) HEALTH ADMINISTRATION – BRADFORD COLLEGE – HAVERHILL, MA MEDICAL ASSISTANCE – GEORGIA MEDICAL INSTITUTE – ATLANTA, GA MAY 1995 – AUGUST 1995 HIGH SCHOOL DIPLOMA – SOUTHWEST DEKALB HIGH SCHOOL – DECATUR, GA – AUG 91- MAY 1995

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