Revenue Cycle Home Health

REVENUE CYCLE MANAGEMENT EXECUTIVE

EXECUTIVE MANAGEMENT SUMMARY

Over 20 years of Revenue Cycle Management success in the healthcare industry

RCM leadership for Academic Health Systems

RCM leadership for Level 1 Trauma Centers

RCM leadership for Children’s Health systems

Home Health RCM leadership

Hospice RCM leadership

Critical Access RCM leadership

RCM leadership for large group practices

RCM front end, revenue integrity, coding and backend leadership

Reformation of patient scheduling and EHR optimization

Patient Access leadership / pre-service collections

Develops sustainable performance through analytics, metrics, reporting and leadership

Manages outcomes via denial management Payment Variance analytics

Managed Care Contracting and optimization

Control cost through budgeting, staffing, productivity and resource utilization

RCM KPI Analytics and optimization

Denials Management development and mitigation strategies

EHR RCM Design, Implementation and optimization

RCM Vendor Management and accountability

Clinical Documentation Improvement (CDI) process and utilization of Clinical Documentation Improvement Specialists (CDIS) to improve cash collections and optimization documentation and coding

RCM Educational development

Charge Capture / Revenue Integrity optimization

Multi-state health system RCM operations leadership

RCM Consultation and EHR design for a Large 16 Health System management in Southern California

RCM Consultation and EHR design for a 7 Hospital system in the North East

EXPERIENCE

BROWARD HEALTH, FT LAUDERDALE, FL

Senior Consultant Revenue Cycle Department – Revenue Integrity (2024)

Epic go live assistance with various department executive directors and directors developing necessary reports, work flows, and charge reconciliation processes.

PROVIDENCE HOME HEALTH AND HOSPICE, AK, CA, OR, TX, WA

Senior Consultant Revenue Cycle Department (2022 to 2023)

I managed backend revenue cycle for billing and collections across 5 states. I identified major denials regarding the Notice of Admissions requirements by government and private payers for their Home health and Hospice lines of business. We appealed and won over 90% of the denials as well as developed system and work flow fixes to mitigate the issues moving forward.

SIGHT GROWTH PARTNERS, HAUPPAUGE, NY

Revenue Cycle Interim Executive Director (2022)

Reduced AR>90 from 37% to 30% via the automation of secondary billing

Reduced manual posting of cash by 50% due to the automation of secondary billing.

Updated and resolved payer identification issues within the EHR that provided the opportunity to identify and reduce denials

UNIVERSITY OF VIRGINIA HEALTH, CHARLOTTESVILLE, VA

Revenue Cycle Project Manager (2022)

Epic Implementation Project Manager responsible for establishing necessary meetings, documenting requirements, tracking project status updates and risks, performed analysis and design for Patient Access and Billing/Collections.

PRISMA HEALTH, COLUMBIA, SC

Interim Executive Director (Service Area VP) (2019 to 2021)

I developed a denials management/underpayment team and provided work flows and education that helped reduce initial denials by 20%.

I conducted a cash acceleration project by providing focus on point of service collections program that increased collections by 20%.

I assisted in the development of Corrective Coding Initiatives by educating and rolling out Coding Specialists (CDIS) to review and optimize the coding of sever cases, which resulted in $2M+ more of cash per month.

Implemented cost reduction strategies by reducing our vendor footprint within revenue cycle and renegotiating contracts with our 3rd party vendors. The cost savings were in excess of $1M/month.

CHILDREN’S MERCY HEALTH SYSTEM, KANSAS CITY, MO

Interim Senior Director / AVP of Revenue Cycle Department (2017 to 2018)

Reduced credit balances from $10M to $3M

Promoted by CFO to Interim PFS Senior Director

Mobilized a cross-functional team to resolve duplicate charge posting for 6 months of Anesthesia charges and resolved billing errors

Identified as RCM subject matter expert working with Accenture to transform all of revenue cycle and develop best-practice work flows

ENGLEWOOD HEALTH SYSTEM, ENGLEWOOD, NJ

Senior Consultant for Revenue Cycle EHR (2016 to 2018)

Cerner IT Support services for all Revenue Cycle applications and integrations

DUKE UNIVERSITY HEALTH SYSTEM, DURHAM, NC (DUHS)

Interim Senior Consultant of Revenue Cycle Department (2011 to 2015)

Improved cash flow by automating Medicare IME billing. Prior to this automation, DUHS was billing the primary payer and waiting on the payment process before billing Medicare for the IME portion of the claim.

Assisted in the project management of the Epic EHR implementation for RCM as well as designed and built the charge conversion for inhouse patients at go live.

Implemented the new claim formats from 4010 to 5010 837 claim files.

Updated HIM coding process to the mandated ICD-10 format and coding structure

UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, JACKSON, MS

Interim Regional Director for Revenue Cycle EHR Optimizations (2010 to 2011)

Revenue Cycle IT Project Leader for PB and HB optimizations

I led a team of seven consultants working on all aspects of RCM operational and system improvements for scheduling, admissions, backend billing and secondary billing updates, IME billing automations, and contract calculations to net down the AR at time of billing

ST. VINCENT HEALTH SYSTEM, INDIANAPOLIS, IN

Revenue Cycle Project Manager Lead (2010)

Project Management Lead for RCM Optimization and Reconfiguration, which includes Medicare and Medicaid corrective claims and denials mitigation

ST. MARY’S MEDICAL CENTER, EVANSVILLE, IN

Revenue Cycle Project Manager (2009)

Primary responsibilities were to review the RCM EHR set up and design, identify production improvements through use of new technologies, improve and optimize system design, automation, and performance, and identify revenue and cash improvement opportunities

JACKSON HEALTH SYSTEM, MIAMI, FL

Revenue Cycle Project Leader/Manager (2008 to 2009)

Improved cash flow via automations to IME Billing and integrations to charge capture

Ensure proper reimbursement calculations for accurate net down of AR at time of billing

MERCY HEALTH SYSTEM, TOLEDO, OH

Interim RCM Regional Director (2008)

Improved Medicaid cash collections by $5M /YR with billing improvements

Mentor staff on RCM EHR capabilities and Project Management methodologies.

EASTERN MAINE HEALTH SYSTEM, BANGOR, ME

Senior RCM IT Consultant (2007 to 2008)

NORTH SHORE LONG ISLAND JEWISH HEALTH SYSTEM, SYOSSET, NY

Revenue Cycle Project Manager (2007)

RCM EHR Implementation

ALBANY MEDICAL CENTER, ALBANY, NY

Interim RCM IT Manager (2007)

DUKE UNIVERSITY HEALTH, DURHAM, NC

Senior RCM IT Consultant/RCM Project Leader (2007)

WESTCHESTER MEDICAL CENTER, VALHALLA, NY

Revenue Cycle Consultant (2005 to 2006)

EASTERN MAINE HEALTHCARE SYSTEM, BANGOR, ME

RCM IT Consultant (2005)

ST. LUKE’S REGIONAL MEDICAL CENTER, BOISE, ID

IT Project Manager (2004 to 2005)

Consolidation of multiple EHR platforms into a single occurrence

COMPUTER TASK GROUP HEALTHCARE, CINCINNATI, OH

Senior RCM Consultant (1999 to 2004)

COLUMBUS REGIONAL HEALTHCARE, COLUMBUS, GA

Manager of Financial Applications (1995 to 1999)

CAROLINA HOSPITAL SYSTEM, FLORENCE, SC

Information Services Director (1990 to 1995)

CREDENTIALS

TROY UNIVERSITY, TROY, AL

M.B.A

FRANCIS MARION UNIVERSITY, FLORENCE, SC

B.S. in Computer Science and Mathematics

HFMA CRCR Certification 2022

INDUSTRY EXPERIENCE

10 years of Epic experience

15 years INVISION Experience

20 years of personnel management experience

Over 20 years in the healthcare

5 Years Home Health & Hospice

2 Years Critical Access

20 years of Project Management experience

CHIME and HFMA member

HFMA CRCR Certified

EPIC EXPERIENCE

Resolute HB and PB

Integrations

Reporting

INVISION EXPERIENCE

Patient Accounting

Patient Management

HEALTHCARE ORGANIZATIONS

Broward Health

Providence Home Health and Hospice

Sight Growth Partners

University of Virginia Health

Prisma Health

Children’s Mercy Health System

Englewood Health System

Duke University Health System

University of Mississippi Medical Center

St. Vincent Health System

St. Mary’s Medical Center

Jackson Health System

Mercy Health System (OH)

Eastern Maine Health System

North Shore Long Island Jewish Health System

Albany Medical Center

Duke University Health

Westchester Medical Center

St. Luke’s Regional Medical Center

Columbus Regional Healthcare

Carolina Hospital System

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