Management Revenue Cycle

Rebecca France MBA

*** ** ****** ***** **** Palm City Florida 34990

(M) 718-***-****

**********@***.***

Summary

Operation and revenue cycle expert with 15 years of experience in cost control, performance improvement and physician management. Continuous change actions to reduce cost, enhance quality, and increase positive operating margins with a team approaching and hands on management style.

Experienced in pharmacy, DME, physician practice, clinic and acute /sub acute care operations that includes action oriented results. Merger and acquisition, due diligence experience for RCM for large health care system within New York.

Education

MBA Health Care Administration - Health Care administration and finance / Business development certificate- Regis University, 2007

Bachelors of Arts - Psychology - Binghamton University, 1996

Certificate of Merit -Scholarship award Leopold Eckler

Associates in Science - Mental Health - Broome Community College 1993

Award of Distinction Technology Skills

Access, Excel, Word, PowerPoint, Visio, Oracle, PeopleSoft, and IDX, GE Centricity, Meditech, SSI, EPIC, Repository, ADL, MISY, Rate Manager, HSS, HBOC, CERMES,MACS,PACS,CU,HBS,TIMS, System conversion and installs.

Certifications

Business Development, Steven Covey Leadership training, Mental Health counseling

Member

HFMA PA/NY Chapter membership, AHAIM membership, Revenue Cycle Management

Experience

Liberty Medical Supply/Medco Health Solution Port St Lucie Florida

Medco’s 2010 net revenues were $66 billion; it is ranked number 35 on the Fortune 500 list. Liberty Medical: Diabetes management, home healthcare products and Medicare specialists. Liberty Medical Supply, Inc., Medco provides clients with industry-leading home-delivery services for diabetes testing supplies, prescription medications and other diabetic and nondiabetic medical products.

Director of Revenue Cycle Management 2011 –Current

Reporting to the System VP of Revenue Cycle Management with a team 600 FTE’s that include onshore and offshore responsibilities. 8 Direct Reports

• Revenue cycle management for national based RCM team includes multiple states

• Publicly traded SOX’s, SOP SLA matrix system responsibilities

• Contract negotiation and development

• Insurance verification

• Billing

• Denials management reorganization and vendor oversight for offshore

• Finance and cost management

• Reimbursement and strategic pricing

• System upgrade and integration

• Compliance and regulation maintenance within RCM

Bon Secours Health System New York Division- System Net revenue $900 million

The New York division is a part of a multi-state matrix health care system.

The NY Division is comprised of three acute hospitals, two SNF’s, Hospice, homecare, two free standing dialysis centers and a medical group. Good Samaritan Hospital is a non-profit, 370-bed hospital/ Level II Trauma Center. Bon Secours Community

encompasses the hospital with 187 beds for acute care and medical/surgical services, including long-term care and behavioral health services. St. Anthony Community Hospital is a non-profit, 73 bed hospital. Schervier Pavilion is a 120 bed, skilled nursing facility. St Joseph’s Place offer long-term nursing care while Mount Alverno Center provides quality adult residential and assisted living services. Day-At-A-Time, Bon Secours Charity Health System's adult day care program, Bon Secours Medical Group Physicians consist of 150 physicians.

Vice President of Revenue Cycle- 2010 –2011

Revenue Cycle consists of Patient access, CBO, revenue integrity, CDMP, call center, charge master integrity, and HIM. Reporting to the corporate office SVP of Integration with the responsibility for revenue cycle team 300+ FTE’s. 10 Direct reports include Case Management, CDNP, Patient Access, HIM,CBO, Revenue Integrity, Physician Revenue ,call center and collections.

• Redesigned and implemented revenue integrity team to monitor and increase revenue flow.

• Implementation of EPIC modules.

• Redesigned revenue cycle flow to be aligned with the HSO directives.

• Redesigned and restructure of consolidate HIM, Patient access, and integrated call center

• Case Management and CDNP over site and management.

• Strategic pricing initiative

• Contract management

Guthrie Health Systems, Sayre PA- System net revenue flow $700 million

This large health care system is comprised of three acute care Hospitals, LTC, Hospice, Physician group and an Ambulatory Surgery Center.

Robert Packer Hospital is a 264 bed level 1 trauma, research and teaching facility that was nominated as a top 100 Cardiac Hospital, Corning Hospital is a 99 bed hospital with a free standing Cancer Center, Breast Imaging Center, and off campus Erwin Rehabilitation center, Troy Community is a 25 bed Critical Access Hospital, swing/vent.

Guthrie Same Day Surgery Center is a free standing Ambulatory Surgery Center

Systems Corporate Director of Patient Financial Services 2007- 2010 Reporting to the VP/CFO with responsibility for revenue cycle team of 105 and operational systems within Patient Financial Services. Includes a FTE reassessment and reassignment.

• Process improvement for business operations that include patient access, billers, coding, charge master maintenance, payment posting, refunds, and AR analysis.

• Successfully implemented phase one of EPIC EMR/OPTIME/PHARMACY and test phase of EPIC Radiant through strategic planning committees.

• Implemented payor audits groups and revenue cycle team review committee to reduce late charge and denials by 35%

• Weekly revenue cycle review and education for department staff determined to have a significant impact on revenue flow

• Implementation of credentialing and compliance review for Federal and State audit for New York and Pennsylvania

• Gross margin review of revenue flow for departments that impact cash flow.

• HIM /UR reviews to reduce coding and Physician queries for order and documentation errors.

• Implementation of POS collection that included patient education of levels of care.

• Revenue cycle management that includes corporate compliance, system IT and contract enforcement.

• NYAPG,APC,APRDRG updates.

• M & A RCM due diligence for acquisition of smaller acute care systems.

Metropolitan Jewish Health Systems, Brooklyn, New York - 1 billion in Net revenue

Is very well known health care system that showcases a unique organization. MJHS includes Sub acute, LTC, Home care, in house hospice, managed Medicaid and Medicare. MJHS was recently the recipient of a 17 million dollar HEAL grant.

The system included three major facilities, MJGC 519 bed facility that has a RUSK affiliation and referral base hospitalist program within Maimonides Medical Center, SJGC 364 beds LTC and sub acute rehab specializing in wound care and physical therapy, Menorah 264 beds acute and sub acute rehab center certified vent,

Each facility houses an on- site clinic that is made up 60 specialty physicians for all three sites. The LTC services also include 24/7 Physicians Group LLC, Hospitalist, Fellowship program, onsite pharmacy, and DME.

Corporate Director of Clinic and Vendor Services and Prospective Payment Systems 1999-2007 Reporting to VP/CMO and dotted line to CFO

• Revenue cycle management for third party billing acute care, physician, sub acute and cancer treatment center with a team of 50. Reduced FTE needs by 10.

• Systems team leader for Medicare cost report and physician revenue cycle analysis

• Implemented contract management and negotiation to include outlier and carve outs,

• System billing maintenance and implementation of web based products to reduce denial management

• Revamped ancillary billing to electronic transfer system to increase revenue flow by 25%

• Revenue cycle review team trained to review and complete daily reconciliation of system batch transfers

• Revenue review for unbilled verses billed to reduce AR days. Implemented over 90 accountability and monthly variance report reviews. Reduced AR days from 102 to 38

• Gross margin accountability

• Restructured Pharmacy billing, auditing, utilization

• Audit cost control for all departments that included Physician training and P4P

• Manage clinic and equipment licensure and consultant physician contracts.

Specializations, Diagnostics, Treatment, EPrescriptions, Lab Analysis Reports, X-Ray, EKG, DME reports, Dental clinics,

• Enforcement of Federal and State regulations concerning level reimbursement and

capitated rates, which include audits and analysis of, contracted service rates.

United Methodist Homes Hilltop Retirement Community, Johnson City, New York

Is a Continuing Care environment that includes skilled nursing and Dementia care units, Assisted Living, Adult Home, and independent apartment living with Home Care services. UMH was known for capturing the needs of the elderly and allowing them to live with dignity and respect with in a safe environment. This center had a wait list of clients.

Director of Case Management, 1996 -1998

• Directly involved in planning, budgeting, admissions t

• Content knowledge of patient assessment, case management, and

documentation skills.

• Implemented Medicare and Medicaid regulations

Prepared financial statements and department budgets.

• Social work, and care planning, risk management assessments and crises intervention services.

• Restructured admissions contracts and screening process to reduce payment issues.

Onsite hospital assessment reduced inappropriate admission by 15%

Advanced knowledge of Case Management and understanding of Disease Management

Previous C.N.A, CHHA experience for homecare agencies in 1982 - 1991

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