Revenue Cycle Manager/Project Manager

TEDDY R. JENKINS

***** *.*. ****  Newalla, OK **857  405-***-****  sj58yi@r.postjobfree.com

Professional Summary

Dedicated Healthcare Revenue Cycle/Project Manager executive with 20+ years experience in organizational management, financial process, workflow and operational procedures in hospitals and multi-disciplinary settings. Outstanding communicator experienced in implementing EMR and Practice Management software who excels at facilitating internal and external resources to implement programs, projects, and organizational change. Offers experience with human resource management, managed care process, charge master, rate setting, financial eligibility criteria, fee for service adjudication systems, electronic claims, HIPAA and other federal regulations.

Key Proficiencies

Organizational Management

Teambuilding & Supervision

Staff Development & Training

Positive Community Relations

Accounts Receivable/Payable

Report & Document Preparation

Spreadsheet & Data Analysis

A/R Claims EDI Structure

Operational Budget

Finance Decision Support

Clinical Quality Management

Patient Access & Confidentiality

Experience

Oklahoma Department of Mental Health and Substance Abuse Services 1986 to 2010

ODMHSAS - Central Office Administration, Oklahoma City, OK - Reimbursement Coordinator 2000 to 2010

• Administered the Accounts Receivable of 12 state facilities(36 sites) and Central Office location. Provide personnel assistance, on-site training, interpretation and problem solving support to administrative and clinical staff. Supply consultation to facilities and contracted providers on regulation updates, A/R vendor systems, existing rules, regulations and laws governing hospital, community mental health and other program charges.

• Performed project management role in the purchase, development of business practices, training workgroups, detail table setup for implementation of on-site clinical information system. Pre-Admisson, Admission/Discharge, Scheduling, EMR and electronic A/R claims to any Third Party resources such as Medicare, Medicaid, Insurance and ODMHSAS's Integrated Client Information System (ICIS).

• Provide administrative guidance along with detailed procedures, training and methods in the use of the ICIS and Fee for Service claims adjudication systems. Maintained Eligibility Criteria used in determining consumer indigent status.

• Representative to legislative research and inquiries, Oklahoma Health Care Authority (OHCA), Medicare intermediaries, commercial insurance, and HMO's to resolve issues of state-operated and private non-profit mental health providers. Collaborated with department heads in current implementation of the merging of ODMHSAS and OHCA's information and claims systems.

• Establish contract with Managed Care and other Third Party revenue sources, negotiation of services, documentation requirements and price/cost to be reimbursed. Approve, complete and monitor contracts initiated by state facilities. Involvement in various audit teams to provider locations to research contract and documentation investigations and possible recoupment of funds.

• Developed and reviewed the process of rate setting procedures for A/R claims. Assist in developing and review rates for ODMHSAS's Fee for Service payment system.

• Prepared monthly A/R reports for board meetings. Analyzing the data for trends of decreased federal funding, client loads or system issues. Revenue increased from under $15 million dollars in FY01 to over $42 million dollars in FY2010.

• Interim HIPAA Coordinator, Governor’s task force on HIPAA implementation, statewide workgroups and ODMHSAS discussions related to EDI, disclosure of PHI and prevention of health care fraud and abuse.

• Immediate supervision of Reimbursement activity of Oklahoma County Crisis Intervention Center, Oklahoma Forensic Center, Rose Rock Recovery Center and Tulsa Center for Behavioral Health.

ODMHSAS - Bill Willis Community Mental Health Center, Tahlequah, OK 1989 to 2000

Reimbursement Officer Promoted to Central Office Reimbursement Coordinator

• Supervised the Reimbursement office functions for the 4 outpatient clinics and Chemical Dependency Unit (CDU). Established A/R procedures including client financial interviews documentation and entry of services provided, claims processing for Third Party sources and Self Pay clients and reconciliation of accounts. Develop policies and procedures, initiate Third Party revenue contracts for Central Office administrative review.

• Process clients of the CDU for approval of food stamps, monitor the activity and identify the appropriate amount to supplement the unit's cafeteria budget.

• Project annual revenue budget and prepare reports for Executive Director and the Reimbursement Coordinator of ODMHSAS.

• Develop procedures, collaborate with clinical staff, train all staff and incorporate audit activities related to performance and data entry ODMHSAS's Integrated Client Information System.

ODMHSAS - Western State Hospital, Woodward, OK 1986 to 1989

Reimbursement Assistant Promoted to Reimbursement Officer, Bill Willis CMHC

• Conduct client financial interviews, establish Third Party eligibility, data entry of account setup information, services provided, payments, adjustment and reconciliation of accounts for 4 outpatient clinics.

• Received all accounts receivable revenue for Western State Hospital, Ft. Supply Alcohol and Drug Treatment Center and Northwest Community Mental Health Center with daily reconciliation with accounting staff.

• Prepared monthly and quarterly audits for 4 outpatient clinic's finances, performance and personnel management. Prepared monthly accounts receivable reports for the Reimbursement Officer and executive management.

Education

• May 1985 - Southern Nazarene University, Bethany, OK, Bachelor of Science in Business Administration

• May 1985 – Oklahoma City Comm. College, OKC, OK, Assoc. Degree in Petro. Land Mgmt. - Incomplete

• December 1986 - Hi Plains Area Vo-Tech, Woodward, OK, Licensure as Real Estate Sales Associate

Community Involvement

• Church of the Nazarene – Sunday School Teacher/Breakfast Cook

• Athletics – Coach Soccer (& Referee), Baseball, Basketball

• Little League Football – Treasurer

• Charitable Events – Various walks and fund raisers.

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