Description :

1. Established Process Improvement Teams to address critical cash flow issues, enhancing revenue collection efficiency.
2. Achieved a revenue increase of $18.4 million over three years through targeted process enhancements.
3. Reduced Net Days in Accounts Receivable to 36 while maintaining departmental budgets and minimizing authorization denials.
4. Oversaw financial hardship approvals and patient portion write-offs, improving patient relations.
5. Managed payer websites and bulletins, ensuring compliance with policy changes affecting collections.
6. Supervised all billing edits related to claims processing to ensure timely claim submissions.
7. Implemented a new workflow system to streamline billing operations and enhance team productivity.

Experience

5-7 Years

Level

Management

Education

MBA

Description :

1. Directed daily operations of an Orthopedic Business Office for 28 physicians, enhancing overall revenue cycle performance.
2. Reduced net accounts receivable days to 34, significantly improving cash flow and operational efficiency.
3. Increased cash collections by $500K in the first year, surpassing previous year’s charges by over $2 million.
4. Established key performance indicators (KPIs) to track revenue cycle effectiveness and drive team performance.
5. Managed critical functions including coding, billing, and financial counseling, ensuring compliance with regulations.
6. Oversaw staffing and development initiatives within the Revenue Cycle department to enhance productivity.
7. Monitored multi-million dollar accounts receivable and payer regulations to optimize financial outcomes.

Experience

7-10 Years

Level

Senior

Education

MHA

Description :

1. Developed and executed strategies to enhance the revenue cycle, resulting in improved financial outcomes.
2. Compiled and presented financial data to the governing board to inform strategic decisions.
3. Oversaw the operations of three rural health clinics, focusing on efficiency and quality.
4. Directed the billing department, ensuring compliance and accuracy in all processes.
5. Collaborated with the admissions team to implement effective point-of-service collections.
6. Utilized extensive knowledge of the revenue cycle to identify and rectify process inefficiencies.
7. Applied strong organizational skills to streamline revenue cycle operations, enhancing reimbursement timelines.

Experience

10+ Years

Level

Management

Education

MHA

Description :

1. Successfully implemented a new practice management software, resulting in a 20% increase in billing efficiency.
2. Facilitated the successful launch of three new centers, contributing to a 15% growth in annual revenue.
3. Designed and executed a comprehensive training program, enhancing staff performance and reducing onboarding time by 30%.
4. Consistently achieved monthly collection targets, improving cash flow by 25% year-over-year.
5. Negotiated favorable contracts with insurance carriers, resulting in a 10% increase in reimbursement rates.
6. Oversee all aspects of revenue cycle management to optimize financial performance.
7. Develop and implement strategies to improve billing and collections processes.

Experience

0-2 Years

Level

Entry Level

Education

B.S. in HCA

Description :

1. Planned and directed revenue cycle operations, including claim generation, AR follow-up, and reporting enhancements.
2. Supervised hiring and training processes, ensuring staff are well-equipped to meet departmental goals.
3. Analyzed Key Performance Indicators weekly to identify areas for operational improvement.
4. Formulated strategies to achieve departmental objectives when performance goals are not met.
5. Managed Denial Management processes, identifying patterns and developing strategies to minimize revenue impact.
6. Coordinated performance benchmarks and quality standards for revenue cycle operations.
7. Collaborated with cross-functional teams to enhance operational efficiencies and patient experience.

Experience

10+ Years

Level

Executive

Education

MBA

Description :

1. Reduced holds over 30 days by 50% through targeted process improvements.
2. Conducted monthly regional calls to review key metrics including cash collections and denial rates.
3. Identified process deficiencies and error trends through data analysis and team discussions.
4. Managed detailed reports to track claim holds by category and assigned responsibilities.
5. Recruited and trained staff for the Revenue Cycle Department, enhancing team productivity.
6. Ensured accuracy in charge capture processes, including compliance with medical necessity regulations.
7. Implemented a new tracking system for performance benchmarks and quality standards.

Experience

2-5 Years

Level

Freelancer

Education

B.S. in HCA

Description :

1. Directed all revenue cycle operations for a multi-site outpatient imaging company with 32 centers across 4 states.
2. Established a Centralized Services department to streamline scheduling and authorization processes.
3. Led the transition to ICD-10 across all relevant systems, ensuring compliance and accuracy.
4. Designed and implemented PQRS reporting to enhance quality metrics.
5. Collaborated with hospitals and managed care organizations to optimize contracts and vendor relationships.
6. Oversaw operations management, analyzing processes to maximize efficiency in coding and claims filing while maintaining high customer service standards.
7. Served on the Internal Compliance Committee, developing policies and procedures to ensure regulatory adherence.

Experience

5-7 Years

Level

Management

Education

MHA

Description :

1. Managed audits of financial operations and developed a comprehensive collections strategy for outstanding accounts receivable.
2. Led the hiring process and conducted employee performance reviews, revising policies to enhance operational efficiency.
3. Coordinated surgery scheduling, including pre-authorizations and patient payment plans.
4. Oversaw IT updates and ensured system connectivity and security compliance.
5. Conducted Security Risk Analysis, developing risk assessment strategies to protect patient data.
6. Provided operational direction to a high-performing revenue cycle team, promoting a culture of excellence.
7. Created policies and procedures to ensure accurate and timely revenue capture and billing.

Experience

2-5 Years

Level

Junior

Education

BSHM

Description :

1. Evaluated and restructured the Patient Financial Services department, aligning personnel with skill sets for optimal performance.
2. Redesigned departmental workflows to enhance efficiency and accountability.
3. Developed ongoing education initiatives for staff to stay current with industry standards.
4. Restructured Health Information Management and Coding departments, ensuring proper coding certification and workflow optimization.
5. Monitored quality metrics and productivity trends to provide actionable insights for improvement.
6. Oversaw coding audits and collaborated with compliance teams to ensure adherence to regulations.
7. Maintained accurate payer files for effective claim submissions and timely month-end reporting.

Experience

7-10 Years

Level

Senior

Education

MHA

Description :

1. Maintained accounts receivable for nine psychiatric hospitals, ensuring timely collections.
2. Supervised and trained a team of 21 staff members, enhancing operational efficiency.
3. Collaborated with utilization management to resolve denials related to medical necessity and pre-authorizations.
4. Educated staff on billing and collection policies, improving compliance and accuracy.
5. Credentialed over 38 doctors with Medicare and commercial carriers, expanding service offerings.
6. Reconciled cash receipts and accounts receivable to ensure accuracy in financial reporting.
7. Oversaw the Billing and Collections for the Physicians Central Billing Office, improving cash flow.

Experience

0-2 Years

Level

Fresher

Education

BSHA