Healthcare Executive - Operations Director - Revenue Cycle Management
  • Swedesboro
  • May 6, 2020

More than 30 years’ experience leading healthcare revenue management AR and Operations. Core competencies include optimizing revenue recovery, redesigning work processes, knowledge transfer, and training. Adept in the management of Revenue Cycle systems:
Coding management Denial management Accounts receivable
Inventory accountability Call center + patient services Medical records
Insurance verifications Cash management ER reimbursement

E-mail
Locked
Phone Number
Locked

Experience

Director of Operations @ Zotec Partners
Apr 2001 — Feb 2018

CONSULTANT — HEALTHCARE REVENUE MANAGEMENT
Client list:
• ASPIRE BARIATRICS
o Patient access management consultant.
o Establish workflow to coordinate insurance coverage for Bariatric services. Scope included establishment of pre-authorization between patients and insurance carriers, as well as setting operations for appeals.
o Six-month engagement.
• BRAULT/EGO
o Director of Patient Access for national emergency physician coding and billing company in Southern California
o Operations change management for high-volume call center, including:
 Development of Standard Operating Procedures and Quality Control standards. Evaluated staff, with a goal of providing the premier patient experience for clients.
 Establishment of performance standards, including daily average call volume, average call length, abandoned call statistics. Managed staff to ensure performance standards were exceeded.
 Six-month engagement.
DIRECTOR OF OPERATIONS
• ZOTEC PARTNERS, 2014 TO FEBRUARY 2017
• CBIZ MMP, 2009 TO 2014 (Acquired by Zotec)
• HBR, VP of Operations 2001 TO 2009 (Acquired by CBIZ MMP)
Responsible for daily operations and internal controls of professional Emergency Medicine coding and billing services. Areas of ownership included all workflow involving chart flow, coding, charge entry, claim processing, cash posting, denial management, accounts receivable, reimbursement and provider enrollment.
Led 200+ domestic and global employees in the professional coding and billing of 2 million+ annual patient visits.
• Liaise with clients, Client Services and Sales to provide excellent customer service. Quickly resolve client escalations; define, develop and implement action plans to maximize client satisfaction.
• Key member of offshoring implementation team, migrating most functional tasks to Omega Healthcare in India.
o Vendor selection and setup.
o Initial implementation wave established lock boxes, enabling offshore vendor to gain image access to post-cash receipts through our workflow software.
o Phase two implemented access to scanned medical records to offshore vendor, enabling ICD9 and CPT coding and charge entry. Developed, trained and implemented internal controls and QA to ensure accuracy and compliance.
o AR tasks included insurance follow-up, claim acknowledgement (tracking claims submitted to carrier vs claims received by carrier), insurance eligibility updates, and refiling of claims.
DIRECTOR OF PATIENT ACCESS AND PATIENT ACCOUNTING
COOPER MEDICAL CENTER, 1992 TO 2000
Maintain full accountability for Admissions and Emergency Department registrations, as well as Patient Accounting for all hospital-based services of a large teaching hospital. Led process improvement initiatives resulting in efficiencies in major diagnostic areas, including Radiology, Lab, Surgical Services, as well as Patient Access and Business Office redesign.
• Captured otherwise lost revenue by conceiving and implementing an Internal Charge Audit Program in the Medical Records department.
• Provided defense support against outside auditors. Folded compliance training into orientation and education programs, resulting in improved compliance with documentation and correct charging protocols.
DIRECTOR OF PATIENT ACCOUNTS
SOUTH JERSEY HEALTH SYSTEM, 1986 TO 1992
Initial employer was Millville Hospital who merged with Bridgeton Hospital creating the South Jersey Health System.
• Led Patient Financial Services of a two-hospital system, including Admissions, Emergency Department and Outpatient registration areas. Successful merger of two hospitals’ Patient Financial Services departments. Member of core team selecting patient accounting system. Established a central business office, consolidating business office operations.
Prior Professional Experience:
o Business Office Manager
o Outpatient Business Office Manager
o AR Supervisor
o Hospital Cashier
o Emergency Department Registrar

Contact Candidate

Login or register as Employer to contact this candidate.