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Vp Of Revenue Cycle Management Resume

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Hamilton, OhiO

SUMMARY:

  • Highly experienced financial executive who works with other senior leadership team members to manage all financial aspects of the company. Possess a thorough understanding of healthcare financial management and the insurance industry. Scope of responsibilities has included financial reporting, annual budget planning and analysis, cash flow, sales to key referral sources, due diligence and negotiating of contracts with various insurance companies.
  • Prior to Premier Health, I was extensively involved in the financial managing of multiple locations nationwide. While at Premier Health and Confidential, my key functions included monthly financial preparations financial results, provider credentialing, EPIC, compliance and process improvements for all billing and collection functions, and bad debt analysis. I excel in streamlining processes, leading teams and developing organizational financial strategies.

PROFESSIONAL EXPERIENCE:

Confidential - -Hamilton, Ohio

VP of Revenue Cycle Management

Responsibilities:

  • Managed all financial aspects for multiple business divisions within Confidential . Long Term Care Division, Pharmacy, Behavioral Health, Rental Houses
  • Overall Company revenues are $50M annually
  • Prepared annual budget
  • Created new Revenue Cycle Management Department for the company
  • Work with all insurance companies for each division to negotiate and manage contracts
  • Have worked to streamline all monthly financial reporting results to each of the divisions Board of Directors
  • Reviewed and have created to streamline many new processes for the company
  • Created Compliance and Process improvements throughout the company saving so far in excess of $300K for the budget
  • Implemented successfully a new billing system for the Behavioral Health division
  • Working to implement and update new billing system for the Pharmacy division to accurately bill all services
  • I have created multiple written documented Revenue Cycle Management processes for the billing and accounting teams to streamline the financial reporting
  • I have created a reporting dashboards to show improvements in billing and cash flows for each division for all senior leadership to view all trends to expand all business opportunities

Confidential - Dayton, OH

Director of A/R Services

Responsibilities:

  • Created new centralized payment posting department for entire network in order to transition banks to save our division over $300K per year
  • Prepared the annual budgets
  • Created new physician credentialing department
  • Created Compliance and Process Improvement Department
  • Work with all insurance companies to negotiate contract rates, and to resolve outstanding claim issues
  • Worked to make improvements in our EPIC billing system to ensure we are using the system to full capability
  • Improved our EPIC department for the network billing staff
  • Responsible for over 1,000 Providers coding, billing and collection of A/R in the CBO
  • Managed 200+ employees, 15 of those are direct reports
  • Working to transition the Non CBO Provider locations into the CBO office location
  • Have developed new policy and procedures for my various departments within A/R Services and the accounting department in order to create accountability to drive results
  • Have reorganized the Central Business office billing teams to work more efficient in the daily work flow processes as well as created accountability for the month end goals
  • Have lowered the days in AR from 68 down to 38 for the CBO with multiple specialty billing responsibilities
  • Manage variety of Provider specialty service types
  • Streamlined many accounting functions

Confidential - Cincinnati, OH

Director of Revenue Cycle Management

Responsibilities:

  • Increased cash collections during 2013 vs. 2012 by 66%
  • Decreased DSO by 102 days
  • Lowered the bad debt reserve by 52%
  • Hired and trained all new staff for each reimbursement functions for new division
  • Worked with all insurance companies to review contract rates, to resolve claim issues
  • Work with offsite pharmacy locations to ensure patients shipments are reimbursed
  • Daily interactions with CFO, and sales staff
  • I managed staff both on and off site at the other pharmacy locations
  • Developed reimbursement policies and procedures for department

Confidential

Director of A/R Department

Responsibilities:

  • Reorganized the reimbursement functions, streamlined processes and provided consistent leadership in successfully merging all 50 branch locations into one A/R department; resulted in a 60% increase in monthly cash flow and a reduction of bad debt by 40%.
  • Developed strategic collections plans for teams, created implementation schedules, and gave directional advice to help resolve issues with top payers
  • Impacted departmental attainment of monthly cash/bad debt goal targets with a monthly average of $20M
  • Reduced outstanding invoice credit balances from $20M down to $9M by developing a reduction plan and facilitating the efforts of selected project team members.
  • Performed Bad debt analysis of the overall A/R on a monthly basis to keep the bad debt % at or below 4% of the overall A/R
  • Ensured correct payment amounts by staff on all aspects of the collections process, including interpretation of contract language of numerous insurance companies

Area Reimbursement Manager

Confidential

Responsibilities:

  • Implemented collection plans for key accounts reducing DSO by a total of 48 days; this improvement led to recognition as being the best region in the company.
  • Attained the lowest bad debt % on adjustments and the cleanest outstanding Medicare documentation needed in order to bill out of 5 regions
  • Implemented electronic billing and virtual filing system for the region resulting in faster payment turnaround time by approximately 35 days.
  • Audited branch reimbursement charts ensuring accurate billing of HCPC and J codes
  • Reviewed month end revenue verifying accuracy of revenue, and adjustment request
  • Worked with sales staff to market to referral sources in order to get therapies covered with insurance companies for their patients

Reimbursement Manager

Confidential

Responsibilities:

  • Held the lowest branch DSO of 40 in the company
  • Created and implemented collection techniques for other reimbursement staff to follow
  • Lowest branch bad debt % in the company

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