PROFESSIONAL SUMMARY

Motivated, assertive systems accountant with over thirteen years of strong combination of cross-functional experience in diverse markets in health care: skilled nursing, home health, managed care, acute care, physician billing, rehabilitation, auditing.

FINANCE / ACCOUNTING

• Accountable for controlling accounts receivable in excess of 32.5 million per month, advised on rate structures, revenue maximization, and Medicare/Medicaid and Commercial reimbursement issues. Developed revenue cycle management teams and system applications and tracking tools to implement strategies for all facilities
• Reduced accounts receivable turnaround time by 50 percent by gaining access to key members of HMOs Humana, Aetna, Cigna, United Healthcare Kaiser, and Blue Cross/Blue Shield, Tricare to streamline cash flow processes. Developed and trained facility staff on EDI systems for managed care claims processing.
• Trained hundreds of facility staff in all aspects of admissions, accounting, clinical and systems applications processes, policies and procedures, state and federal regulations.
• Provided expertise to facilities for state and federal audits, JCAHO certifications.

MIS / TECHNOLOGY

• Increased productivity of office/support staff by 25 percent by creating and implementing fully automated systems for Medicare, Medicaid, and HMO billing, medical supplies and resident trust funds. Experience with Meditech, Accumed, Epic, Delta, Siemens,, Genecare and McKesson, Paragon ,Star, JD Edwards. FAS,MAS90 applications
• As accounting coordinator, developed and created a fully computerized and versatile data dictionary report writer that linked all product lines, and was utilized by the total Northeast region. Developed reports for real time data sales, finance and operations.
• As field accountant, responsible for all system implementation and continuous maintenance including software and server upgrades, system project management including migrations, data imports and exports.

OPERATIONS / MANAGEMENT

• Initiated changes and re engineered quality assurance and improvement processes while maintaining positive environment. Developed compliance teams for client feedback survey process and internal tracking process to identify user needs and requirements. Lead regional operations in the achievement of quality best practices, production and ethical protocols. Developed market assessment and developed business strategy.
• Ensured profitability financial and operational targets during transition into PPS, RUGs III environment, HIPAA, and MMIS .Implemented applications and process for medical necessity and CCI protocol for correct procedural coding. Responsible for overall management of data integrity, data analysis, report generation, claims adjudication payment and provider relations, utilization management and care coordination

PROFESSIONAL EXPERIENCE

Confidential

• Implemented action plans onsite for 90 day and day one projects for revenue cycle process improvement to maximize project results. Total AR 49.5 M resolved over 20000 cases on 90 day and 30M 12000 cases on day one per month
• Utilized KPI measures to monitor improve process performance for facility and staff Develop plan for staff for continuous monitoring of targets
• Trained onsite and service center staff for billing and follow up ,process develop proficiency for accounting applications for patient accounting billing systems, payer website ,claims scrubber, document imaging security, report writing
• Identify potential risks and financial compliance liabilities Contract negotiation and monitoring of reimbursement
• Responsible for project target resolution goal : exceeded initial placement resolution goals monthly by 20 . Exceeded cash collection goals by 35 overall since inception of project.
• Motivate and develop team for current and changing roles
• Develop reporting to identify patterns and trends in accounts receivable
• Analyzed AR fully and quickly to develop opportunities for recovery and resolution to ensure documented results. Presented onsite and to service center monthly results to the Executive tem. PFS and Revenue Cycle teams. Interfaced with executives and department leaders Patient Access .Clinical HIM, Revenue Cycle to provides solutions to expedite claims adjudication and reduce denials
• Developed process for resolution and appeals onsite for the denials team and revenue cycle team

Confidential

• Prepared budgets and system imports for multi divisional companies 140 million
• Generated profit and loss statements profitability 105 year to date
• Developed internal auditing compliance team and systems to reconcile all accounts to Generally Accepted Accounting Principles
• Prepared all taxes for federal state local and business
• Developed and lead project management team for implementation of uniform timekeeping system from Kronos to PIMMS for payroll process and interfaced into payroll systems
• Created and managed team to develop new transportation company to realize tax savings in excess of 250,000 and control costs including system development and process documentation
• Headed project to transition accounts payable process from manual to fully automated paperless
• Monitored receivables and implemented revenue cycle management to reduce bad debt to .06 for 2009. Implemented systems for automated cash receipts posting
• Lead team of twelve to transition accounts receivable process to a single uniform application to realize improve efficiencies and eliminate duplication of processes for invoicing and cash receipts
• Monitored IT team and tested data for transition of platforms from Citrix and Novell to Oracle and remote access server
• Reengineered changes in purchasing cycle to eliminate inefficiencies, implemented systems to reduce inventories 30
• Controlled FAS system, developed and monitored new capitals project including new plant operations and division operations
• Lead team to create interface to website to improve customer service by providing invoices and online bill paying
• Developed strategic management team and operational planning teams
• Created systems documentation -process and training for accounting functions
• Develop divisional controllers and financial analyst for performance reviews and feedback

Confidential

• Provided 13years hands on leadership and training to twenty skilled nursing facilities and two home health agencies and three acute care facilities in the following states: Maryland, Virginia, Massachusetts, Connecticut and New Jersey and Pennsylvania.
• Reported directly to Vice President of Operations, direct liaison between facilities and corporate office.
• Set up network protocols and health care applications on Oracle Novell, Citrix remote access network environment.
• Developed and lead transition teams to facilitate leading changes in healthcare: RCM,PPS CCI, MMIS
• Lead facilities projects for fully automated EMC and EDI billing processes for all payors
• Developed and implemented admissions, clinical, and business staff standards system training and system documentation
• Implemented systems to interface central and medical supplies from Orbits PDA to vendor billing applications
• Provided application support and training for online trust fund accounting
• Created facility compliance teams to monitor clinical and financial progress
• Provided key replacements in all accounting positions at the facility level.
• Prepared and monitored budgets in excess of 500 million all financial statements for seventeen facilities.
• Implemented corporate policies and procedures.
• Interfaced with state and federal regulators to ensure strict compliance with Medicare and Medicaid guidelines.
• Performed financial analysis and developed automated system tracking tools for monitoring case mix, revenues, profits.
• Targeted problem areas and provided timely solutions with internal online tracking tools.
• Evaluated annually facility/agency performance both operationally and financially, conducted audits and special projects.
• Created revenue cycle management teams to track and control receivables over 22 million per month
• Developed prospective payments RUGs clinical /financial teams to ensure compliance with Medicare and correct coding
• Reduced days outstanding receivables from an average of 55 to 38 within 8 months for seventeen facilities
• Provided hands on billing expertise to facilities for all payors: Medicaid, Insurance ,Managed Care, Private and Medicare
• Created front end collection process and strategies to include and to educate clients and agents regarding payments policies
• Developed transition teams : social services , finance ,clients and family members to ensure smooth transition from payors

Confidential

• Controlled and monitored all accounting processes for the Ohio rehabilitation units and Pennsylvania auditing product lines.
• Created and generated over forty reports for all areas marketing, management, accounting , for distribution throughout the
• Mid Atlantic and Northeast Region
• Prepared monthly, quarterly, and yearly financial reports for auditing product lines.
• Implemented and coordinated program for processing claims for certified outpatient rehabilitative facilities.
• Verified the analysis of staff of over twenty.

Confidential

• Coordinated and implemented activities relative to the applied principles of accounting procedures.
• Responsible for financial planning, control, and management.
• Functions included budget formation, accounts receivable, accounts payable, job costing, bid preparation, and general

Financial statements.