Obtain a challenging leadership position while applying creative problem solving and lean management skills with a growing company to achieve optimum utilization of its resources and maximum profits.
Compliance leadership experience: Oversee all organizational compliance education, audits, population health and investigations. Develop risk based program to ensure alignment with Federal and State regulatory initiatives. Collaborate with operations and the administrative leadership to provide a full scope effective program. Act as the primary authority to the Chief Executive officer for informing, auditing and reporting matters pertaining to policies, procedures and ethical issues. In addition, i collaborate closely with department leaders for ancillary services, self pay services, credentialing services, pharmacy services, risk management, operations, Ryan White programs, Americorps Vista and anything related to patient patient privacy/security. Prepare and report leadership efforts to the compliance committee and senior leaders of the organization, in coordination with CEO's operational strategies/citizenship committee. I also analyzed/investigated complex compliance related activities such as JOINT COMMISSION readiness committee, compliance hotline and trained the organization on all aspects of HIPAA/HITEC/BREACH and SRA endeavors.
Patient Safety and Risk Officer: Reporting to the Chief Executive Officer, as the patient safety and risk officer, I provide oversight of the facility's patient safety program including the coordination of all risk management activities as per the requirements of the Florida Statutes, CMS and The Joint Commission.
Audits and monitors the staff assigned processes that include but are not limited to pre-billing, billing, follow-up, collections, cash receipts, managed care, customer service, and support staff. Acts as a resource person for the staff in order to resolve problem areas and interpret contractual language. Ensures maintenance of patient accounts and the daily updates into the computerized claims transmission files. Coaches PFS team to perform according to quality control procedures. Oversees posting of payments and establishes banking process following Community Health of South Florida procedures.
•Manages the daily activities of personnel in the inpatient and outpatient admitting areas, to ensure timely registration of patients, accurate data entry of patient biographical and financial information and provide supervision of the cashiering process.
•Oversees business front end clinic functions for all related departmental entry points.
•Reviews each clinic three days ahead of the clinic date to determine if each patient has been properly verified for insurance purposes including proper authorizations, and proper information is written on each patient as it relates to co-payments, etc.
•Acts as a resource for any departmental staff or managers when it comes to information about registration, insurance verifications, and documentation guidelines including advising or referring providers to appropriate sources accordingly.
•Reviews and trains front office business personnel in completing front end processes timely and accurately.
•Responsible for completing yearly and special performance appraisals for the staff, and recommends merit increases, promotions, disciplinary actions etc., to the Director, Revenue Cycle.
Leadership: With a concentration on Organizational Behavior and Business management.
Athenahealth Billing Collector certified.
Managed Cared organization
American Medical Association Physician Recognition Award certified in billing and providers documentation.
AR, AP, billing, compliance audit, Community Health, staff training, finance, Insurance, Leadership, provider assessment and plan, Medical Manager, developer, Organizational Development, Organizational Leadership, project management, reporting, UDS reporting.
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