To obtain a full time position with a company to utilize my leadership competencies in the revenue collection cycle process which includes extensive experience with private collections, billing resolution, insurance issues related to healthcare receivables, governmental and commercial programs and provider contract negotiations. I am a committed and technically skilled business professional with a leadership skill set developed through experience as a Manager, Director and a Vice President. I have significant strengths in operations, systems, recoverable collections, audits, claims, negotiations, team building and dispute resolution. I have a proven history of excelled proficiency in resolving organization and departmental challenges with innovative solutions, systems and process improvements, having successfully increased efficiency and customer satisfaction.
Vice President of Revenue Cycle Management, 03/2016 to Current
Villa Healthcare – Skokie, IL 60076
Reporting to the President of the company, I lead overall strategy, optimization and implementation guidance of revenue cycle operations required for the insurance verification, patient financial services and overall collection of patient service revenues across the revenue cycle. Duties and responsibilities include decisions related to investments and changes in net revenue enhancement tactics, software applications, outsourcing vendors, recovery projects, and other interventions to collect the net revenue associated with patient services delivered. The organizational scope of this role includes oversight of revenue cycle performance in the following areas.
Regional Business Office Consultant, 01/2016 to 03/2016
Villa Healthcare – Skokie, IL 60076
Area Director of Business Office Services - Interim Position, 02/2015 to 01/2016
Kane Financial Services – West Palm Beach, FL
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Responsible for analyzing and implementation of initiatives for
accounts receivable outcomes for 43 facilities including DSO, Cash collected vs.
goals, Percent of A/R outstanding over 90 days, Medicaid pending dollars outstanding
and other metrics as established.
-
Identified and arranged training and communication to all A/R personal in
the area of accounts receivable billing and collections. This includes
quarterly meetings with employees to communicate goals and objectives, changes
in regulations or established policies and procedures, and changes to the
billing software.
-
Review all Regional's (RBOC's) trip reports, checklist, and A/R results
to identify training opportunities and strengths of each employee assigned.
- Assess the business office function and provide observations and
recommendations for improving it. This includes but is not limited to the
quantity of staff and adequacy of policies and procedures.
-
Collaborate with financial and audit teams to establish policy and
procedures that guide and promote an efficient and accurate billing and
collection function, solid internal controls and adherence to all state and
federal regulations.
-
Review and approve/reject all bad debt write off requests and Resident
Refunds in accordance with established policy.
-
Identify poor performing buildings through review of A/R metrics,
maintain a hot list of the facilities, and identify appropriate resources and
actions needed to improve performance to an acceptable level.
-
Perform monthly A/R review conference calls with the assigned BOM,
Administrator, RBOC and Regional of Vice Presidents' of Operations for each
facility.
Manager of Collections and Commercial Insurance Billing , 01/2015 to 01/2016
Extendicare Health Services, Inc. – Milwaukee, WI 53207
Oversee day to day
operations for 15 on site employees in all aspects of Co-Insurance Billing,
Private Collections, Managed Medicaid Billing and Medicare Dually Eligible and
Private Reimbursement for 146 skilled nursing facilities. Provide critical information to the
management team by assisting the A/R Senior Director and the Vice President of
Corporate Accounting with implementing procedures which increased cash flows,
improved A/R trend results, and increased revenues.
Works directly with
Corporate and Field Management to ensure that facility level processing is completed
accurately and timely.
Developed efficiency-enhancing workflow/process
improvements for billing and collection procedures to increase cash revenue and
decrease days in active receivables. Prepared month end collection statistics
for all areas and levels of management.
Corporate Liaison for Third Party Collection Agencies
and Debt Collection Attorney's throughout the states Extendicare operates in.
Making decisions on settlements, attending hearings, preparing facility
witnesses. Oversee all of the accounts signed with an Alternative Dispute
Resolution Agreement. Work closely with the Risk Management team for any
potential professional liability issues.
Involved in the
interviewing, hiring, new employee orientation process, corrective action plan
management, and performance reviews.
Oversee the
MasterCard/Visa payment program for all facilities including monthly balancing
with bank accounts.
Formulated
collection policy and procedures and monitored implementation of the same.
Implemented a
3 phase collection training program within the skilled nursing centers and the
corporate office.
Assisted in
analyzing billing and payment data and provider insurance contract negotiations
to ensure that maximum insurance recoveries are received.
Reduced over
90 DSO in Co-Insurance Billing from 48.2 to 16.8 since September of 2009.
Ensures
proper accounting and follow through of insurance denials, partial payments,
appeals and write-offs.
Ensures that
carriers are following contract guidelines and that optimal payment is
received.
Area Director, 02/2015 to 02/2016
- Responsible for analyzing and implementation of initiatives for accounts receivable outcomes for 43 facilities including Days sales outstanding, Cash collected vs.
- goals, % of A/R outstanding over 90 days, Medicaid pending dollars outstanding and other metrics as established.
- Identify and arrange training and communication to all A/R personal in the area of accounts receivable billing and collections.
- This includes quarterly meetings with employees to communicate goals and objectives, changes in regulations or established policies and procedures, and changes to the billing software.
- Review all Regional's (RBOC's) trip reports, checklist, and A/R results to identify training opportunities and strengths of each employee assigned.
- Assess the business office function and provide observations and recommendations for improving it.
- This includes but is not limited to the quantity of staff and adequacy of policies and procedures.
- Collaborate with financial and audit teams to establish policy and procedures that guide and promote an efficient and accurate billing and collection function, solid internal controls and adherence to all state and federal regulations.
- Review and approve/reject all bad debt write off requests and Resident Refunds in accordance with established policy.
- Identify poor performing buildings through review of A/R metrics, maintain a hot list of the facilities, and identify appropriate resources and actions needed to improve performance to an acceptable level.
- Perform monthly A/R review conference calls with the assigned BOM, Administrator, RBOC and Regional of Vice Presidents' of Operations for each facility.
01/2008 to 01/2015
Extendicare Health Services, Inc – Milwaukee, WI
Insurance Billing Analyst, 01/2008 to 01/2009
Insurance Billing Analyst Team Leader, 01/2009 to 01/2009
Insurance Billing Supervisor, 01/2009 to 01/2011
Manager, 01/2011 to 01/2015
- Oversee day to day operations for 15 on site employees in all aspects of Co-Insurance Billing, Private Collections, Managed Medicaid Billing and Medicare Dually Eligible and Private Reimbursement for 146 skilled nursing facilities.
- Provide critical information to the management team by assisting the A/R Senior Director and the Vice President of Corporate Accounting with implementing procedures which increased cash flows, improved A/R trend results, and increased revenues.
- Works directly with Corporate and Field Management to ensure that facility level processing is completed accurately and timely.
- Developed efficiency-enhancing workflow/process improvements for billing and collection procedures to increase cash revenue and decrease days in active receivables.
- Prepared month end collection statistics for all areas and levels of management.
- Corporate Liaison for Third Party Collection Agencies and Debt Collection Attorney's throughout the states Extendicare operates in.
- Making decisions on settlements, attending hearings, preparing facility witnesses.
- Oversee all of the accounts signed with an Alternative Dispute Resolution Agreement.
- Work closely with the Risk Management team for any potential professional liability issues.
- Involved in the interviewing, hiring, new employee orientation process, corrective action plan management, and performance reviews.
- Oversee the MasterCard/Visa payment program for all facilities including monthly balancing with bank accounts.
- Formulated collection policy and procedures and monitored implementation of the same.
- Implemented a 3 phase collection training program within the skilled nursing centers and the corporate office.
- Assisted in analyzing billing and payment data and provider insurance contract negotiations to ensure that maximum insurance recoveries are received.
- Reduced over 90 DSO in Co-Insurance Billing from 48.2 to 16.8 since September of 2009.
- Ensures proper accounting and follow through of insurance denials, partial payments, appeals and write-offs.
- Ensures that carriers are following contract guidelines and that optimal payment is received.
Associate Claims Representative, 01/2007 to 01/2008
American Family Insurance – Madison, WI
- Analyzed claims to determine company's liability, made approval or denial decisions and negotiated settlements with claimants in accordance with policy provisions.
- Investigated claims and determined cause and extent of damages.
- Prepared auto estimations and worked with body shops on final payouts.
- Uncovered fraudulent claims schemes; provided evidence leading to recovery of insurance overpayments.
01/2000 to 01/2007
Legion Insurance Company – Milwaukee, WI
Underwriting Technician, 01/2000 to 01/2001
Claims Data Analyst, 01/2001 to 01/2003
Reinsurance System Analyst, 01/2003 to 01/2004
Claims Supervisor, 01/2004 to 01/2006
Assistant Manager, 01/2006 to 01/2007
- Actively managed and participated in the collections of more than $10 million in reinsurance recoverables for a property and casualty insurer.
- Supported overdue reinsurance collection efforts through the establishment of a management system.
- Tracked collections and developed reports using strong Excel skills.
- Used knowledge of reinsurance agreements coupled with established relationships with reinsurers resulting in collection of routine and difficult reinsurance claims.
- Created a process and database, developed procedures and maintained oversight of an overdue collection system - monthly and quarterly reporting to the Senior Vice President of Service Operations of collection activity.
- Trained and coached staff on current procedures when required and new procedures when they are developed.
- Created department policy & procedure manuals Involved in the interviewing, hiring, and new employee orientation process, Assisted in the preparation of recommendations to the State's insurance committee of participating Guaranty Associations under the joint collection plan.
