Aaron Resnik Email & Phone Number

Kennett Square, Pennsylvania, United States

Kennett Square, Pennsylvania, United States

• Championed the development of 25 new audit queries, strengthening payment integrity• Uncovered $1M+ in payment opportunities, driving fiscal health• Fostered collaboration with Senior Management to institute standard reporting and recurring queries

King Of Prussia

Conshohocken, Pa

Direct all aspects of payment integrity audit including client relations, budgeting and revenue optimization.Improved operating efficiency by 25% and increased insurance overpayment identification 15%.Achieved company cost savings of >$500k through development and implementation of software engineering. Launched new auditing methods utilizing ICD10, CPT, and HCPC coding.Utilizing Agile methods optimized and streamlined audit processes and efficiencies.Managed client… Show more Direct all aspects of payment integrity audit including client relations, budgeting and revenue optimization.Improved operating efficiency by 25% and increased insurance overpayment identification 15%.Achieved company cost savings of >$500k through development and implementation of software engineering. Launched new auditing methods utilizing ICD10, CPT, and HCPC coding.Utilizing Agile methods optimized and streamlined audit processes and efficiencies.Managed client problems or conflicts, as company liaison. Excelled at mentoring and individual development majority of team members achieve promotions and advancement within the company. Moved team from low engagement score to top 10 within 1 year. Show less

Charlotte, North Carolina Area

Directing day to day relationship between Carolinas HealthCare System (CHS) and over 20 contracted managed care organizations (MCO's).Exceed department revenue projections by 10% on a $10M base. Strengthened company position by collaboration with Patient Financial Services, medical records, information services, and senior administration to ensure operational issues were resolved timely.Established and monitored performance measures concerning MCO compliance, claim processing… Show more Directing day to day relationship between Carolinas HealthCare System (CHS) and over 20 contracted managed care organizations (MCO's).Exceed department revenue projections by 10% on a $10M base. Strengthened company position by collaboration with Patient Financial Services, medical records, information services, and senior administration to ensure operational issues were resolved timely.Established and monitored performance measures concerning MCO compliance, claim processing and recovery.Reduced underpaid claims by 40%.Developed team to top tier engagement within company. Show less

Charlotte Nc

Direct a Tier 1 department responsible for identification and collection of managed care underpaid claims. Department responsible for 12 hospitals and 1900+ physicians. Development of policy and procedures to ensure maximum revenue collection. Team was collecting 95% of identified hospital underpayments, in excess of $10M yearly.Created production and productivity metrics and MCO scorecards to ensure growth within department.Provide guidance and language structure to ensure… Show more Direct a Tier 1 department responsible for identification and collection of managed care underpaid claims. Department responsible for 12 hospitals and 1900+ physicians. Development of policy and procedures to ensure maximum revenue collection. Team was collecting 95% of identified hospital underpayments, in excess of $10M yearly.Created production and productivity metrics and MCO scorecards to ensure growth within department.Provide guidance and language structure to ensure compliance and functionality with new contracts.Worked closely with Managed Care Contracting, and C-Suite hospital areas to ensure language and contract compliance by MCO's.Responsible for all budgeting and cost control measures for department. Show less

Charlotte, North Carolina Area

Supervision of the team managing the PCON contractual system, including building and maintenance of managed care contracts for 12 hospitals.Managed contract interpretation, contract language development and implementation of procedures to ensure PCON is reflective of the contract intent.Supervise the Clinical Denial Management division for 11 hospitals, consisting of appeals to providers for inaccurately denied claims. Success rate for team was greater than 80% adding additional… Show more Supervision of the team managing the PCON contractual system, including building and maintenance of managed care contracts for 12 hospitals.Managed contract interpretation, contract language development and implementation of procedures to ensure PCON is reflective of the contract intent.Supervise the Clinical Denial Management division for 11 hospitals, consisting of appeals to providers for inaccurately denied claims. Success rate for team was greater than 80% adding additional $4M to bottom line revenue.Collaborated with other lanes to reduce original denied claims. Within 3 years reduced clinical denials by 40%.Direction and maintenance of the HBO/STAR insurance, employer, and reimbursement master tables across 9 facilities. Show less

Charlotte, North Carolina Area

Directly responsible for a 42 person SBO billing department. Team responsibility included all payers across 8 hospitals, 1800+ total beds. Annually claim volume approximately 1.6M claims.Facility services range from Level 1 Trauma Center, Rehabilitation and Mental Health to outpatient cancer and ambulance billing.Medicare and Medicaid billing compliance, including the development of Medical Necessity LMRP edits.Development of policy and procedures to ensure timely and compliant… Show more Directly responsible for a 42 person SBO billing department. Team responsibility included all payers across 8 hospitals, 1800+ total beds. Annually claim volume approximately 1.6M claims.Facility services range from Level 1 Trauma Center, Rehabilitation and Mental Health to outpatient cancer and ambulance billing.Medicare and Medicaid billing compliance, including the development of Medical Necessity LMRP edits.Development of policy and procedures to ensure timely and compliant billing for all payers. Collaboration with various payers to increase electronic acceptance of hospital claims.Develop daily and monthly billing activity for the SBO, including staff production, DNFB, In-house unbilled. Show less