Aaron Rimby, Mba Email & Phone Number

United States

Provide financial clearances for Ambulatory clinics to include: Cardiology, Audiology, Physical Rehab, Radiology, Specialist visits, Otolaryngology, Neurology, Dermatology, Pain Management. (November 2023 – Present)Provide financial clearance for Clinical Trials, Genetic Testing, and Transplants (Kidney, Liver, Heart, BMT) (April 2022 – February 2024)Provide financial clearances for Ambulatory clinics to include: Cardiology, Audiology, Physical Rehab, Radiology, Specialist/PCP visits. – November 2021 – November 2023Key accomplishments- Clearance rate of 96.3% for encounters scheduled >3 days prior to DOS across all areas.- Documented clearance workflows for gap analysis and process improvement. - Utilized reporting of CPTs per Visit Type to quickly gather into a grid to compile payor authorization requirements. Developed scheduling guidance to align with authorization requirements and determination timeframes to decrease patient rescheduling.- Developed reporting through Epic MyReports to measure Productivity, Payor Mix, and service volume. Reporting used to provide monthly productivity scores and understand the ongoing trends of the business. - Developed visual data using Epic’s SlicerDicer for Write-Offs/Initial Denials, tracking pilot initiatives, and supporting C-level presentations.- Routinely meet with Executive Director stakeholders to collaborate on Clearance department performance.Projects- Acted as SME for WQ redesign, worked heavily with IT to develop parameters and validate iterations.- Collaborated with IT and developed criteria for ASA table to automate aspects of clearance work for known scenarios were authorization is not required.- Collaborated with scheduling departments on decision tree enhancements related to authorization determination timeframes.- Led operational implementation of EPIC's Electronic Authorization module.

Lancaster, Pennsylvania, United States

Financial Clearance Center• Maintain productivity of staff to obtain benefits and start pre-authorization • Liaise with internal and external customers to ensure correct patient status, correct authorization, and correct reimbursement • Supervise 21 staff and directly responsible for Financial Clearance Center metrics to improve Quality of Work, workplace satisfaction, and Operating Margin of 3.6% for the enterprise• FCC protected > $2Bil in total charges, approximately 75% of charges for the health system with a denial rate of <1%• Positive culture change and team building to Utilization Management and Financial Clearance Center departments to increase employee morale and retention • Liaise with eHealth team to ensure proper IS implementation to support operationsPre-Arrival Services• Increased productivity from 18 accounts/hour to 21 accounts/hour while simultaneously increasing clearance scope from appointments scheduled 3-14 days in advance of DOS to >3 hours• Supervise 15 staff and directly responsible for Pre-Arrival Services metrics to improve Quality of Work, workplace satisfaction, and Operating Margin of 3.6% for the enterprise• PAS clears approx. 58% of organization’s Family Medicine/Specialty visits• Liaise with eHealth team to ensure proper IS implementation to support operationsCentralized Authorizations and Referrals Team• Supervise 14 staff and directly responsible for CART metrics to improve Quality of Work, workplace satisfaction, and Operating Margin of 3.6% for the enterprise• CART obtains auth for OP testing (CT, MRI, cardiac monitoring, etc.) and insurance referrals for consulting practices for most PM/LGH Family Medicine practices• Liaise with eHealth team to ensure proper IS implementation to support operations

Lancaster, Pennsylvania Area

Utilization Management▪ Maintain Inpatient denial rate under .65% of total revenue▪ Co-Chair Care Management Committee▪ Supervises 20 staff and directly responsible for Utilization Management metrics to improve Quality of Care, Operating Margin of 3.6% for the enterprise, and Patient ExperienceFinancial Clearance Center▪ Maintain productivity of staff to obtain benefits and start pre-authorization▪ Liaise with internal and external customers to ensure correct patient status, correct authorization, and correct reimbursement▪ Supervises 20 staff and directly responsible for Financial Clearance Center metrics to improve Quality of Work, workplace satisfaction, and Operating Margin of 3.6% for the enterprise

Reading, Pa

Billing• Prepare Medicare, VA, and skilled commercial claims for billing• Track Auth for all Waiver, VA, and MA patients• Maintain and track all Skilled Commercial, VA, MA, Self-Pay, Waiver Claims• Skilled Commercial claims follow-up• Liaise with Provider Representatives• Post remittances• Communicate benefits to all patients with Skilled Commercial insurance prior to Start of Care• Ad hoc reporting of Accounts Receivable• Educate staff on billing practices and how it relates to visit performanceIT• Accountable for all software updates• Help Desk responsibility for ~100 user organization• Liaise with Vendors• Maintain all IT equipment and configure it for deployment• Maintain user profiles, GPOs, security certificates, and user profiles of third-party apps• Maintain HIPAA compliance on ePHI and PHI• Vett new technologies for adoption

Mba, Business Administration, 3.7

Social Work

Web Development Certificate, Web Development

Education record