Brian Moffitt Email & Phone Number

United States

OpenPoint Health Solutions is a consulting firm that specializes in the out-of-network healthcare cost containment industry. The services that we offer include revenue-generating strategic product expansion and business development initiatives, product development and enhancement, and provider network optimization software and consulting. OpenPoint Health.

United States

• NMFS enhances the cash flow and reduces the administrative burden of Medical Providers and Commercial Payors by consolidating hospital reimbursements, accelerating Medical Provider reimbursement and performing value.
• Directed on-boarding of initial hospital clients onto the NMFS claim payment platform with commercial payor partners.
• Established interfaces and protocols with commercial payor partners for the transfer of claim payment data to NMFS medical providers.
• Coordinated cross-team development of the NMFS claim payment platform across operations, finance, client relations, and IT departments.

Gaithersburg, Maryland, United States

• Evaluated operational processes to determine methods for improving efficiency of organization. Provided direction on additional cost containment services for organization to offer to marketplace. Located acquisition.
• Significantly decreased labor expenses by developing and supervising a team to recruit providers for internal discounts resulting in a drop of fee negotiations from 90% to 70% of claim volume which continued to rise by.
• Cultivated and executed relationship with partner organization, offering Medicare reference-based pricing as additional service to existing clients and in marketplace.
• Generated a 20% increase in success rates and 25% increase in saving dollars from HRGi's Elite Provider Program through improved provider matching criteria.
• Led team that performed rewrite of critical behaviors and practices for organization’s fee negotiation team, leading to 10% increase in success rates and saving rates of overall fee negotiation results.
• Managed the transformation of the negotiation audit team from being considered a daily burden whose only goal was to find mistakes to a helpful unit designed to highlight the best practices and improve the overall.

Gaithersburg, Maryland, United States

• Managed growth of operations team, maintain rapid expansion of overall organization. Led implementation of several national insurance companies and third-party administrators onto organizational platform. Cultivated.
• Managed growth of California operations team from 13 employees in 2012 to 60 employees in 2017, increasing revenue 700%.
• Led implementation team for onboarding onto organizational platform for top five health insurer, three of top 10 third-party administrators, two of five largest Canadian travel insurers and top five auto insurer.
• Created daily and monthly trend utilization reports at both the product and client level to ensure management visibility into the claim activity at our California operations office.
• Contributed to the sales process with our CMO through leading the in-person discussions surrounding how HRGi would interface with the potential client’s claims administration system and our previous implementation.
• Brought two venture capital firms onboard as investors in 2017.

Rockville, Maryland, United States

Implemented all payor clients, focusing on systems integration area. Developed process for transfer and maintenance of provider network data to web-enabled repricing partner for payor client access and EDI file processing. Researched and performed due diligence on TPAs, medical billing companies and fee negotiation companies as possible acquisition.

Rockville, Maryland, United States

Analyzed demographic results of direct marketing campaigns with multiple credit card companies to provide improvements for future campaigns. Coordinated initial online website development and online advertising campaign with companies, including Yahoo, AOL, DrKoop and DoubleClick. Identified initial Pharmacy Benefit Management acquisition and led due.

Rockville, Maryland, United States

Provided consistent reporting on utilization at client and provider level of PPO network to senior management. Located and performed due diligence activities on potential PPO network acquisitions. Developed set of monthly analytical reports on claim and provider demographic data to assist management in understanding current business trends and future.

Greenbelt, Maryland, United States

Worked with finance department to improve medical cost projections and IBNR forecasting. Created episodic database for cost analysis of outpatient hospital versus ambulatory surgery center procedures. Developed and presented reports to hospitals explaining relative costs. Supported decision-making process on Medicare HMO program strategy.

Assisted in setting inpatient hospital payment rates for Medicare. Determined standardized payment amount and outlier payment thresholds.

Doctor Of Philosophy - Phd Program, Economics

Bachelor Of Science - Bs, Economics