Brian Wentworth, Cpc, Alhc, Hia Email & Phone Number

Boston, Massachusetts, United States

Legal/Healthcare consulting firm – Claims management and negotiations. Build, grow and maintain business relationships with Firm clients, medical facilities, and providers nationwide. • Consulting services to clients related to healthcare claims, billing, settlements and plan contractual issues• Negotiate large healthcare settlements between healthcare plans and medical facilities and providers nationwide• NSA (No Surprises Act) claims and Federal IDR arbitration process administration• QPA (Qualified Payment Amount) calculations• Reference Based Pricing expert• CPC – Certified Professional Coder• Data Analytics • Achieving seven figures in annual cost savings - negotiations expertise• Coding, billing, medical terminology, commercial, Medicare/Medicaid billing knowledge • Complex financial calculations, build and maintain key databases, Tableau, Excel

Boston, Massachusetts, United States

• Negotiate large healthcare settlements between healthcare plans and medical facilities and providers nationwide• NSA (No Surprises Act) claims and Federal IDR arbitration process administration• QPA (Qualified Payment Amount) calculations• Reference Based Pricing expert• CPC – Certified Professional Coder

Boston, Massachusetts, United States

Revenue Cycle Analyst role assigned to the practice billing areas of MGH General Surgery Department, BWH Brookside Community Health Center, MGH Oral Maxillofacial Surgery Department, MGH Dental, BWH Oral Medicine, and BWH Dental• Ran all monthly financial reporting and ad-hoc reporting using Epic, Cognos Analytics, IPort Reporting, Excel Advanced – Variance analysis• Applied coding, billing, medical terminology, commercial, Medicare/Medicaid billing knowledge• Ran, reviewed, analyzed claim rejection, denial reports, and review critical issues - root cause analysis• Coordinated with practices to eliminate denials and rejections on problematic claims and codes (e.g, D7880 Device FY17 33% denial rate to FY19 zero; E0486 Device FY17 19% denial rate to FY19 zero)• Eliminated problem of significant patient payments being carried monthly in Credit Work Queue (Reduced from FY17 $1M annually to FY19 near zero)

Attleboro, Massachusetts, United States

Conversion of medical records to paperless system. Audited for accuracy.

B.S. Finance

Associate Of Arts - Aa