After a successful 11-year career leading governmental and commercial payer contracts for a large, national Respiratory DME and Pharmacy company with 140 service locations across the US, I left the company in February 2012 to start my own healthcare provider payer management, contracting and credentialing consulting business—Sonoma Credentialing Services. To learn more, please visit www.sonomacredentialing.com.Provider clients served include: Behavioral Health, Device Manufacturer, DME/HME, Hearing Aid, Home Health Care, IDTF, Incontinence/Urologic, Mental Health, Orthotics & Prosthetics, Physical Therapy, Podiatric, Practitioners, Respiratory/Sleep, Substance Use Disorder Residential Treatment Facility, Speech Language Therapy, Telehealth, Healthcare Consulting, Medical Billing/RCM Software, CVO, and Billing companies across the US.Specialties include:Medicare, Medi-Cal, State Medicaid, Managed Care, Commercial Payer Provider Network Management:• Full Cycle Procurement and Implementation of New Contracts / Enrollments• Contract Negotiation / Reimbursement Rate Negotiation• Re-Credentialing / Revalidations• Reporting Changes of Information / Ownership / Acquired Locations / Multiple Tax IDs• NPI Enumeration / Management• Set up of EDI, EFT, ERA, PECOS, PAVE Processes and Provider Web Portals• Response to Provider Compliance Inquiries• Payer Issue Liaison / Resolution with Payers, CMS, NSC, MACs, NPPES etc.• Local, State, Federal Licensure Procurement• Credentialing Software Implementation• Provider Contracting & Credentialing Process/Best Practices Education & Training• Live and Virtual Webinars & Presentations, Web Content/Article Writing

Contributing educator and original founding member of the Payer Enrollment Institute and TMG University, which provides instructional programs, resources, and mentorship on Payer Enrollment processes and best practices through online learning, live presentations, and written advisories. Active member in the development, design and execution of programs including presentation topics, outline, content formation, PowerPoint construction, delivery, and attendee feedback/evaluation response.To learn more, please visit TeamMedGlobal.com.

Headquartered in the Chicago area, Sleep Rx LLC DBA Aura Healthcare is a TJC accredited, national respiratory DME provider with Medicare Competitive Bid awards in multiple US markets to provide CPAP, BiPAP, Oxygen and RADs and holds State Medicaid and commercial contracts across the US. Unlike its competitors, Sleep Rx specializes in a highly unique and effective, in-home, full airway clearance program with products that no other provider offers all together, and is designed to help adult and pediatric patients and their doctors completely manage advanced respiratory diseases such as COPD, Cystic Fibrosis, Congestive Heart Failure, Bronchiectasis, and severe respiratory conditions resulting from advanced neuromuscular diseases such as ALS. To learn more, please visit www.aurahc.com.

Sending Out An SOS raised awareness and funding to help provide education, orthotics and prosthetics equipment, care and support to less fortunate victims of limb loss. To learn more, please visit http://www.sendingoutansos.org/.

Specialized Orthopedic Solutions DBA SOS Medical is a Joint Commission accredited and Medicare and Medi-Cal approved provider of specialty and custom-made Orthotics and Prosthetics and related equipment serving the Central & Southern California area. Based in Chatsworth, California, SOS Medical was founded in 2003 as a provider of post-operative, rehabilitative and pain management products. Since then, SOS Medical has evolved into one of the leading providers of specialty prefabricated and custom Orthotics and Prosthetics, which are painstakingly made by hand in their one-of-a-kind, on-site central fabrication facility.To learn more, please visit www.sosmedical.net.

Farallon Home Health Care is a Community Health Accreditation Partner (CHAP) accredited, Medicare and Medi-Cal certified provider of home-based nursing services in the greater San Francisco Bay Area offering Skilled and Non-Skilled Nursing, Occupational and Physical Therapy, Social Work and Dietician services.Headquartered in Burlingame, California, Farallon serves patients 6 San Francisco Bay Area counties including: San Francisco, San Mateo, Santa Clara, Alameda, Contra Costa, and Marin-- and is expanding coverage area north to the counties of Sonoma, Napa, and Solano. To learn more, please visit http://www.farallonhealth.com.

ActivStyle is one of the largest providers of incontinence and urological supplies to Medicaid and Dual Eligible beneficiaries in the US. To learn more, please visit www.activstyle.com.Responsible for managed care payer contracting and business development assistance in the Western US market.-Obtained top 3 targeted health plan contracts in CA and WA within first 3 months.

National provider of home respiratory equipment and medication therapy services. During its height, PPS served 140,000+ patients from 140 branch centers located in 25 states, 5 regional revenue billing offices, and 2 pharmacy locations, with headquarters located in Novato, CA. Acquired by Adapt Health in 2018. For 11 years, sole person leading governmental and commercial contracts for 140 DME & Pharmacy locations. Full cycle contract process including procurement, credentialing, recredentialing/revalidations, demographic information and ownership changes, and electronic billing processes for company's 300+ Medicare, Medicaid, and US Dept of Labor contracts, which represented >80% of total company revenue.*Helped company grow from 40 to 140 US service locations in 11 years (averaging 9+ new location openings per year) and an average of 10 location address changes per year.*• Integrated contracts & billing processes for 40 acquired service locations, under multiple provider tax ID #s.• Directed government & commercial contract integration & ownership changes for 15 acquired service locations.• Migrated 50 contracted locations to new entity.• Centralized remittance, mailing & payment address changes for 300+ contracts.• Designed company’s system for obtaining, implementing and managing over 200 NPI #s.• Researched, recommended and implemented Credentialing Software solution.• Established Internet-based PECOS Authorized Officials and End Users for multiple provider entities.• Established electronic billing (EDI), funds transfer (EFT), and remittance advice (ERA) support processes for all governmental provider contracts with multiple tax ID #s.• Liaison among internal departments and external agencies to research, analyze, and resolve payer issues.• Electronic provider tools: PECOS, NPPES, and payer web portals.• Assisted in shepherding governmental regulatory site inspections.• Maintained master database and electronic provider contract files.

Responsible for the procurement of new, and the evaluation of existing, all national governmental and private payer health plan contracts and electronic funds transfer set up processes.• Strategized targeted payer mix with national field sales and management.• Initiated contact and creative outreach to health plans.• Developed relationships with payer contracting and network management.• Prepared contract proposals and RFPs, negotiated favorable pricing, implemented new contracts with payers and internal RCM and IT teams.• Presented managed care contracting goals and performance at annual department meetings.• Created and maintained master contracting database and electronic files.

Managed all State and Federal provider contract credentialing and implementation processes.• Timely, accurate, and compliant contract submissions for 75 service locations.• Governmental compliance and audit documentation, correspondence, and tracking.

Operational support including service location lease contract and business license administration.• Leased 50 commercial properties, including renewals and relocations; negotiated lease terms.• Administered and coordinated monthly lease payments for commercial properties.• Procured business licensure, utilities, services, and liability insurance for leased locations.

Privately held, national manufacturer of consumer fraud detection software for the banking and financial services industries. Clients included Bank of America, Wells Fargo, Wachovia, Chase, Charles Schwab, Fidelity Investments, E*Trade. Company sold to Early Warning Services, now based in Scottsdale, Arizona. To learn more, visit www.earlywarning.com.Sole person responsible for the execution of bi-monthly accounts receivable billing and collections of high profile banking industry clients.