Revenue Cycle Management project management for the TPR National RCM team in liaison with on-boarding/off-boarding/IT/credentialing and the TPR RCM vendor partners, including completion of all notifications and forms for new provider billing or providers leaving; manages credentialing denials; project manager for RCM system transitions and new processes and procedures.• RCM project manager for all new physician on-boards and/or off-boards ensure all appropriate paper work is accurate and completed timely.• RCM project manager for all AR run-down projects; assigns staff and represents RCM in weekly meetings with operations teams and vendor partners associated with rundown projects.• RCM project manager for all system transitions, liaison with vendors and ensures all appropriate paper work is accurate and completed timely. Work with project leads from home office.• Analyze denial trends for credentialing or system issues and work with appropriate teams to address and correct.• Notify vendors of all claims refiling due to audits or system/credentialing issues. Works with RCM Director from each market and ensure claims are refiled. Prepares reports and weekly updates/monthly updates on claims payments or denials.• Project lead for revenue cycle issues log; leads weekly meeting with each TPR department and manages resolution. Follow-up on all issue throughout the week and escalates unresolved issues to RCM Sr. Director as needed.• Attends meetings with RCM Vendors as required• Attends all quarterly RCM team meetings• Stays current with industry standards• Stays current with payer credentialing requirements

Responsible for on-boarding physicians and allied health preofessionals by allowing all providers to transition to employment on the projected dates.Work closely with the Business Development Dept., identifying site locations for new build outs.Assist General Contrators with office lay outs and review of estimatesOrder Medical Equipment/Office FurnitureAssist with the creation of new entitiesAssist with DBA's for Marketing PurposesLead the on-boarding team (IT, HR, Operations) as the project manager on a weekly basis to ensure timely completion of each task, each project has more than 250 Individual, but co-dependent tasks for completion, each with specific dates for completion.Assist with the design of Marketing Collaterals, biocards, website and announcements.Lead terminations projects to transition each of these providers out of the group. Project plans are equally challenging with tight deadlines and legal notifications requirements.

Start-up OperationsImplemented physician on-boarding and credentialing process.Assisted with the merge of existing employed physicians.Assist Corporate Legal applying for Medicare/Medicaid Group Provider numbers.Supports Managed Care dept., with Delegated Credentialing, audits, policies and procedures.Assist with the creation of new entitiesAssist with DBA's for Marketing PurposesResponsible for on-boarding physicians and allied health preofessionals by allowing all providers totransition to employment on the projected datesLead the on-boarding team as the project manager on a weekly basis to ensure timely completion of each task, each project has more than 300 Individual, but co-dependent tasks for completion, each with specific dates for completion.Lead terminations projects to transition each of these providers out of the group. Project plans are equally challenging with tight deadlines and legal notifications requirements.CredentialingResponsible for coordinating Medicare/Medicaid and Managed Care (Local & National) Credentialing process for each provider.Coordinates work with outside Credentialing groups, ensuring the Internal Credentialing Committee reviews and acts on applications for all providers applicants on a timely manner. Implemented CAQH profile creation/attestations internally.Implemented eCho electronic Credentialing process.MSO - Managed Services Organization/New Product Line (2013 - 2014)Actively assist COO with the Implementation of the MSOEstablish weekly meetings with the on-boarding team and outside vendorsSuccessfully On-Boarded two MSO providersPhysician Practice Setup ServicesRevenue Cycle Management Services

Start-up Operations Assisted with collaboration of Corporate the facility and entity setup.Office setup ­ Implemented Policies and Procedures, Human Resources training based on Tenet'sManuals/HRMS, IT setup ­ Taleo, Prosource, Ivis, HireRight and communications. Hire nurse recruiters & scheduling coordinators Work in collaboration with Corporate Kronos process to capture real time.Became proficient in Prosource for scheduling purposesTransfer existing employees into the Resource PoolImplemented hiring process and forms required by CorporateImplemented verification of credentials and background reportsDeveloped tracking system for Credentialing follow upsDeveloped relationship with outside vendors in case of internal shortage Process and approved payroll

Start-up OperationsCentralized Revenue Cycle for all Tenet Local home care agencies (12), three year later added all other National locations for a total of 32 Agencies.Supervise a team of 20 employeesSuccessfully maintained collections under 40 days in Accounts ReceivablesSupported all agencies thru JAHCO surveys and any other Government audits.Conducted monthly audits to insure accurate information for billing.Decentralized CBO due to changes in reimbursementAssisted Aysis with the purchase of Tenet's Home Care AgenciesOrganized Collection dept., to collect all remainded ARCeased operations 04/2006

Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.Educated staff on state and federal statutes, rules and regulations governing home care services.Oversaw private and MCR billing, payroll, AP, and AR and verified that proper procedures were followed.Developed and achieved financial and growth goals.Encouraged creative thinking, problem solving, and empowerment as part of the facility management group to improve morale and teamwork.Participated in facility surveys and inspections made by authorized governmental agencies.Initiated audit process to evaluate thoroughness of documentation and maintenance of facility standards.