 Reported directly to the Chief Financial Officer. Overseen all functions relating to the organization. Managed the month-end close process. Developed and implemented key performance metrics for the department. Monitors all physician’s employment agreements and compensation packages. Monitor key performance indicators and implements performance improvements. Managed the EDI functions as they related to electronic claims submission. Ensured the maximization to utilize all EDI capabilities to enhance cash flow. Directed the daily operations of billing, cash posting, follow up and customer service teams with forty staff associates. Worked in conjunction with the Director of Revenue to oversee the entire RCM staff and structure. Interacted with IT related channels to ensure technology is interfacing properly with client systems and processes. Established and maintained controls for all cash collected and posted in the Patient Accounting System. Maintained effective communications with the leadership tem to ensure that all third party compliance guidelines are achieved. Selected and monitored outside collection vendors engaged in the collection of the entity receivables. Reviewed and balanced agency reports to hospital system reports and approved agency invoices. Led and provided operational directives for all business office activities related to the claims management and collections of the hospital’s receivables and ensure timely, efficient cash collections to support the overall financial goals of the facility Manage Government (Medicare and Medicaid) and commercial credit balance reporting process. Established policy and procedure for managing government reimbursement re-processing resulting from audit programs, i.e., RAC, MAC, OIG, MIC.

 Accountable for balancing all patient service cash postings from bank deposit confirmations through postings on host information systems. Manage electronic processing vendor to ensure efficiency and quality of electronic posting of cash payments and adjustments including all zero dollar payments. Manage and train staff to ensure the timely and accurate cash postings of all manual payments including zero dollar payments. Monitor and reconcile payer recoupments. Recognized for designing, developing and implementing Cash Reconciliation process to achieve full unprecedented, reconciliation of all Revenue Cycle/Fin&Acctg accounts. Developed and implemented CMS 1011 program with PFS Director. Implemented On-Line Bill Pay for organization. Manage Government (Medicare and Medicaid) and commercial credit balance reporting process. Ensure all payments and adjustments are posted within two days of receipt. Manage the timely resolution of system transaction control errors including accountability for root cause identification and resolution through consistent documented feedback loop to respective parties. Ensure that audit requests are completed in a timely and accurate manner. Provide recommendations for continuous process improvement. Respond to issues identified and escalated and any adverse unplanned situations; resolve or escalate issues to management as appropriate along with recommended solutions. Responsible for developing and executing third party payer collection efforts as well as accounts receivable reduction strategies. Manage and monitor accounts receivable and payer aging categories as assigned. Coordinate re-billing and adjustments of accounts. Manage vendor processing and relationships for specific Government and Non-government AR lines of business (Early Out, Worker’s Compensation, Small Balance, Self-Pay and Bad-Debt). Developed and monitor vendor analytics and performance metrics.

 Recorded all journal entries posted to the General Ledger for Spalding Regional and Sylvan Grove Hospitals. Performed full month-end close process that included balance sheet and cash reconciliations, variance account analysis and ad-hoc management reporting to corporate within an eight day close for each month-end. Created reports and analyses for the Chief Financial Officer, Controller, Directors, Governmental Agencies and auditors both internal and external. Performed proactive audits, reviewed internal controls and implemented process improvements where audit deficiencies existed. Assisted with key variance explanations, the annual budget process, cost reporting and tax packages. Researched and resolved various accounts payable, accounts receivable, payroll and Visionware issues. Responsible for developing and executing third party payer collection efforts as well as accounts receivable reduction strategies.

 Ensured that all National Insurance Centers (NICs) complied with corporate cash policies and procedures. Trained all new employees on all job specific cash functions through-out the NICs. Reviewed and coordinated all process improvement requests to determine feasibility and cross-functional alignment. Created all process documentation to include all cash operations process flows for current and future business states.