Senior Manager Revenue Cycle Operations

Manage revenue cycle staff for Providence Health Post-Acute services across 5 states, AK, CA, OR, TX, and WA. Identified issues with billing Notice of Admissions within the 5-day time frame that were both system and operational in nature, reducing the number of denials by 30%. As these were during the first year of the new NOA process and the regional MAP was unable to properly accept electronic NOA's, we were able to bill on exception with success and increased our cash collections with the 30% denial rate.

Revenue Cycle Interim Executive Director charged with identifying process issues, cash posting concerns (manual), secondary billing, and denials management. I was able to resolve the secondary billing issues which parlayed into resolving many of the manual cash posting issues. Additionally, I mapped out the denial reason codes as appropriate and set up processes to ensure that the codes are captured for reporting purposes.

Working with the EVP/CFO in improving overall Revenue Cycle operations performance with focus on Cash Acceleration, coding improvements, charge capture, denials analysis and reduction efforts, system and operational education, unbilled analysis and reduction, credit balance resolution, and process mapping / improvements.

Senior Manager of Revenue Cycle Operations and IT Support for their 3 hospitals during their Epic Implementation

Seniir Director for Revenue Cycle Operations and Cash Acceleration/System Optimization and system standardization across 8 Hospital Systems.

• Revenue Cycle Project Manager for Operational Improvements and Siemens INVISION System Optimization and Reconfiguration to meet best practice standards.• Initial responsibility was to perform an operational and system assessment of the Revenue Cycle Operations and application configuration to then provide recommendations for overall process improvements.• Primary responsibilities are to identify and engage in Process Improvements within the Revenue Cycle - Review Siemens INVISION set up and design, identify production improvements through use of new technologies, improve and optimize system design, automation, and performance, and identify revenue and cash improvement opportunities.• Operation improvements include mitigation of late charges, denials, and rework.• Assisted in the design and implementation of Enhanced Name & Address (ENAD) Processing.• Mentor the staff as needed and develop an ongoing training program. Training provided to PA Staff for Status Transfers, billing functions.• Implementation of REF and REF Desktop Tool for correcting errors from other systems.• Identify key areas for cash acceleration and increased cash reimbursementsAssisted as interim senior director of PFS and improvement processes

Report to RCM VP for Systems Implementation and operational improvements• Primary responsibilities are to review operation work flows, design and improvements, Siemens INVISION set up and design, identify production improvements through use of new technologies, improve, and identify revenue and cash opportunities.• Identify and engage in Process Improvements within the Revenue Cycle Departments• Support and optimization of the HIS applications for Patient Registration areas, Health Information Management, and Patient Accounting. As well as other add-on applications such as the SSI Billing Editor and Document Imaging.• Mentor the staff as needed and develop an ongoing training program• Assist the staff with standard project management methodologies.• Identify key areas for cash acceleration and increased cash reimbursements• Identify areas for improved revenue capture

Interim Regional Director of Revenue Cycle Application Support.Identify and engage in Process Improvements within the Revenue Cycle suite of applications.Identify key areas for cash acceleration and increased cash reimbursements.Manage staff and other standard management practices.

• Responsible for Revenue Cycle Process Improvements and the support and optimization of the Siemens INVISION applications for Patient Registration areas, Health Information Management, and Patient Accounting. As well as other add-on applications such as ePremis.• Primary Activities to date include: (1)Review their charge processes, identifying missing revenue and enabling a stop gap of missing charges; (2) Review and redesign of their insurance and self pay follow up activities and programming the necessary updates in RPM; (3) Review and update their Siemens INVISION Patient Accounting Master Files and Profiles; (4) Identify and reduce manual processes to improve efficiency and reduce errors; (5) Provide key statistical data for CFO and other finances officers; (6) Review and update their statement processing. (7) Review and improve where necessary their processes and work flows for the patient revenue life cycle to minimize inefficiencies, reduce errors, and improve employee and patient satisfaction, while increasing revenues and cash collections.

•Project Manager responsible for the Project Initiation and Implementation of Siemens INVISION OAS Gold applications for Patient Registration areas, Health Information Management, Patient Accounting, and Nursing.•Developed the Project Charter and Proposal, Project Work Plan, communication standards for issues, decisions, and Change Control, and budget for approval.

• Provided application support for Siemens INVISION Patient Accounting. This includes support for OAS coding, OAS Profiles, Ad hoc Reporting, CWS, Room and Bed, Error Reconciliation, Case Mix, Doctor Master, RPM, PRM, OML/Billing, HPPI, and CDM.• Assisted the direction of INVISION system configuration for operational process improvement initiatives.• Identify additional areas of opportunities for system improvements, “best-practice” opportunities, and overall patient accounting system optimization.• Continue to provide remote support as needed and as time permits.

• Provide Revenue Cycle consultation within Patient Financial Services and Patient Management Departments. We have been able to improve the overall cash collections by over 80% while reducing the number of accounts by 33% and increasing the 0 to 60day aged revenue through improved charge capture initiatives by 30%. • Provide management and cash flow improvement initiatives within the government payers billing department. This included the overall reduction of the outstanding AR, denials, and account volumes while increasing cash collections.• Developed automated secondary billing processing to improve billing functionality and reduce timely filing denials for secondary payers.• Developed specific database reporting for non-billed accounts which isolates billing issues and email these reports to the proper management/support staff daily.• Assisted in the development of a Denial Management Process which has seen a steady decline in our denials through focused reporting and system automation.