Jorge Quintero,Crce-P, Crcr, Chfp Email & Phone Number

Florida, United States

Miami Lakes, Florida, United States

Florida, United States

Miami, Florida

Plymouth, New Hampshire

Responsible for Patient Access, PBX, and Business Office functions

Fort Kent, Maine

Responsible for overseeing Customer Service, Financial Counseling, Billing, and Collections for 49 Bed ACF, Level II Trauma Center.

Miami/Fort Lauderdale Area

American Ambulance Service which serves Miami Dade, Broward and Monroe Counties provides basic and advanced life support and also provides ventilator and bariatric services. Interim Director of Revenue CycleSpearheaded the responsibilities of managing annual revenue in excess of $40 million for several subsidiaries including, All County Ambulance of the Treasure Coast, AMC Medical Transportation, and American Ambulance of New England; Oversaw a staff of 23 Accounts Receivable staff.MAJOR CONTRIBUTIONS Supervised Billing & Collections and monitored Regulatory Compliance both at the State and Federal level Ensured the accuracy & timeliness of insurance verification and obtained pre-authorization from all managed care organizations and submission of claims  Developed workflows for Verifiers, Billers, and Collectors to optimize desired outcomes Conducted weekly audits of accounts to meet quality and compliance metrics  Handled all Contract negotiations and re-negotiations for new and current contracts Coordinated with Operations Managers to address issues related to incomplete data or reporting missing or incorrect from the field EMT’s or Paramedics

Medford, Wi

Memorial Health Centre is a non-profit health care organization that serves Taylor, Price and Clark counties in north central Wisconsin. The hospital is accredited by the Joint Commission, and is a Critical Access, Level III Trauma Care Centre. Interim Director of Patient Financial ServicesOversaw all aspects of the Business Office for a 25 Bed Critical Access Hospital which includes Skilled Nursing Facility, Retail Pharmacy, Outpatient Dialysis Center, Home Health, Durable Medical Equipment, and four Satellite Clinics; Managing a staff of 17 Hospital & Clinic Billers, Collectors, Financial Counsellors, and Posters MAJOR CONTRIBUTIONS Successfully led a Revenue Cycle Committee comprising leaders from HIM, Patient Access, and IT with the intent of improving Revenue Cycle functions across the organization  Accomplished transition of Physician Billing from CBO back in house Managed Net Operating Margin of 9.2% and cash on Hand of 225 Days

Cooper City, Fl

Oversee staff of 20 Denial Resolution Specialists for a Denial Management/Consulting Firm Responsible for all aspects including but not limited to day-to-day activity, project scope, revenue, expenses, staff management, maintain client/vendor relationship, and overall project success. Responsible for managing P&L and adhere to budget. Monthly deliverables to client included Client Service Review with Executive Summary outlining denial trends, cash impact, overall analysis of hospital deficiencies and recommendations to mitigate and eliminate denials and improve client's cash on hand. Reduced Medicaid Denials from an average of 2700 per month to 1400 in Q3 & Q4 of 2010Reduced Medicare Denials from an average of 1500 per month to 800 in Q3 & Q4 of 2010Identified Process Improvement opportunities in CIV and HIM departments that lead to improved outcomes for coding and eligibility related denialsImplemented Employee Training program focused on Revenue Cycle and Contract Interpretation which helped reduce staff turnover and increase staff retention.

Miami/Fort Lauderdale Area

Oversee staff of 6 billers and collectors in outpatient behavioral health center. Working manager** Increased cash collections by 80% in 2008-2009 * Developed and implemented authorization and collection protocols * Work closely with CFO on policy and procedure updates; oversaw revenue cycle * Reduced bad expense exceeding expectations * Actively participate on Corporate Compliance Regulatory Committee*Credentialed staff of 100 Licensed Clinical Social Workers, Licensed Mental Health Counselors, Licensed Marriage & Family Therapists, and Psychiatrist*Negotiate managed care contracts with all major payers*Handle hiring; firing; day-to-day staff issues*Knowledge of HCFA 1500 billing

Miami/Fort Lauderdale Area

Oversaw staff of 10 billers and collectors*Responsible for the daily operations and revenue cycle of the collections department. Responsibilities include daily monitoring of collection activity efforts and ensuring prompt payment of account receivables. Knowledge of HCFA 1500 billing. In addition, maintain close contact with all Managed Care Payers to ensure prevailing contracted rates are reimbursed and address any claims issues should they arise. Maintain close contact with all facility managers to correct any registration/authorization discrepancies. Responsible for negotiating out-of-network discounts with commercial payers as well as attorneys. Oversaw implementation of new billing software system; project management to "go live;" coordinated with other departments. Handled hiring; firing; day-to-day staff issues.Attained monthly cash goal for the month of August Reduced percentage of accounts over 180 days from 44% to 32%

Miami, Fl

Collected on assigned managed care claims in the Accounts Receivable Aging Report. Established direct contact with payers via telephone, email or internet on a daily basis, to ensure timely payment on submitted claims. Maintained direct contact with Health Information Management, Utilization Management, and Billing Departments, in order to immediately address concerns that delayed payments. Presented monthly analysis reports to the Director of Patient Accounts and CFO to help identify internal deficiencies in the collection process, with the purpose of maximizing cash flow. Improved cash collections with assigned payers by 37% in 2004Established a working relationship with all payers, thus giving our Hospital priority to resolve problems in a timely fashionHelped decrease AR days from 45 to 33 days, well above national standards

Miami/Fort Lauderdale Area

Oversaw staff of 7*Daily supervision of collectors including planning, organizing, and staffing. Handled hiring; firing; day-to-day staff issues. Made regular contact with all delinquent payers in an attempt to collect financial obligations owed to the hospital. Ensured all denied or underpaid claims were properly worked and collected as assigned. Prepared monthly reports for administration, detailing collection efforts, and expected cash flows. In addition, worked very closely with the contracting department to ensure payers were contacted when not honoring the prevailing reimbursement agreements.Helped decrease Medicare AR days from 30 to 24.4 days and Managed Care AR days from 47.9 to 39.8 daysIncreased monthly collections from an average of $700K to over $1 million