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Mike has over twenty-five years of experience in health care. He has held executive positions in risk adjustment solutions, provider network management and development, and reimbursement systems design for all lines of business. Mike has extensive experience in contracting with individual hospitals, multi-hospital systems and large integrated delivery systems. Mike has also assisted clients with network operational and compliance assessments and process improvement initiatives. Mike is CEO at 360 CDI, an international leading medical coding company and Executive Chair at Adjacent, a leader in business process outsourcing.Mike leads 360 CDI which offers solutions for risk adjustment coding, clinical documentation improvement, concurrent coding reviews, and quality measure abstraction. Mike has implemented comprehensive solutions with clients to dramatically improve coding accuracy and realize improved and correct risk adjusted revenue for Medicare Medicaid and ACA lines of business. Mike provides strategic direction at at Adjacent which offers best-in-class offshore healthcare operational support, such as credentialing, billing, data analyses and reporting, medical record transcription, medical record quality assurance, and clinical coding services. With our extensive experience and expertise in healthcare management, we assist healthcare organizations in enhancing operational efficiency, impact, and ROI. Adjacent significantly reduce costs by leveraging offshore, nearshore, and onshore expert team members and solutions. But best of all, we provide onshore client management and oversight to ensure your outcomes, efficiency, and project milestones exceed expectations. Mike has developed commercial and Medicare Accountable Care Organizations nation-wide. Completed applications and/or served as Project Manager on five of the original thirty-two approved Medicare Pioneer ACOs and additional ACOs in subsequent application cycles. As Chief Operating Officer of a large physician hospital organization in Scottsdale, AZ, Mike was responsible for health plan contracting strategy, physician and hospital system reimbursement and incentive programs, claims operations, and all information technology. Mike also has held several executive positions at major health plans in the Southwest marketplace.Mike worked for a leading health care software development firm responsible for developing and enhancing software to manage provider data, and administer Medicare and commercial reimbursement methodologies and directed the firm’s product support department.
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Chief Executive Officer360Cdi Jan 2021 - PresentPhoenix, Arizona, United StatesMike is CEO of 360CDI, the foremost onshore and offshore clinical documentation improvement company with a global presence spanning India, Nepal, the Philippines, Mexico, Puerto Rico, Colombia, and the United States. Mike plays a pivotal role in guiding the organization towards continued excellence. As the CEO, he is for responsible for leading the strategic vision and overall direction of the company, ensuring its growth and prominence in the healthcare industry. Mike oversees a wide range of services, including HCC coding, HEDIS and Star abstraction, virtual scribe, and clinical documentation support. Mike has a deep understanding of healthcare documentation and compliance. -
Executive ChairmanAdjacent Jan 2021 - PresentTempe, Arizona, United StatesAs the Executive Chairman of Adjacent, Mike plays a pivotal role in guiding and overseeing the strategic direction of this prominent global healthcare company. With a specialization in offshore operations support for a wide spectrum of healthcare entities, including health plans, medical groups, and ACOs, Adjacent's core areas of expertise encompass credentialing, billing, EMR interoperability support, provider data cleansing, and business process outsourcing. Mike's leadership as Executive Chairman is instrumental in driving innovation and operational excellence, ensuring that Adjacent continues to deliver high-quality, cost-effective solutions that enable healthcare organizations to thrive in an ever-evolving industry landscape. -
Senior ConsultantHealth Care Consultant Aug 2006 - PresentNationwide• Mike has worked with clients nationwide developing commercial and Medicare Accountable Care Organizations. Mike completed applications and/or served as Project Manager on five of the original thirty-two Medicare Pioneer ACO applicants approved and additional ACOs in subsequent application cycles. Mike has also assisted clients with CMMI Bundled Payment Initiative applications providing all data analytics and financial analysis for the projects. • Mike has worked as a Senior Network Development Consultant for multiple health plan clients in markets across the United States for over eight years. Mike has focused on contracting with individual hospitals, multi-hospital systems and large integrated delivery systems and has extensive expertise in identifying optimal network reimbursement strategies and methodologies. Additional expertise includes developing CMS compliant contract language. Mike has managed project teams and developed out-reach tracking tools to facilitate status reporting and workload management.• Mike has developed network adequacy analysis with target providers to ensure complete and competitive network to satisfy HSD regulatory requirements and service needs of enrollees.
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PrincipalIntellia Insight Aug 2015 - Dec 2020Edina, Mnintellia INSIGHT offers solutions for risk adjustment coding, clinical documentation improvement, concurrent coding reviews and quality measure abstraction.
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PresidentInnovative Health Care Solutions, Llc Aug 2006 - Mar 2011Medical Billing CompanyFounder and general manager of medical billing company. Responsible for all phases of business operations, business development and technology integration and application.• Developed start-up company to serve physician practice billing service needs• Experiencing good client growth and increased profitability• Establishing reputation for high quality operations and excellent customer service
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Board MemberMountain Park Ranch Hoa 2003 - 2008Past President and Board Member of one of the country's largest self-managed home owners' associations. MPR, located in Ahwatukee, has an annual operations budget in excess of $2 million and 7,500 Members.
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PresidentAln Medical Management Sep 2005 - Aug 2006Market lead for ALN’s largest region representing $43 million in client revenue annually. ALN is one of America’s fastest growing providers of outsourced medical billing solutions for private physician practices. Responsible for all client matters in the Arizona market, including marketing, sales, client management and profitability. P&L responsibly for Arizona market.• Managed clients though transition of new leadership and subsequent operations delivery system reorganization.• Provided local leadership for staff through corporate structural redesign and staffing reductions.• Lead region’s sales efforts to existing clients as well as new business development. -
Director Product SupportQcsi, Inc Jan 2005 - Aug 2005Responsible for operations of department providing general and technical support for QCSI’s healthcare related software products. Accountable for customer satisfaction and customer relationship management. Served as primary escalation point for customer reported issues and resolution. Provided support to internal departments for complex issue resolution. -
Product ManagerQcsi, Inc Mar 2003 - Dec 2004Designed software enhancements based on requests from internal and external clients. Translated customer business needs and requests into functional and technical designs for developers. Focus on provider contract management and reimbursement system design. -
PresidentScan Claims, Inc Nov 2000 - Jan 2002Founded and responsible for all general management, strategic planning and administration of document imaging company. ScanClaims specializes in scanning and Optical Character Recognition (OCR) of data from physician claims (HCFA 1500s). Scanning/OCR technology, combined with a proprietary Claims Inventory Management Solution, eliminates data entry expense, improves data accuracy and significantly reduces administrative expense for payors.
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Chief Operating OfficerScottsdale Pho Feb 1997 - Sep 2001Primary responsibility and accountability to negotiate and manage health plan risk contracts delivering annual revenue of over $120 million and 70,000 covered lives. Managed operations of fully delegated physician hospital organization with network consisting of 440 physicians and a two-hospital health system. Non-voting member of Board of Directors, Officers and Financial Performance Committees. Served as Interim Chief Executive Officer. Responsibilities included: Contracting and Business Development, Information Technology, Claims and Provider Reimbursement Departments.
Mike Opich Skills
Mike Opich Education Details
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Econometrics -
Economics -
Economics
Frequently Asked Questions about Mike Opich
What company does Mike Opich work for?
Mike Opich works for 360cdi
What is Mike Opich's role at the current company?
Mike Opich's current role is CEO 360CDI; Executive Chairman Adjacent.
What is Mike Opich's email address?
Mike Opich's email address is mo****@****saz.com
What is Mike Opich's direct phone number?
Mike Opich's direct phone number is +172038*****
What schools did Mike Opich attend?
Mike Opich attended Michigan State University, University Of Detroit Mercy, Michigan State University.
What skills is Mike Opich known for?
Mike Opich has skills like Medicare, Healthcare, Leadership, Healthcare Consulting, Management, Healthcare Information Technology, Process Improvement, Strategic Planning, Analysis, Medical Billing, Hospitals, Health Policy.
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