Consultant to physicians, practice administrators and office managers in the assessment and development of efficient, effective operational processes and internal controls to support good compliance practices while generating improved cash flows. Also support financially distressed medical practices in addressing adverse billing audit findings

Provided a positive and engaging learning experience to prepare students for employment in the revenue cycle industry within the hospital, clinic, physician office, nursing home and medical lab community. Utilized classroom, lab instruction and student assessment techniques to provide real world examples, support, tutoring and other assistance as needed for success. Administered on Campus and via LMS virtual learning platform.

Team Lead 2014-2018Subject Matter Expert leading a team of field reimbursement managers providing reimbursement access, support and education to our customers. Effectively coached, developed, motivated and monitored team performance to include regular and timely feedback, proven coaching techniques and actionable plans to develop talent. Contributed to the development of reimbursement and patient access strategies and tactics for product and brand launch and/or expansion of FDA indications.

Worked directly to support the needs of the manufacturer’s sales force and their customers in coordination with their client liaison serve as an expert in payer policies and provide support to facilitate appropriate patient access and utilization of services to ensure their access to care. Developed and maintained strategic business relationships with appropriate key stakeholders involved in patient’s access to therapy, within a practice, clinic or hospital. Leveraged health system experience to maintain credibility as a valuable resource in resolving product specific inquiries such as coverage criteria, PA support, product acquisition (buy/bill, retail, SP, limited distribution) and reimbursement services to include benefits verification, copay assistance and site of care/transition of care needs.

Reporting directly to the Chief Compliance Officer provided oversight of the entire compliance training (New Hires as well as Annual Training Program), from design through implementation for all hospital employees as well as compliance monitoring and OIG workplan development. Lead and managed a team of three certified coders and nurse auditors responsible for conducting compliance training and internal monitoring activities

Under the leadership of the Corporate Chief Compliance Officer, provided compliance and privacy officer oversight and subject matter expertise to Revenue Cycle Services leadership and associates. Provided Patient Financial Services division guidance and support to ensure RCM billing integrity policies and procedures were effective in the creation and processing of healthcare claims in accordance with payor and CIA reporting requirements. Developed and maintained strategic relationships with associates, health teams, and physicians as a knowledgeable resource in response to compliance and privacy matters affecting Revenue Cycle operations.

Planned, coordinated and directed third party insurance billing functions (UB04/1500) for a multi state hospital organization. Ensured timely claim submissions and department processes were completed in accordance with company policy and federal compliance guidelines. Core contributor in the successful systematic conversion of 6 diverse claims system into a successfully financial consolidated regional office.

As a member of a dynamic revenue cycle leadership team at one of the country’s largest Level 1 Trauma hospitals serving an average of 1M OP visits annually; I lead an impressive 120 member team excelling in service, productivity, quality and financial performance objectives specific to claims processing (UB02/1500), denial management and revenue collections in hospital, ambulatory and physician practice.

Direct supervision, training, allocation of the daily workload and motivation of hospital, clinic and physician billing staff to achieve strategic objectives and peak productivity.