Spearheaded the research into market viability to move from a 100% cash-based operation to accepting insurance within the organization. Assessed the current revenue cycle processes and financial performance of the healthcare organization and identified areas of inefficiency and developed strategies to optimize revenue generation.Key Accomplishments:• Educated executive leadership giving Compliance and Regulatory Guidance.• Improved the patient’s financial experience by presenting various transparent billing practices, offering payment options, and providing financial guidance through the insurance process. • Contributed to the development of long-term revenue cycle strategies aligned with the organization's goals and financial objectives.

I partnered with executive leadership, resulting in the successful opening of 23 clinics across 5 markets in just three years. I also achieved a significant increase in total cash collections, growing from zero dollars per month to an average of $5.5 million per month. Finally, I established and streamlined the RCM department for scalability, including the hiring, retention, and onboarding of a high-performing team of over 25 individuals.Some Key Accomplishments Includes:• Creating the RCM team and business lane, implementing successful career development and succession plans for RCM leaders.• Utilizing a combination of outsourcing and internal IT infrastructure to enhance lane efficiency and optimize operations.• Leading the development and implementation of an in-house dental insurance verification application, resulting in a team of 10 full-time employees conducting verifications and a projected cost savings of over $250,000 annually for the RCM budget.• Achieving a successful rollout of a test-bed dental clinic in Manhattan through a partnership with Juxtapose VC.• Amplifying the effectiveness of the Revenue Cycle Function in the test clinic, leading to improved insurance verification, patient collections, claims billing, cash application, and accounts receivable processes.• Attaining valuable insights by testing and analyzing reimbursement rates, claim denial rates, and contracting in-network relationships with dental insurance payers.

I led the hiring and management of a highly skilled offshore SDC Insurance Team consisting of 20+ full-time employees in Costa Rica. Designed and implemented a comprehensive revenue cycle process for Smile Direct Club, encompassing insurance benefits verification, charge entry, cash posting, and A/R reconciliation. I also increased the efficiency of the Insurance Verification Team by managing and overseeing the handling of 10 - 15,000 verifications per month.Some Key Accomplishments Includes:• Achieving a successful partnership with Change Healthcare as the main point of contact for Insurance Verification, ensuring seamless integration and effective collaboration.• Establishing and maintaining a strong relationship and budget management with MOS, an RCM outsource vendor for Insurance Verification.• Successfully selecting a reliable 3rd party Revenue Cycle IT solution for Charge Entry, Claims submission, and A/R Management.• Developing and implementing a comprehensive training curriculum for all new Revenue Cycle employees, enhancing their skills and performance.• Capturing lucrative contracts with major benefits payors, including Delta Dental, HUMANA, United Concordia, and Blue Cross Blue Shield of Tennessee.

Work with the VP of Revenue Cycle to develop IT requirements and American Home Patient Business rules to implement or improve processes. Oversee the maintenance and implementation of Insurance master file for American Home Patient; testing and deployment of Cash Applications, CMN/PAR Task tracker Deployment, as well as Claims Management. Plan action items and communicate reasons for slippage in timelines to executive management teams. Work Directly with IT development team for implementation and improvement of Revenue Cycle Applications.

• Primary point of contact for outsourcing vendor (IBM) for QA results and process improvement.• Identifying and implementing process improvement initiatives for Revenue Cycle management lines of business.• Lead Conference calls and WebEx’s for Accounts Receivables, Cash Posting, Credit Management, and Billing services.• Manage the day to day processes of the RCM Quality Assurance team and ensure that the QA testing is as effective as possible.• Working with the RCM Leadership team to maintain and reach Quality and throughput goals.