Provide consulting and auditing services for various clients in the healthcare arena.

Provide consulting and auditing services for various clients in the healthcare arena.

Admissions, payable, resident trust accounts, AR posting, insurance verification, obtaining authorization for services and many more hats.

• Accomplished reduction of outstanding Accounts Receivables over 365 days by <60% in less than eight months• Performed all functions of Private Pay billing for self-pay residents for two facilities• Identification of uncollectible accounts and decision-making on resolution of accounts, i.e. collection, legal action, or bad debt write-off’s• Provided assistance to residents and families regarding financial responsibilities for self-pay and Medicaid cost-sharing program• Assisted corporate attorney in procedures for obtaining judgments against responsible parties with outstanding accounts in accordance with St. Ann’s policies and procedures• Compared and chose collection agency for smaller outstanding accounts and negotiated points from contract percentage• Performed billing functions for Long Term Care Insurance billing• Implemented procedure for follow up on outstanding accounts and provided reports as requested by Senior Management on status of outstanding accounts• Accomplished reduction of Accounts Receivables over 240 days approximately $500K each month• Provided vigilant follow up of outstanding private accounts and review of procedures for follow up, to continuously improve the process and create new ways to streamline• Uncovered erroneous posting and adjustments by diligent research of account ledgers and corrected the issues in the proper manner

● Accomplished reduction of 120+ accounts receivable by 60% by identification of missing receivables and postings of paid claims ● Identified patterns in aging reports which indicated system issues, corrected issues to control AR● Implemented HIPAA compliance for paper and email transmissions● Trained staff in correct billing procedures for ePaces claims● Applied knowledge of Prompt Payment Laws, Worker’s Comp and No Fault regulations to collect on claims in excess of 365 days overdue, including interest● Billing for neurosurgery and radiology● Physician credentialing for all major insurance carriers

● Uncovered collected in excess of 10K in unpaid Medicaid claims in first 6 months● Identified open accounts in Blue Cross Financial Class and worked with management atExcellus to reach a settlement for payment of claims going back four years and accomplishedreduction of Preferred Care claims by 6K with settlement● Assisted in creation of Accreditation manual for company and created Corporate ComplianceProgram and implemented compliance procedures company-wide, implemented HIPAAcompliant documents; brought all aspects of billing practices, patient files and companydocumentation/forms into compliance with CMS accreditation guidelines● Implemented and follow up procedures and maintained constant attention to accountsreceivables and dealing with issues in an immediate fashion to reduce AR in all financialclasses● Identified system errors resulting in AR loss, corrected root causes and provided directinfluence on adjusting the claims to maximize receivables going back up to six years

● Accomplished reduction of AR from 3.9M to 2.7M in first 8 months, including identificationof outstanding receivables from previous ownership as noncollectable and/or incorrectlyposted● Provided oversight to prevent current accounts from aging into >90-120 days● Accomplished opening of dozens of Medicaid cases, representing approximately $10K weeklyincome for company● Provided direct influence on initiation of lawsuits against residents, families or estates, workingclosely with company attorneys to provide accurate information● Provided assistance to off-site IT personnel, by taking over on-site IT and other computerneeds● Performed credentialing due to ownership change & maintained NPI information for threefacilities● Assisted in conversion to new claim form formats and provided training to billing staff on errorsand denials in original billings

● Claims submission for Medicare Part B and HMO claims for Skilled Nursing Facilities for PT, OT & SLP, ● Medicaid transportation billing & clinic billing● Workers Compensation and No Fault billing● Uncovered incorrect coding and allowances for Medicare Part B therapy claims● Provided direct influence on adjusting the claims to recover in excess of half a million dollars in lost revenue

● Part B billing for 14 Skilled Nursing Facilities● Medicare reviews and appeals with a 90% win rate● Posting of cash receivables● Customer Service