• Partner with executive leadership in developing overall strategic direction and execution plan for all business lines• Support organizational communication and presentations for quarterly business reviews and other executive levelsmeetings• Maintain vendor relationships and work with legal on contracts and other documents required to deliver services• Implement governance framework and establish meeting series to manage processes• Oversee budget development and monthly accountability working with finance and other stakeholders• Oversee training, quality, and project management teams supporting all business lines• Work to develop and maintain IT strategies in collaboration with Revenue Cycle Management updates and compliance.• Drive process improvement initiatives, strategic plan implementations, and change management actions. Provides insight, advice, and consultation to ensure the use of the most appropriate processes and procedures to increase efficiency and effectiveness of the reimbursement function.• Measure performance and monitor monthly and annual trends and other pertinent performance metrics, providing analyses, observations, and recommendations to management to drive continuous improvement efforts in all areas of the revenue cycle.• Drives the performance of the employees by establishing expectations/goals, providing informal feedback throughout the year, and formal feedback in the form of the annual performance evaluation.• Monitors all major issues impacting divisional reimbursement operations and collections, ensuring appropriate actions are taken to address identified issues and providing guidance and expertise as necessary to ensure an effective and suitable resolution.• Other duties as assigned

Hired to train new Hospital Revenue Cycle Manager on the responsibility of managing the complete revenue cycle process, how to manage daily monitoring, analyzing billing effectiveness and cash flow, how to identify issues and trends and make procedural changes to help drive productivity and profitability where warranted. Training included utilizing knowledge of revenue cycle operations to maximize performance relative to hospital relationships, client satisfaction, desired survey results, and hospital financial performance indicators. Trained new manager onleadership responsibility of leading, managing, and developing other employees as it related to all phases of revenue and reimbursement. Created policies and procedures to set a benchmark to operate.

Hired as the right hand to the Mayor; manage daily functions of eight employees in office. Manage all licensing matters; review, sign off and seal licenses for businesses in need of licenses, enabling economic development. Implement written policies and procedures that govern the accounting and business functions of the municipality. Record and prepare meeting minutes; handle invoices; monitor and collect accounts receivables; assist in preparing monthly financial statements to include preparing monthly balance sheet, income, and expense reports. Compose written and oral reports/recommendations to the Mayor concerning market trends. Handle all financial matters including reconciliations, preparation of trial balances and financial and statistical reports as directed by the Mayor.• Transformed office by introducing controls, improving accountability, and reducing losses/theft of assets.• Built relationships with various groups; manage bidding process to execute largescale projects including the construction of a new fire and police departments.

Oversaw revenue cycle process for 25 bed critical access hospital, a FQHC, and multi-specialty clinics. Led and managed 5 departments with accountability for up to 10 direct reports. Plan and direct daily operations of the patient financial services department which included scheduling, registration, collections, coding, and billing, ensuring all areas of responsibility operate in accordance with accreditation standards, federal, state, and local regulations and organizational policies and procedures. Analyzed insurance payer agreements, evaluated current practice management software; calculated and maintained payer tables and produced revenue accrual in direct alignment with payer contracts. • Implemented RYCAN Software, which replaced old billing software, resulting in attainment of higher clean claim rates resulting in faster turnaround time of claims.• Improved Clean-claim rates from 0% rate to 85-90% where all claims were touched prior to submission, enabling efficiency and more time to follow up on past due claims.• Reduced number of AR days from 60 days to 40 days for SH and 30 to 25.5 days for SMCS.• Exceeded goals of collecting 85% of revenue billed within 60 days in the first six months in the position.• Implemented new denial management software, which improved the denial management process for hospital, and SMCS, which reduced the bottom line of accounts receivables.• Improved accuracy of billing information coming out of various departments to ensure less manual correction of CPT & diagnosis codes, reducing billing and compliance issues• Implemented the HRSA COVID 19 uninsured billing process, enabling hospital and SMCS to collect cost of billing for COVID 19 tests, resulting in additional $350,000 monthly revenue.• Improved and recovered lost revenue in lab requisitions due to poor work processes with no accountability, which previously lost $60K+ each month; increased lab revenue by additional $400,000 in six months.

Developed, monitored, and directed audit and compliance in coordination with the Integrity Program. Ensured accurate coding, audit, documentation, and data quality complies with all regulatory federal and state requirements. Led and accomplished key elements of an effective revenue cycle compliance program was in place and operationalized as it related to the Corporate Integrity Program (e.g., policies, education, risk assessments, profiling, work plan monitoring, audit, reporting and corrective/remedial actions and daily operations). Provided guidance and education designed to promote regulatory compliance related to charge capture, documentation, coding, and billing. • Successfully led the advancement of the hospital mission of providing quality health care to all patients, while ensuring prevention of fraud, waste, and abuse in the health care delivery system.

Assigned for Critical Access Hospital, Rural Hospital Clinic, and a Stand-Alone Family Healthcare Clinic management oversight for the development of high quality, cost effective, and integrated Revenue Cycle, including billing, collections, patient/resident accounting, information management, utilization review, patient access/registration, and charge master management for the hospital and clinics. Directed and managed billing department team of 12 employees; supervised a registration departments and data management departments. Managed complex revenue cycle projects, working with key stakeholders across hospital. Coordinated and implemented revenue cycle initiatives, including identifying and assembling resources; monitored operational performance to anticipate and met the needs of leadership. Ensured that organizational integrity and regulatory standards were maintained in all policies, procedures, and processes. Provided appropriate education, training, and monitoring of these policies. • Served as Facility Manager of clinic and Pod rentals to external providers, maintained and updated budget and contracts.• Formulated and made recommendations to leadership on policies/practices relating to revenue cycle improvements; received buy-in, approval, and feedback.• Improved claim rate from 25% to 95% and improved revenue/accounts receivable by 60%.• Restructured billing department, making it more efficient.

Monitored risk management strategies to ensure regulatory compliance with timely and detailed reports. Assisted director, manager, and coordinator of billing compliance in organizing and implementing compliance initiatives related to hospital and physician billing in accordance with rules, regulations, laws, and payer contractual requirements. Finalized reimbursements based upon audit findings. Accepted and rejected clinical coding recommendations based on provider documentation details, administrative policies, regulatory codes, legislative directives, precedent, or other guidelines to perform analysis of provider billing against Current Procedural Terminology (CPT) coding logic and rules.• Met all goals for 2 years consecutively.

Led and supervised all revenue cycle activities related to several departments - central billing, customer service, admissions, and registration staff, comprised of up to 30 staff.• Met all collection goals throughout tenure.

Developed learner-centered curriculum, instructs students, and employs various methods of assessments for the following classes: Health Information Data Management, Human Biological Systems, Medical Billing & Coding, and ICD-9 Coding.• Achieved high student pass rates.

Directed billing department operations for four facilities a total 20 employees. Managed, coached, and motivated staff. • Achieved high levels of team performance, met budgeted goals, and demonstrated consistency in current A/R.