Experience

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  The orlando heart center

  Jul 1998 - Jun 2000

  Business office manager

  • Managed an accounts receivable of $5M with monthly revenue of $2M.• Accountable for the operations of billing, collections, patient registration, scheduling, and cash application, pre-cert, coding, and patient discharge (30 employees at multiple locations).• Monitored managed care contracts, indemnity plans, Medicare, and Medicaid to identify payment errors, denials and reimbursement trends.• Developed departmental budget.• Identified and resolved compliance issues.• Improved the flow of information throughout the business office to reduce errors.• Reorganized patient access to effectively obtain eligibility information, referrals, and authorizations.• Resolved and responded to customer complaints.• Educated medical staff on managed care contracts.• Trained schedulers to collect patient information essential for pre-certification. Show less

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  Curascript pharmacy inc.

  Jun 2000 - Nov 2001

  Director of billing and reimbursement

  • Managed an A/R of $23M and monthly cash of $13M.• Directed the operation of the billing/reimbursement department (40 employees).• Billed and collected from 180 managed care contracts, IPAs, Medicare and Medicaid throughout the U.S• Resolved sensitive reimbursement issues concerning internal and external customers.• Educated staff regarding new managed care contracts.• Created and implemented billing/ reimbursement policies and procedures.• Initiated monthly financial reports.• Comprehensive knowledge of: timely filing, refund, collections, and managed care laws for multiple states. Show less

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  Self-employed

  Jan 2002 - Nov 2004

  Healthcare consultant

  • Reviewed and resolved physician’s accounts receivable issues.

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  Axium healthcare

  Nov 2004 - Jul 2006

  Vice president of billing and reimbursement

  Managed an A/R of $7M• Directed the operation of patient verification, authorization, billing, collections, and cash application (15 employees)• Resolved sensitive reimbursement issues concerning internal and external customers.• Educated staff regarding new managed care contracts. • Wrote and implemented departmental policies and procedures.• Extrapolated data to create monthly financial reports.• Trained staff on new Medicare Part D program.• Implemented electronic billing.• Designed relational database to sit on top of inadequate patient accounts receivable system. Show less

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  Ameripath/quest

  Oct 2006 - Sept 2014

  AMERIPATH Orlando, Florida Anatomical Pathology Billing Director (10/2006 – 7/2008)• Managed an A/R of $42M with monthly cash of $26M. • Directed Orlando Billing Center operations to included: billing, collections, coding, customer service, and payment posting (68 employees).• Established new billing center in Orlando, Florida: staffed, developed departmental structure, wrote job descriptions, and coordinated all training.• Implemented and tested new account receivable system.• Resolved sensitive reimbursement issues concerning internal and external customers.• Comprehensive knowledge of: revenue cycle process, managed care contracting, electronic claims submission, ERAs, clearinghouse processing, credentialing, banking, refund processing, credit card processing, detailed AR analysis/trending and productivity measures. Show less

  • Regional Manager, Business Transformation

    Jul 2008 - Sept 2014

  • Billing Director

    Oct 2006 - Jul 2008
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  Consultant

  Oct 2014 - now

  Consultant

  Consulting – Orlando, FloridaAvella Specialty Pharmacy• Assisted in establishing new billing center in Lake Mary, Florida: staffed, developed departmental structure, wrote job descriptions, and coordinated all training.• Restructured the job responsibilities in the Phoenix Arizona location to take advantage of existing talent.• Established new policies and procedures because very few were in place.• Resolved sensitive internal reimbursement issues around Medicare.Behavior Support Services Inc. Orlando, Florida• Analyzed current rejections and established action plan.• Resolved provider rejection problems with Medicaid and Medicaid HMO plans.• Developed managed care contract matrix while collecting and reviewing all managed care contract. Show less

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  Healtfirst

  Sept 2015 - now

  Performance improvment manager