Experience

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  Taylor medical center-northeast tx physican services (gsfhc)

  Aug 1998 - Jun 2003

  Clinic coordinator/manager

  • Responsible for all management and operational aspects of the clinic and staff• Daily/monthly administrative and financial reporting and budget• Monthly chart compliance audits• Cpt/ICD-9 coding, billing, and collections• Payroll• Purchasing and Inventory• Maintained policies and procedures to ensure that all aspects of the clinic were compliant will all accrediting bodies (i.e. JCAHO)• Received Employee of the Year

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  Good shepherd medical center-family health center

  Jun 2003 - Nov 2005

  Clinical coordinator/practice manager ii

  • Responsible for all management and operational aspects of the clinic and staff• Daily/monthly administrative and financial reporting and budget• Monthly chart compliance audits• Cpt/ICD-9 Coding and Billing• Payroll• Purchasing and Inventory• Maintained policies and procedures to ensure that all aspects of the clinic were compliant will all accrediting bodies (i.e. JCAHO)

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  Wellness pointe

  Nov 2005 - now

  Corporate compliance officer

  •Manage and oversee all Quality and Compliance related functions including Provider Credentialing and Networking, Safety and Risk Management, Corporate Governance and Quality Metric Reporting to all appropriate entities.•Project Management and Oversight for Compliance Performance Improvement (CPI), Patient-Centered Medical Home (PCMH), Uniform Data System (UDS) Reporting, Federal Torts Claims Act (FTCA) Deeming, Health Resources and Services Administration (HRSA) Site Visits and Service Area Competition (SAC) Applications, Electronic Handbook (EHB) Required Reporting and Auditing (i.e. clinical, billing, financial, grant, etc.).•Grant Writing (State and Federal), Grant Management, and Quality and Financial Reporting•Develop; Implement; and Train on Policies, Processes, and Procedures to enhance Operations and Profitability•Subject matter expert in the rules and regulations of Medicare, Traditional Medicaid, Chip, and Managed Care Organizations (MCOs).•Maintain Practice Management System reporting and functionalities. Work closely with IT Director to ensure that the center’s E.H.R. systems are set up to capture the required data elements for billing, meaningful use, PCMH, UDS Metrics, HEDIS Measures, etc.•Assist CFO with budgets, Medicare Cost Report, Financial and Single Audits, etc. Show less

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  Wellnesspointe

  Nov 2005 - now

  Management and oversight of all aspects of the Revenue Cycle and Provider Credentialing. Specialize in FQHC Coding, Billing, and Collection Techniques as well as State and Federal Grant Billing. Practice Management System set-up and ongoing maintenance. Financial Reporting for trends, growth, and variances. •Manage and oversee all revenue cycle functionalities including Coding (CPT/ICD-9 and ICD-10), Billing and Collections and all related workflows for the center’s six clinics and two local hospital affiliates (i.e. Pediatrics, OB-Gyn, General Practice, Psychiatry, Psychology, Counseling, Substance Abuse, Vision, Dental and Hospital).•Subject matter expert in the rules and regulations of Medicare, Traditional Medicaid, Chip, and Managed Care Organizations (MCOs).•Exceptional Collection Percentages; less than 5% denial rate and less than 2% Past Timely Filing.•Oversight of Provider and Facility networking with Medicare, Medicaid, Children’s Health Insurance Plan (CHIP), Managed Care Organizations (MCOs) and Private Insurance carriers. •Manage Provider Credentialing and Privileging pursuant to FQHC and the local hospital's rules and regulations.•Facilitated the upgrading and maintenance of the Practice Management System for revenue/billing purposes.•Responsible for grant reporting, audits (state and federal), meaningful use readiness, and Financial KPI Reporting.•Assist with budgets, Uniform Data System (UDS) Reporting, Financial, QI/QA and Single Audits.•Received numerous accolades from state and federal agencies and other FQHC constituents in reference to our billing and collection activities.Over 20 years of hands-on Practice Management and Professional Physician Billing/Collections. Show less

  • Director Of Quality and Compliance

    Mar 2017 - now

  • Revenue Cycle Director

    Nov 2005 - now
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  Management solutions consulting group

  Jan 2019 - now

  Healthcare consultant

  Health Center Program - Site Visit Consultant Audit Reviewer for Federally Qualified Healthcare Centers (FQHCs)