Experience

NeurAbilities Healthcare

• United States
• Medical Practices
• 100 - 200 Employee

• Director Revenue Cycle Management

  • May 2022 - Present



United Community & Family Services, Inc.

• Norwich, CT

• Director of Outpatient Revenue

  • Mar 2013 - May 2022



Self

• Griswold, CT

• Independant Practice Management Consultant

  • Jan 2011 - Sep 2013

  Consult with Federally Qualified Health Centers (FQHC) to review, assess and make recommendations on the following: Practice Management / EMR Setup Policies and Procedures Fee schedules Front desk procedures, best practices/work flow Staff assessment / Training Specialty Billing (BH and Dental) Data collection / Reporting Contracting / Credentialing AR / Business Plan Practice Manager for implementation of Practice Management System and Electronic Medical Records (EMR) Facilitate contracting and credentialing, as needed Maintain current information for CMS, State Medicaid, HRSA, NACHC, etc. Show less



Community Health Services, Inc

• Hospitals and Health Care
• 1 - 100 Employee

• Director of Revenue Management

  • Apr 2009 - Jan 2011

  In concert with the IT Directors ensures that all components of Practice Management System, Electronic Health Solutions (EHS) and Dentrix are operating efficiently Design of operating policies and procedures, workflow patterns, distribution of responsibilities and creation of data collection tools for all revenue management areas including patient accounts, provider credentialing and MCO contracting Periodically reviews the CHS fee schedule, provider coding practices and billing procedures to ensure compliance with federal and state regulation and makes recommendations to the CEO. Works with various clinical directors and their office manager to provide guidance and suggestions to improve the patient registration process to accurately collect patient demographic and insurance data Compiles and provides statistical information as requested by both internal staff and external sources Responsible for departmental operating budget, staffing level and strategic planning as it relates to the revenue function Establishes and fosters an active working relationship with payer source in order to have firsthand knowledge of the most recent developments and trends in claims processing and covered services Show less



United Community & Family Services, Inc

• Director of Corporate Contracts & Revenue Management

  • Nov 1999 - Mar 2009

  Oversee and manage client information system and database structure through analysis, development and implementation of internal policies. Prepare and conduct research for migration to Electronic Health Record environment Develop and implement systems, tools, reports and policies for revenue management Analyze data and recommend actions to maximize funding and maintain Regulatory compliance Manage internal and external statistical and data reporting Direct, monitor and provide follow-up on corporate billing, both outpatient and contractual Liaison with Managed Care and Insurance Companies as well as State government agencies Oversee UCFS and Managed Care credentialing for all agency providers Director of Health Services Administration 1999-2007 Monitored accounts receivable aging for all Outpatient Services including investigating and responding to any unfavorable trends identified Maintained all components of Medical Manager Practice Management System Designed operating policies and procedures, workflow patterns, distribution of responsibilities, and creation of data collection tools for all components of Administrative Health Services including, client registration, reception, medical records, patient accounts and provider credentialing. Managed and motivated staff of 35 personnel Compiled statistical information as requested by internal staff and external sources Collaborated with Outpatient Services Directors to design, implement and maintain service provider scheduling templates and encounter forms Prepared and assumed accountability for departmental operating and capital budgets Established and fostered working relationship with insurance company representatives to maintain first hand knowledge of most recent developments and trends in claims processing and covered services. Attend and participate in related meetings at State level Show less



United Services, Inc

• Managed Care Specialist

  • Jan 1996 - Jan 1999

  Prepare all insurance / managed care requirements, i.e. initial authorization, client case registration, special agreements, etc., to insure smooth client entry Follow-up and tracking of all authorizations and utilization review requirements Liaison for all managed care / insurance companies relating agency contracts, participating providers, insurance documents, licensures and client authorizations Conduct managed care orientation training for new staff members as needed Maintain list of authorized providers, contracts, managed care guidelines and form supply Verify insurance benefits and eligibility for new and continuing clients Investigate claim denials and advise client account staff Serve as agency's Community Liaison Show less



Stonington Institute

• UR / Billing Coordinator

  • Jan 1994 - Jan 1996

  Effectively managed billing department to ensure quality assurance and efficient workflow Charged with collection of aged accounts including third party and self pay Obtained information from various departments to ensure effective patient account management Directed and tracked utilization review and managed care process Oriented professional staff on policies and procedures related to billing and utilization review Coordinated efforts of clinical team relating to reimbursement to maximize patient benefits Handled all inquiries from staff and outside agencies regarding patient benefits, authorization and status Prepared daily and weekly patient census reports Performed Daily posting of charges and payments, preparation of UB92/ HCFA 1500 bills, electronic claim submission and monthly patient statements Coordinated petty cash disbursements and ledger, prepare daily bank deposits and assist Controller with miscellaneous daily and month end activities Show less