Experience

Accredo - An Express Scripts Company

• Hospitals and Health Care
• 300 - 400 Employee

• Senior Reimbursement Manager, Product Owner

  • May 2014 - Present

  Responsible for managing $130M in Medicaid and Managed Medicaid accounts receivable.Consistently meeting or exceeding cash goals and DSO goals. Organized and led project to streamline payer information to ensure compliance and regulation application within the operating system. Continual review and maintenance of the Medicaid Rules and Regulations internal share point site. Extensive experience researching State Medicaid websites to locate rules and information vital to implementation of compliant processes. Work consistently with Licensing/Legal department , Clearance, Pharmacy, Operations and Billing/Collection work streams to update and maintain payer data to ensure payment optimization and regulatory compliance. Implemented workflow processes reducing DSO and Bad Debt and increasing productivity across the collection teams. Subject Matter Expert on Medicaid Rules and Regulations. Managing multiple specialty therapies per payer.



Accredo Healthcare - a Medco Company

• Reimbursement Manager

  • Feb 2011 - May 2014

  Responsible for management of $50M in Medicaid accounts receivable. Project Manager for creation and maintenance of an internal compliance share point site to list and continuously review all state Medicaid rules and regulations, SOP maintenance and creation of continuous research team responsible for updating and maintains regulations in the site and the Accredo operating system. Presented site to Senior Management and Legal Department gaining full acceptance and approval. Consistently met and exceeded cash and DSO goals. Reduced staff from 23 FTEs to 11 FTEs while continuously improving key performance metrics. Worked with multiple departments to implement operating system protocols and operating system rules to automatically reflect payer rules. Management of multiple specialty therapies per payer.



Accredo Therapeutics

• Pharmaceutical Manufacturing
• 1 - 100 Employee

• Reimbursement Manager

  • Jun 2002 - Feb 2011

  Responsible for managing $10M in accounts receivable across all payer types: Medicare, Medicaid; Managed Medicare/Medicaid; Commercial Plans and Blues Payers. Consistently improved cash collection, reduced DSO and bad debt for all payers assigned with no increase in staff. Managed multiple therapies per payer - IVIg, PAH, Hemophilia, IDPN. Responsible for managing $10M in accounts receivable across all payer types: Medicare, Medicaid; Managed Medicare/Medicaid; Commercial Plans and Blues Payers. Consistently improved cash collection, reduced DSO and bad debt for all payers assigned with no increase in staff. Managed multiple therapies per payer - IVIg, PAH, Hemophilia, IDPN.