Kem Tolliver, FACMPE, CPC, CMOM

President at Medical Revenue Cycle Specialists
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Location
Washington DC-Baltimore Area

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Shawntea Gordon, MBA FACMPE CMOM

Kem is a consummate professional and an invaluable mentor. I had the honor of meeting her at an MGMA meeting and have stayed in touch ever since. Her knowledge of the full revenue cycle is extensive and if there is an answer she doesn't know, she knows the right person to talk to. I attribute much of my career to the long-term mentorship and education she has provided me throughout the years. If you have the opportunity to work with her it may be the greatest thing you ever do for your organization.

Tonda Gibbs

Kem is very detailed-oriented and produces great results for a company's goals and expectations. She definitely leads by example. It was such an honor to have worked with her. I have learned a variety of skill sets within the medical billing and coding (ICD-9 & ICD-10) arena from her lead. These new skill sets have truly enhanced my careers goals. Peace & Blessings to you and your family. Greatfully Thank you, Tonda

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Credentials

  • Fellow (FACMPE), American College of Medical Practice Executives
    MGMA
    Oct, 2014
    - Oct, 2024
  • Certified Medical Office Manager, (CMOM) Practice Management Institute
    Practice Management Institute
    Jan, 2003
    - Oct, 2024
  • Certified Professional Coder, (CPC) American Academy of Professional Coders
    AAPC
    Feb, 2001
    - Oct, 2024

Experience

    • United States
    • Operations Consulting
    • 1 - 100 Employee
    • President
      • Jan 2008 - Present

      Founder and president of this boutique medical revenue cycle consulting firm, which improves workflow and practice revenues for small to mid-size physician practices, allowing them to focus on patient care. Starting with an in-depth practice assessment, its team of highly experienced, certified specialists offers a customized suite of practice management services that includes: • Practice and coding assessments • Revenue cycle and reimbursement improvement strategies • Staffing solutions including interim practice management, staff recruitment services, HR support • Staff training and development • Managed care contract and fee schedule negotiation • HIPAA and regulatory compliance Show less

    • President
      • Jan 2020 - Present

      Serving beside awesome leaders as the President of the Hyattsville/Prince George's County Chapter of the American Academy of Professional Coders (AAPC). We strive to provide innovative educational learning experiences for our members who seek to disrupt the status quo and gain certification, professional development and networking opportunities for growing healthcare industry leadership responsibilities. Serving beside awesome leaders as the President of the Hyattsville/Prince George's County Chapter of the American Academy of Professional Coders (AAPC). We strive to provide innovative educational learning experiences for our members who seek to disrupt the status quo and gain certification, professional development and networking opportunities for growing healthcare industry leadership responsibilities.

    • United States
    • Hospitals and Health Care
    • 300 - 400 Employee
    • Member Institutional Board Of Directors
      • Nov 2016 - Sep 2017
    • Chief Administrative Officer
      • Nov 2003 - Nov 2013

      Provided executive-level leadership for a 12-physician, privately owned physician practice while fostering a collaborative relationship with area medical centers. Oversaw daily clinical, facility, IT, and administrative operations and managed a multi-million dollar budget. Accomplishments included: • On-boarded and doubled the number of practicing physicians and CRNPs. • Consistently increased revenues by 30% annually by establishing, trending, and monitoring coding, billing, and collections protocols. • Led the organization in establishing a formal board structure for optimal organizational governance. • Seamlessly managed all aspects of EMR and PM software implementation. • Worked as a member of the senior leadership team to broker multi-million dollar revenue agreements within multiple reimbursement verticals. • Managed all aspects of human capital, employment law, compensation, and benefits administration. Show less

    • United States
    • Higher Education
    • 700 & Above Employee
    • Adjunct Professor
      • Feb 2009 - Jun 2009

      Teach, mentor, and encourage students to research on the areas of course focus. Accomplishments included: • First Professor to instruct special semester hybrid (on-line and classroom) curriculum on Principles of Healthcare Reimbursement and HIPAA Compliance. • Developed course syllabus, assignments, lectures, and grading structure. Instructed students using first-hand examples of the medical revenue cycle, DRG calculations, fee schedule management, regulatory compliance, and managed care reimbursement guidelines. Show less

    • United States
    • Medical Practices
    • 1 - 100 Employee
    • Practice Administrator
      • Jun 2008 - Jun 2009

      Worked with the president and board of directors to lead a 40-physician group while fostering relationships with several ASCs and medical facilities. Oversaw functions of out-sourced billing company and overseeing a multi-million dollar budget. Key accomplishments were: • Renegotiated managed care reimbursement contracts with multi-million dollar outcomes • Initiated auditing and tracking mechanisms to monitor reimbursement trends of the out-sourced billing company. • As part of the senior management team, negotiated multi-million dollar services agreements. • Revised and implemented the organizations HIPAA compliance plan, billing compliance plan, and standard operating manual. • Performed credentialing, recruiting and on-boarding of new physicians. Show less

    • Practice Manager
      • Nov 2003 - Jul 2008

      Managed day-to-day operations, HR, and finances for a growing multi-specialty group. Accomplishments included: • Analyzed and renegotiated all managed care reimbursement contracts with an annual revenue increase of $650K. • Negotiated medical directorship and services agreements for a new sleep laboratory. • Directed billing, collections, and coding audits to maintain 90% collections ratio. Managed day-to-day operations, HR, and finances for a growing multi-specialty group. Accomplishments included: • Analyzed and renegotiated all managed care reimbursement contracts with an annual revenue increase of $650K. • Negotiated medical directorship and services agreements for a new sleep laboratory. • Directed billing, collections, and coding audits to maintain 90% collections ratio.

    • United States
    • Hospitals and Health Care
    • 700 & Above Employee
    • Administrative Coordinator
      • Mar 2003 - Nov 2003

      • Managed administrative, billing and clinic operations as well as residency programs for two specialty departments. • Awarded Ryan White HIV/AIDS Program grant funding

    • Q/A Training Coordinator
      • Mar 2002 - Mar 2003

      • Developed & conducted classroom training programs on intake, CPT & ICD-9, billing and collections and software use. • Initiated reconciliation processes to bill for uncaptured services for 30 departments.

    • 1 - 100 Employee
    • Operations Manager
      • Mar 2001 - Mar 2002

      Worked in collaboration with CEO and Board of Directors to ensure effective management of 7 physician offices and a centralized call center. Performed oversight of satellite Office Managers. Accomplishments included: • Initiated new-hire orientation and training programs. • Implemented organizational standard operating manual. • Researched, implemented, and provided training on company-wide HIPAA compliance program. • Collaborated with A/R Manager to increase time of service collections by 25% for all satellite medical offices. Show less

    • Bill Audit Rep III
      • Jun 1999 - Mar 2001

      • Initiated internal audits of medical billing, collections, and coding. • Created Medical Office Liaison role to enhance communications and reduce errors. • Developed SOP’s for intake, charge entry and coding for 30 departments. Initiated special collections projects grossing $1M monthly revenues.

    • Residency Program Coordinator
      • Mar 1997 - Jun 1999

      • Managed all aspects of residency programs. • Performed intake, charge entry, coding, surgical posting, pre-certification and transcription. • Created uncaptured charge reconciliation tools, time of service and coding maximization protocols; generating over $1M annually

Education

  • Washington Adventist University
    Bachelor of Science (Double Major), Majors: Healthcare Administration & Organizational Management

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