Experience

Colorado Pain Care

• United States
• Medical Practices
• 1 - 100 Employee

• Director, Revenue Cycle Management

  • Feb 2020 - Present

  Receivables Management:• Terminated relationship with billing company, transitioned practice to in-house billing providing hands-on management of full revenue cycle.• Implemented correct coding measures, restructured financial classes.• Performed gap analysis across departments, implemented process improvements.• Identified and corrected coding practices to maximize revenue.• Perform contract analysis and interpretation, charge master management.• Implemented patient collection policies to comply with Medicare guidelines.• Perform hands-on management of full revenue cycle, from contract analysis and interpretation through patient collections.IT Management: • Analyzed practice management system set-up. Corrected PM system set-up errors including a complete rework of insurance plan set-up and e-remit set-up.• Identified and added missing payer IDs for electronic claims submission, electronic insurance eligibility verification and e-remit auto-posting.Personnel Management: • Manage and direct personnel in Billing, Central Referrals, Authorizations & Insurance Verifications departments.• Interview, hire, evaluate, coach, counsel and terminate employees.



Colorado Orthopedic Consultants, a division of Orthopedic Centers of Colorado

• Revenue Cycle Director

  • May 2016 - Jul 2019

  Summary of Accomplishments:• Hired, on-boarded, and trained new billing staff, insurance verifications, and authorizations staff• Terminated relationship with billing company, implemented correct coding measures, restructured financial classes, implemented charge capture and revenue integrity processes• Implemented month-end balancing, corrected PM system set-up errors including a complete rework of insurance plan set-up and e-remit set-upReceivables Management:• Evaluated and recommended optimal revenue cycle organizational structure• Transitioned practice to in-house billing, providing hands-on management of full revenue cycle for 3 companies• Established and implemented standard metrics to monitor revenue cycle• Developed analytics dashboard reporting real-time KPIs for operational, managerial and executive leadership• Performed contract analysis and interpretation, charge master management, revenue integrity monitoring and assurance• Implemented collection procedures to bring practice into compliance with Medicare guidelines• Wrote and implemented new financial policy to eliminate carrying patient debt• Researched, evaluated and implemented patient financing alternative to Care Credit• Achieved 29-day reduction in DSOIT Management: • Analyzed practice management system set-up• Added payer IDs for electronic claims submission, electronic insurance eligibility verification and e-remit auto-posting• Identified, evaluated and recommended front-end technology to streamline check-in, patient collections and eliminate data entry errors impacting the revenue cyclePersonnel Management: • Managed and directed personnel in Billing, Central Referrals, Authorizations & Verifications• Interviewed, hired, evaluated, coached, counseled and terminated employees• Created a more inclusive cultural environment that fosters horizontal learning and employee participation



Balboa Nephrology

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Revenue Cycle Manager

  • Nov 2014 - Apr 2016

  Challenges Resolved: Poor A/R follow-up, poor employee morale, practice management system set-up errors impacting reporting, lost claims files. “VAR” disconnect. ICD-10. Receivables Management: • Hands-on management of full revenue cycle, from contract analysis and interpretation, to appealing claims and assigning follow-up duties• Identified and resolved process problems in A/R follow-up• Restructured financial classes to correct reporting discrepancies • ICD-10 training and testing• Selected new collection agency• Implemented patient collections policies to comply with Medicare guidelines• Built Coding Compliance & HIPAA Compliance TeamsIT Management: • Analyzed practice management system set-up• Added payer IDs for electronic claims submission and electronic insurance eligibility verification• Identified and resolved issue causing lost claims batches, which included researching and selecting a new clearinghouse Coding Compliance Management:• Selected and trained chart auditing team• Performed in-depth chart audits• Generated and distributed coding reports to physicians



Denver Nephrologists, PC (DNPC)

• Central Billing Manager

  • Jan 2009 - Oct 2014

  Challenges Resolved: High timely filing write-offs, poor A/R follow-up, under-trained staff/poor employee performance. Practice management/EMR software conversion.Receivables Management:• Hands-on management of full revenue cycle, from contract analysis and interpretation, to appealing claims and assigning follow-up duties• Negotiated reimbursement increases with numerous payers• Trained staff in appeals techniques including using Title 10 of the Colorado Revised Statutes to obtain payment• Eliminated timely filing write-offs by implementing better claims follow-up/appeals processes• Reduced DSO from 48 to 23 daysIT Management: • Active participant on EMR Committee• EHR/PM software evaluation, selection and implementation• Co-Administrator for new PM/EMR software eClinicalWorks• Responsible for table creation and maintenance; calculating, loading and maintaining fee schedules; creating explosion codes; setting billing parameters; creating billing procedures; user set-up and security Personnel Management: • Managed and directed personnel in 3 departments• Interviewed, hired, trained, evaluated, coached, counseled and terminated employeesCoding Compliance Management: • Created and implemented coding and compliance program• Performed in-depth chart audits• Generated and distributed coding reports to physicians



Stuebner, Saari & Somers, PC

• Chief Operating Officer

  • Oct 2007 - Dec 2008

  Receivables Management:• Implemented system to ensure 100% charge capture, corrected coding• Analyzed and negotiated 3rd party payer contractsFinancial Management and Analysis: • Performed all accounting functions, from A/P processing through financial statement preparation, analysis and dissemination• Identified, researched and recommended opportunities for passive income• Identified excesses in expenses and implemented changes to reduce overhead Receivables Management:• Implemented system to ensure 100% charge capture, corrected coding• Analyzed and negotiated 3rd party payer contractsFinancial Management and Analysis: • Performed all accounting functions, from A/P processing through financial statement preparation, analysis and dissemination• Identified, researched and recommended opportunities for passive income• Identified excesses in expenses and implemented changes to reduce overhead



Eye Care Center of Northern Colorado

• United States
• Medical Practices
• 1 - 100 Employee

• Chief Operating Officer

  • Jun 2003 - Oct 2007

  Challenges Resolved: Poor internal controls, under-trained staff/poor employee performance, poor collections. Practice management software conversion.Receivables Management: • Responsible for clean-up of old billing system and outstanding A/R• Increased revenue by implementing system to ensure 100% charge capture• Implemented system to identify and recapture 100% of contracted allowable• Implemented collection policies• Hands-on management of patient collections• Resolved patient billing issues• Trained staff on online claims verification, A/R follow-up and appeals, insurance verification and collections procedures• Performed CPT & ICD-9 coding, billing, claims transmission and corrections, appealed claims• Met collection goals for bonus/incentive 10 of 12 months for each year employedFinancial Management and Analysis: • Performed analysis of open A/R and internal controls to identify areas of potential loss• Implemented separation of duties, system of checks and balances to eliminate practice exposure to riskPersonnel Management: • Interviewed, hired, trained, coached, counseled, evaluated and terminated personnel• Managed staffing levels and payrollCompliance: • Created compliance program• Performed chart audits for correct coding and to minimize risk• Resolved physician coding issuesIT Management: • Hands-on management of practice management software conversion including populating data tables, building templates and security accessOther Administrative Functions: • Participated in legal and financial strategic planning• Identified growth opportunities, including expansion into surrounding communities to shore-up market share• Added a satellite clinic and 2 physicians



Foothills Pediatrics

• United States
• Medical Practices
• 1 - 100 Employee

• Practice Manager

  • 2002 - 2003

  Challenges Resolved: Poor billing service performance. High staff turnover, poor employee morale. Practice relocation. Receivables Management: • Increased 2002 revenue by recapturing $25,000 from a single payer• Implemented system to identify and recapture underpayment by all contracted payers• Identified problems with billing service resulting in renegotiation of fees and generating savings of $25,000• Implemented hands-on management and oversight of billing service to ensure 100% capture of maximum allowable fees per contract• Analyzed and negotiated 3rd party payer contractsFinancial Management and Analysis: • Prepared revenue and growth projections• Performed all accounting functions from A/P through financial statement preparation, analysis and dissemination. Initiated and maintained internal controls• HIPAA Privacy Officer: Created and implemented HIPAA compliance program at no cost to the practice