Experience

• 

  KeyCare

  • Director of Revenue Cycle

    • Feb 2023 - Present

• 

  Roundtable Strategic Solutions

  • Pacific Northwest

  • Interim System Director of Revenue Cycle Operations

    • May 2018 - Present
    • Pacific Northwest

• 

  Nordic Consulting Partners, Inc.

  • Madison, Wisconsin Area

  • Senior Consultant

    • Feb 2017 - Present
    • Madison, Wisconsin Area

• 

  Culbert Healthcare Solutions

  • Client Based

  • Senior Revenue Integrity Consultant

    • Feb 2016 - Nov 2016
    • Client Based

• 

  Texican, Inc

  • Client based

  • Senior Project Manager

    • Jan 2015 - Jan 2016
    • Client based

    * Served as interim coding manager for current client* Restructured coding department to improve workflows and increase productivity* Assessed training needs by evaluating baseline performance metrics in comparison to industry standards* Calibrated coding department skill set to meet the needs of the client* Applied coding expertise to eliminate redundant and incorrect edits resulting in $4M reduction of unbilled charges* Completed comprehensive charge capture assessment with recommendations to standardize processes * Centralized coding intake procedures* Policy and procedure composition and implementation* Transitioned $36M in outpatient coding/charging from paper to electronic format* Reduced $2M in denials by implementing front-end coding edits* Created ICD-10 transition plan

• 

  Ochsner Clinic Foundation

  • Benson Tower-New Orleans

  • Chargemaster Manager, Revenue Integrity Department

    • Jun 2009 - Dec 2014
    • Benson Tower-New Orleans

    * Servant leader responsible for managing the daily operations of the Revenue Integrity Chargemaster Department* Direct staff management and fiscal responsibility of $1.2M annual budget * Developed operational processes that provided financial improvements in DNB from $9M to $3M in a 3 month span via CDM changes/enhancements* Key contributor in development of CDM functions for implementation of provider based billing resulting in an annual profit of $17M* Successful consolidation of 9 hospital facility chargemasters for Epic implementation* Provided onsite department level support for 10 separate Epic go-lives* Invented “Open House” method of Revenue Cycle outreach for clinical customers during which 55 CDM’s were reviewed in collaboration with 6 members of Revenue Cycle leadership* Developed and implemented charge capture and charge reconciliation process* Direct oversight and report out of work queue, DNB, and productivity metrics* Served as chargemaster resource in partnership with Nurse Audit Team to provide departmental chart audits reviews* Developed department specific standards of operation and policies to include pricing transparency* Responsible for development and recommendation of pricing strategies for the health system* System wide administrator for Med Assets CDM Manager and Knowledgesource applications

• 

  Cardiovascular Associates, LLC

  • Covington, Louisiana

  • Business Office Manager

    • Nov 2003 - Jun 2009
    • Covington, Louisiana

    * Managed and performed all aspects of Business Office functions to include the following duties: - Scheduling, Registration, Coding, Billing, Collections, Payment Posting, Follow-Up, Denials, Credentialing* Developed business office policies and procedures regarding billing, coding and collections* Increased collection ratio from 37% to 52% by developing & implementing a structured follow-up protocol resulting in net increase of $1M annually* Devised patient financial agreement forms and policies* Organized a self-directed team to conduct business office responsibilities* Authored and implemented business office accountability plan* Successfully negotiated contracts and fee schedules with commercial insurance carriers* Directed the acquisition and installation of practice management software* Implemented PQRI and pay for performance billing procedures* Moderated monthly financial meetings with physicians* Decreased denial rate 10% by educating front desk personnel* Facilitated education for staff and physicians regarding carrier rules and regulations* Tracked and analyzed billing trends with an emphasis on denial management* Utilized knowledge of insurance tactics to effectively engage in appeal techniques

• 

  David R. Silvers, MD FACG

  • Metairie, Louisiana

  • Billing and Coding Manager

    • 1993 - 2003
    • Metairie, Louisiana