Experience

The Health Care Management Group

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

• Credit and Collections Manager

  • Nov 2006 - Present

  Private Pay Collection Manager for a seven facility ILU/ALU/LTC Rehab organization; Credit risk analysis on prospects; Works in coordination with management to resolve payment issues; Reviews outstanding A/R with facility personnel; Initiates private pay bad debt with collection agency and legal resources; Represents facility in probate court matters. Private Pay Collection Manager for a seven facility ILU/ALU/LTC Rehab organization; Credit risk analysis on prospects; Works in coordination with management to resolve payment issues; Reviews outstanding A/R with facility personnel; Initiates private pay bad debt with collection agency and legal resources; Represents facility in probate court matters.



Drake Center

• Hospitals and Health Care
• 1 - 100 Employee

• Patient Account Manager

  • Jun 2000 - Apr 2006

  Patient Account Manager (June 2005 - April 2005) : Billing and collection of accounts receivable; Oversight of patient accounting software; maintained charge master system; department budget; evaluation for nine employees; internal and external audits, including a county tax-levy supported charity program. The position was eliminated due to a hospital merger. Managed Care Coordinator/Denial Management (Jun 2000 - May 2005) : Explanation of Benefit review/analysis; Filed all technical and clinical appeals; Maintained decision support system with analysis of all variance reports (TSI/Eclipsys); Lead monthly inpatient and outpatient denial management meetings with department heads, social workers, case management, etc; Managed care contract compliance; Negotiated out-of-network reimbursement; Recovered $2.5 million in denied claims in four years. Show less



Medical Mutual

• United States
• Insurance
• 700 & Above Employee

• Professional Contracting Coordinator

  • May 1999 - May 2000

  Assisted the Regional Network Manager in building and maintaining a PPO/POS/HMO provider network with the recruitment and retention of providers; Credentialing of all providers applying to the network; Database management of all providers and their status; Assisted with yearly provider educational seminars; Assisted physician groups with reimbursement issues. Assisted the Regional Network Manager in building and maintaining a PPO/POS/HMO provider network with the recruitment and retention of providers; Credentialing of all providers applying to the network; Database management of all providers and their status; Assisted with yearly provider educational seminars; Assisted physician groups with reimbursement issues.



Deaconess Hospital Cincinnati

• 311 Straight Street, Cincinnati, OH 45219

• Patient Account Representative/Special Project Coordinator

  • Dec 1980 - May 1999

  All billing, credit and collection for all provider types, including Medicare, Medicaid, Managed Care, Commercial Plans, Workers Compensation and Private Pay; Managed in excess of 4,000 accounts; Electronic billing coordinator; Admitting and registration; Registrar; Surgery scheduling; PBX Operator. All billing, credit and collection for all provider types, including Medicare, Medicaid, Managed Care, Commercial Plans, Workers Compensation and Private Pay; Managed in excess of 4,000 accounts; Electronic billing coordinator; Admitting and registration; Registrar; Surgery scheduling; PBX Operator.