Experience

Great Plains Health

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Interim PFS Director

  • Jun 2023 - Present



Trinity Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Cycle Management Consultant

  • Feb 2020 - Mar 2023

  Livonia, Michigan, United States



Inova Health System

• United States
• Hospitals and Health Care
• 700 & Above Employee

• PFS Government Follow-up Manager

  • May 2019 - Feb 2020

  Falls Church, VA • Provides orientation, training, scheduling and supervision of all staff. Establishes and measures competencies and related and related guidelines for staff. • Interface with PFS operations analyst to ensure trends, root causes and opportunities for improvement. • Conduct team meetings to review and discuss outcomes. Creates and execute plans to continually improve quality, operating efficiency, and outcomes using lean methodology. • Strive to achieve outcomes consistent with all… Show more • Provides orientation, training, scheduling and supervision of all staff. Establishes and measures competencies and related and related guidelines for staff. • Interface with PFS operations analyst to ensure trends, root causes and opportunities for improvement. • Conduct team meetings to review and discuss outcomes. Creates and execute plans to continually improve quality, operating efficiency, and outcomes using lean methodology. • Strive to achieve outcomes consistent with all state and federal regulatory requirements and applicable laws in accordance with the financial goals of the organization. • Responsible for understanding and utilizing EPIC reporting and functionality to achieve goals, including escalating issues to EPIC IT as needed. Show less



Palmetto Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• PFS Follow-up Manager

  • Feb 2018 - Apr 2019

  Columbia, South Carolina Area * Develop and maintains competency based training tolls for the patient account team. * Increased revenue $9.3 million dollars, while decreased the AR 3%. * Monitors the Accounts receivable and makes recommendations for improvement. * Provided individual training and education to increase Government follow-up team QA scores from 78% to 91%. * Prepares training guidelines and/or manuals for staff regarding Follow-up functions.



Jacobus Consulting

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

• Senior Consultant

  • Oct 2015 - Feb 2016

  Irvine, CA Monitors Accounts Receivable and make recommendations for improvement. Networks with other facilities to arrive at best practices. Provides input for employee performance reviews. Distributes information to the team as needed. Maintains a working knowledge of the Patient Information System. Monitors the claim submission and rejections within the electronic billing system. Researches problems associated with the export of information from the billing… Show more Monitors Accounts Receivable and make recommendations for improvement. Networks with other facilities to arrive at best practices. Provides input for employee performance reviews. Distributes information to the team as needed. Maintains a working knowledge of the Patient Information System. Monitors the claim submission and rejections within the electronic billing system. Researches problems associated with the export of information from the billing system to electronic payers. Communicates with staff on billing problems, issues, and new developments. Prints and distributes to staff EDI reports as needed. Reviews billing workload and adjust biller assignments as needed from time to time as directed/approved by Department Director. Prepares spreadsheets/reports as requested by Department Director. Trains staff on the billing and collection functions of the Patient Information System and the EDI system. Prepares training guidelines and/or manuals for staff regarding the billing and collection functions. Develops and maintain competency based training tools for Patient Financial Team. Reports productivity and related information to the Director. Insures uniformity in billing and follow-up approaches. Performs other duties as assigned by the Department Director. Demonstrates System Values in performance and behavior. Complies with System policies and procedures. Other duties as may be assigned. Show less



Expeditive, LLC

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

• Senior Consultant

  • Sep 2014 - Oct 2015

  Bronx Interim PFS Manager



Mount Sinai Beth Israel

• Hospitals and Health Care
• 700 & Above Employee

• Data Analyst

  • Sep 2012 - Sep 2014

  New York, NY Coordinated data for HealthFirst & Fidelis "pay 4 Performance” project worth $2.8 million. As requested, prepared data in a variety of formats, including PowerPoint, for presentation at various meetings. Collaborated with our eClinicalWorks team to develop structured data fields and related clinical alerts in our EHR to faciliate documentation related to key preventive and Chronic care measure. Regularly distributed clinical performance reports to providers, the care manager… Show more Coordinated data for HealthFirst & Fidelis "pay 4 Performance” project worth $2.8 million. As requested, prepared data in a variety of formats, including PowerPoint, for presentation at various meetings. Collaborated with our eClinicalWorks team to develop structured data fields and related clinical alerts in our EHR to faciliate documentation related to key preventive and Chronic care measure. Regularly distributed clinical performance reports to providers, the care manager and patient navigator to faciliate idenification and outreach to managed care patients needing key services. Collected and analyzed data related to patient satisfaction surveys. Reviewed data for accuracy, validity and data integrity. Periodically reviewed content and format of reports and revises them as needed. Show less



NYU Langone Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Sr. Financial Associate

  • Apr 2010 - Sep 2012

  Analyzed EOB, medical records and claims to dispute or reimburse charges for service. Reviewed commerical insurance contracts; analyze service rate in which insurance company is accountable for. Prepared documents to appeal denied claims. Interacted with provider representativeson a daily basis to resolve any contract issues.

• Sr. Financial Service Associate

  • Apr 2010 - Sep 2012

  Analyze EOB, medical records and claims to dispute or reimburse charges for service. Review commercial insurance contracts; analyze service rate in which insurance company is accountable for. Prepare documents to appeal denied claims. Interact with provider representatives on a daily basis to resolve any contract issues. Stamford Hospital 2006 - 2010 Accounts Receivable Resolved and collected unpaid medical claims with… Show more Analyze EOB, medical records and claims to dispute or reimburse charges for service. Review commercial insurance contracts; analyze service rate in which insurance company is accountable for. Prepare documents to appeal denied claims. Interact with provider representatives on a daily basis to resolve any contract issues. Stamford Hospital 2006 - 2010 Accounts Receivable Resolved and collected unpaid medical claims with private insurance carriers, Medicare and Medicaid. Called various insurance carriers and verified coverage and claim status for service date specified. Thoroughly reviewed all accounts to determine reason for no payment/partial payment. Ordered itemized statements, medical records, etc., when requested by the insurance carrier or guarantor.



Stamford Hospital, Stamford,CT

• Insurance Verification/Patient Accounts Representative

  • Aug 2006 - Mar 2010

  Verify patients insurance with insurance companis prior to patient procedure. Obtaining Authorazation/precert if need from insurance companies and Physician office. Pre-registering patients. Thoroughly reviewed all accounts to determine reason for nonpayment/ partial payment. Ordered itemized statements, medical records, etc., when requested by the insurance carrier or guarantor.



Landauer Metropolitan Inc

• Medical Insurance Verification Specialist

  • Aug 2004 - Aug 2006

  Called insurance carriers to verify coverage and claim status for service date specified. Resolved and collected unpaid medical claims with private insurance carriers, Medicare and Medicaid. Set up new patient accounts in the Dataline System. Communicated with customer service representatives as a consultant.



Byram Healthcare 2004- 2004

• Collections / Billing

  • Feb 2004 - Aug 2004

  Billed all commercial insurances. Collected payment from overdue bills. Administered follow up calls to insurance companies.