Work History

Work History
Mar 2005 - Apr 2010

Recovery & Collection Analyst

Catholic Healthcare West
Responsible for managing 15 collection vendors (Early Out, Zero Balance, Workers Comp, VA, Government) for performance, access for 578 users to 7 AR systems and high level reporting for 42 acute care facilities Provided guidance and supervision to Unit's initiatives which includes tracking and reporting on various payer projects as needed. This includes collaboration and support of the MCRU's Contract Collection Specialists Recapture of revenue, reducing purchased services costs and assisting in the development of policies and practices to make improvements along the revenue cycle Key focus on CHW denial management and vendor data issue identification (delays, denials and underpayments) to find opportunities to recognize revenue earlier in the collection cycle with an emphasis on managed care payers Performed account audits and regular reviews of vendors collection practices to learn best practices and communicate back to CHW MCRU and hospitals Designed and built Access databases for vendor claims inventories, fees charged and collections received to produce analytical reports, dashboard reporting, collection and fee projections, and comparative analysis between business lines for vendors Designed and built a revenue cycle management application interface to manage all NAT translations, IP’s, Emulators, AR systems, AR Websites, and FTP sites Developed and standardized templates for vendor invoicing and inventory dataset exchanges Created a unique collection vendor data warehousing tool to track vendor collections, measure performance and create a standard baseline Collaborate with Director to identify and research sources of delays, payer trends, denials and underpayments from managed care payers both within CHW and with outside payers Creation and implementation of collection vendor access process to CHW systems, TPA process and VPN modifications and new set-ups
Dec 2004 - Mar 2005

Billing & Collection Manager

Los Angeles Airport Urgent Care
Responsible for managing 5 collection associates Process & analyze detailed AR reports for physicians Implementation of new process’s to increase AR revenue in collections Implementation of billing meetings to improve procedures and billing process’s
Jun 2003 - Nov 2004

Billing & Collection Manager

Southern California Rheumatology Associates
Processed insurance claims, appeals, patient billing and follow-up Coding of claims (procedure and diagnoses) CPT and ICD-9CM Periodic chart reviews for coding and billing compliance Analyzed accounts receivables and report payment discrepancies, high dollar account issues and coding discrepancies Managed all posting, billing and collections process Trained front office staff on new insurance procedures and rules
Feb 2001 - Dec 2001

Billing Manager

Dr. Jerold Beeve Ophthalmology
Responsible for managing billing department and front office staff Processed insurance claims, appeals, patient billing and follow-up Coding of claims (procedure and diagnoses) CPT and ICD-9CM Periodic chart reviews for coding and billing compliance Implementation of new process’s to increase AR revenue in collections
Mar 1999 - Mar 2001

Biller & Collector

VHMA Verdugo Hills Medical Associates
(Urgent Care, WC Clinic, PT, Pediatrics and Family Practice) Implementation of new collections rules and procedures Created collection procedure manual for front office staff Processed insurance claims, appeals, patient billing and follow-up Coding of claims (procedure and diagnoses) CPT and ICD-9CM Periodic chart reviews for coding and billing compliance
Feb 1996 - Mar 1999

Billing Manager

PEMG - Pasadena Eye Medical Group
(Ophthalmology/LASIK) Processed insurance claims, appeals, patient billing and follow-up Coding of claims (procedure and diagnoses) CPT and ICD-9CM Periodic chart reviews for coding and billing compliance Analyzed accounts receivables and report payment discrepancies, high dollar account issues and coding discrepancies Managed all posting, billing and collections process Trained front office staff on new insurance procedures and rules

Education

Education
2008 - Present

BSHA

University of Phoenix
1993 - 1996

Pasadena City College
1986 - 1990

Glendale Adventist Academy

Interest

Fatherhood

Genealogy

Amateur Radio

Paintball

Reading

Small Scale Modeling

Summary

ØDetailed-orientated, highly motivated healthcare professional with more than 15 years experience

ØDeveloped and executed new workflow processes to improve operations and efficiencies within Central Business Offices

ØIn depth knowledge ofmanaged care contracts, reading and interpretation and reimbursement methodologies

ØWork efficiently under pressure, excel as an organizer and can easily accomplish complex assignments while working independently or as part of a team.

ØPossess the ability to analyze underperforming operations and, by applying a unique blend of analytical and people skills, restore them to a profitable operation.

ØOperational analysis, strategic planning, process re-engineering and implementation.

ØIn-depth knowledge of Revenue Cycle Management

ØContract analysis, interpretation and application

ØExcellent written and verbal communication skills

ØAbility to handle multiple priorities and projects simultaneously

ØExperience creating management reporting, financial metrics and goal setting

ØHigh attention to detail and demonstrated proficiency in data management

ØProject management experience and problem solving skills

ØVast experience with patient receivables and days in A/R

ØIn-depth knowledge of insurance companies practices, billing and collections

Objective

Health care management professional with a career path in healthcare administration, business operations, analytics and health information systems. Strengths include policy setting, project management, managed care contracting, vendor negotiations, process improvements, and program development.Well regarded as a dynamic team motivator and presenter with proven accomplishments in the areas of organizational and process assessment, workforce in-service training, and workshop development via Webinar.

I am a results driven, self-motivated, team player with 14 years experience in the healthcare industry including hospital, medical groups, and physician offices. I possess an above average understanding of administrative and clinical operations with an emphasis on revenue cycle management and finance in today’s health care delivery systems.

Skills

Skills

HBOC Star Financial

Siemens Imaging

SSI Billing

MS PowerPoint

I.H.S. Dairyland

Allegra

Meditech

SMS Invision

MS Outlook

MS Word

MS Access

MS Excel

Portfolio

Certifications

Certifications
Feb 1996 - Present

Amateur Radio

FCC