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Work experience

2010Present

Manager, Revenue Cycle

Laser Spine Institute

Responsible for managing the functional operations of collection and A/R management with specific reference to contracted payers, to include policy and procedure development, internal and external communications, statistical reporting, trend analysis, and issue resolution for all medical offices and facilities.

  • Instrumental in establishing new team assignment responsible for handling all non AR duties thereby increasing collector productivity and collections by 20%.
20082009

Manager-Revenue Integrity Services

Lakeland Regional Medical Center

Manager, Revenue Integrity Services

Led team of 7 professional staff responsible for oversight of facility charge master, conducting all audit functions and achieving improvements in charge capture practices for revenue enhancement. 

  • Reduced Late Charges from $10.2 million to $2.9 million at the end of 6 months, by implementing process improvements in clinical areas.
  • Increased net revenues by $350k to $500k in 6 months by implementing charge capture initiative for Nursing Procedures.
  • Realized savings of over $100k in payer refund requests through effective defense auditing techniques.
  • Developed new revenue streams by managing daily charge capture exception reporting and auditing.
  • Ensured billing compliance by communicating coding updates to impacted departments.
  • Initiated and coordinated review and revision of the Third Party Billing Audit Policy.
  • Assisted Patient Financial Services with resolution of billing edits due to Charge master issues.
  • Contributing member on the Value Analysis Committee.
  • Contributing member on the Charge Master Oversight Committee.
20062007

Manager PFS

Organized and managed the daily functions of Business Office and Customer service staff to include billing, collections, cash posting and adjustments. 

  • Increased collections by $350k and reduced account balances greater than 90 days by 30% in 6 months.
  • Increased collections by $500k by managing underpayment review and recoveries on current AR.
  • Improved patient satisfaction within 90 days by creating a centralized Customer Service unit.
  • Reduced denials by 25% due to registration errors in collaboration with the Patient Access Director.
  • Reduced bad debt write-offs by 30% due to roll out of a Financial Assistance Program.
  • Resolved charge master errors with CDM Coordinator impacting billing and collections.
  • Reduced bank deposit errors by tracking and reporting errors to clinic management.
  • Monitored all cash functions and controls within the Customer Service/Financial Counselor areas.
  • Successfully managed cash application project of unapplied payment accounts.
  • Contributing member of Employee Recognition Committee.
20052006

Manager-APC Compliance/Systems

  • Reduced bill hold times due to Medicare CCI edits by 40% in collaboration with clinical areas.
  • Managed the data capture and reporting of monthly concurrent chart audits.
  • Conducted monthly meetings with department heads to review results of concurrent audits.
  • Ensured the accurate and timely completion of month end processing.
  • Functioned as a super user for staff training and support of computerized systems.
19962005

Manager-IT/Compliance/Systems

Insurance Recovery Specialists Inc.

Manager, IT / Compliance / Client Integration (1999 to 2005)

Managed the successful integration of client accounts receivables projects, performance metrics and issue resolution. 

  • Managed retroactive audit project realizing $500,000 in underpayments to clients.
  • Evaluated, implemented and monitored standards for compliance with HIPAA.
  • Developed, implemented and monitored Corporate Compliance program.
  • Developed an electronic method for effecting a reconciliation of account balances between systems.
  • Trained staff in efficient and proper use of all systems.

Manager - Claims Operations(1996-1999)

Managed billing, collections functions and reporting to client hospitals.  

Education

Skills

Medical Coding
Currently preparing for the CCA certification from AHIMA. 
Microsoft Office

References

David Radecki

Jeff Reschke

George Tirlokhi

Certifications

Recommendations

"I worked with Randal as a fellow manager at Lakeland Regional Medical Center, where I often worked on projects with Randal. Randal is a thoughtful, detail oriented, intelligent colleague who could be counted on when I needed to resolve issues of concern for our facility. Randal excelled at using concensus to resolve issues in sometimes difficult circumstances. Further, I could count on Randal to provide accurate, timely and actionable results. For these reasons, I feel Randal will be an asset to any employer. Should you wish to discuss this further, feel free to contact me at (863) 393-8516". July 13, 2009

David Radecki (Manager of Managed Care at Lakeland Regional Medical Center) worked with Randal at Lakeland Regional Medical Center.

"It was a pleasure working with Randal at Cleveland Clinic. We always worked well together despite being in two separate departments within the institution."   July 6, 2009

Ozzie Delgado (Director, Pharmacy Admin at Cleveland Clinic Florida) worked with Randal at Cleveland Clinic.

Randal is a committed and dependable Manager; team oriented he encompasses corporate vision and achieves departmental and organizational goals effortlessly. Randal is meticulous; accurate in his calculations and precise in his reporting. Randal has the ability to adapt to new corporate cultures; founded on sound ethical values with a great sense of humour he is capable of managing efficiently and effectively to accomplish corporate success. July 7, 2009

Andrea Barry (Managing Director at International Procurement Services Ltd) worked indirectly for Randal at Insurance Recovery Specialists Inc..

Objective

Seeking opportunities in Revenue Cycle in a managerial or technical role.

Systems/Applications Experience

  • CareMedic
  • HBOC Star
  • Meditech
  • Casnet
  • Imaging 24
  • OAS Gold Client
  • Concuity
  • IDX
  • RAS
  • Compass
  • MedAssets CDM Master
  • Signature
  • EReserve
  • MedAssets Charge Capture Tools
  • SMS Invision
  • Horizon Patient Folder
  • Medi Finance
  • Visionshare

Summary

SUMMARY

A well educated (Bachelor of Science, major in Accounting), results oriented, Healthcare Revenue Cycle Management professional with extensive experience in Billing, Collections, Revenue Integrity and Compliance.  

Experienced in Project Management and Process Improvement initiatives. Strong communication skills along with a demonstrated collaborative team approach. Partnered with all levels of management in completing complex projects and accomplishing organizational goals. Detail-oriented analytical mind complemented with a persistent nature ensures on-time, accurate results.

Revenue Cycle Systems / Applications Experience:

·

  • Siemens Invision
  • CareMedic
  • MedAssets CDM Master
  • Concuity
  • MedAssets Charge Capture Tool
  • IDX
  • Meditech
  • McKesson HBOC Star
  • OAS Gold Client
  • EReserve

Interest

Jazz music

Sports particularly basketball, football and soccer

Member of Caribbean Community Association.