MARKET DIRECTOR OF PATIENT FINANCIAL SERVICES January 2025 – Present
COMMONSPIRIT – VIRGINIA MASON FRANCISCAN HEALTH
Responsible for planning, directing and evaluating patient access and patient financial/revenue cycle operational functions/services (clinic and hospital) for the assigned Virginia Mason Franciscan Health (VMFH) market in accordance with overall strategic business objectives, professional standards and applicable regulatory requirements. An incumbent provides ongoing leadership in assessing, developing, implementing and executing initiatives/programs that facilitate optimal financial performance/productivity, maximize effective utilization of resources, reduce operational vulnerability, strengthen the focus on patient access/revenue cycle accountability and generate a competitive advantage for the organization. Work involves balancing revenue stream administration with the operationalization of multiple billing requirements and managed care contracts that require exception-based handling.
Hospital admitting, patient access and patient account services.
Responsibilities include:
INDEPENDANT CONSULTANT April 2024 – Present
HEALTHCARE REVENUE CYCLE
Focused on optimizing the financial processes within healthcare organizations. The primary goal is to ensure that the entire revenue cycle, from patient registration to final payment of balances, runs smoothly and efficiently.
INCLUDED HEALTH/DOCTOR ON DEMAND, Remote February 2023 – March 2024
SENIOR DIRECTOR REVENUE CYCLE MANAGEMENT
Responsible for developing and implementing innovative solutions to maximizing overall billing and collections, leading the in-house and outsourced revenue cycle teams, collaborating with teams from various departments across the Company, and maintaining excellent relationships with third-party payers.
Leader of the Revenue Cycle Management team and responsible for ensuring the success and accuracy of our internal and external billing and collection operations. Provide strategic guidance and direction regarding best practices. Guiding the company towards scalable solutions that delight our patients and clients, as well as enable the growth of our business.
HEALTHRECON CONNECT, Remote April 2022 – February 2023
VICE PRESIDENT OF REVENUE CYCLE MANAGEMENT OPERATIONS
Responsible for the operational oversight of several clients to improve the revenue cycle performance. HealthRecon Connect provides technology-enabled Revenue Cycle Management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes and enable peace of mind for their clients
DAMERON HOSPITAL ASSOC, Stockton, CA May 2020 – March 2022
DIRECTOR OF REVENUE CYCLE
Responsible for daily operations of all Billing/Follow up, HIM/Coding and Patient Access functions, including coordination with hospital departments affecting Billing/Collections, HIM/Coding and Patient Access processes for 200 bed acute care facility and clinics, including Pacific Heart.
OPTUM360 / DIGNITY HEALTH, Rancho Cordova, CA June 2015 – January 2020
DIRECTOR OF OPERATIONS
Managed daily operations of all billing and collections functions for patient financial services including coordination with hospital departments affecting billing and collections processes for 19 Dignity Health hospitals. Oversaw 300 team members, including managers and supervisors. Responsible for $4billion in overall AR,
COMMUNITY HOSPITAL OF MONTEREY PENINSULA, Monterey, CA March 2010 – April 2015
ASSISTANT DIRECTOR OF PATIENT BUSINESS SERVICES
Oversee and provide direction and supervision for the day-to-day operations of the business office including systems, billing, cash applications, follow up and customer service. Maintained department practices and systems for a hospital with 207 acute beds, 13 inpatient rehab, 28 skilled nursing and hospice. Managed 4 supervisor direct report, each with 8-10 employees.
COMMONSPIRIT – VIRGINIA MASON FRANCISCAN HEALTH
Responsible for planning, directing and evaluating patient access and patient financial/revenue cycle operational functions/services (clinic and hospital) for the assigned Virginia Mason Franciscan Health (VMFH) market in accordance with overall strategic business objectives, professional standards and applicable regulatory requirements. An incumbent provides ongoing leadership in assessing, developing, implementing and executing initiatives/programs that facilitate optimal financial performance/productivity, maximize effective utilization of resources, reduce operational vulnerability, strengthen the focus on patient access/revenue cycle accountability and generate a competitive advantage for the organization. Work involves balancing revenue stream administration with the operationalization of multiple billing requirements and managed care contracts that require exception-based handling.
Hospital admitting, patient access and patient account services.
Responsibilities include:
- Health Information Management, charge review, professional/OR coding, identification of missed revenue
- Provider audits/assessments and appropriate training to maximize revenue and minimize risk;
- Value based contracts
- Access center/ambulatory scheduling, switchboard
- Claims submission; customer service; financial assistance, self-pay
- Cash applications (payment posting, reconciliation, patient/insurance credits/refunds, etc)
- Hospital/clinic insurance billing, follow-up/denials management, auditing and appeals, recovery audit response
- Advanced revenue cycle analytics
INDEPENDANT CONSULTANT April 2024 – Present
HEALTHCARE REVENUE CYCLE
Focused on optimizing the financial processes within healthcare organizations. The primary goal is to ensure that the entire revenue cycle, from patient registration to final payment of balances, runs smoothly and efficiently.
- Assess and analyze current RCM process and identify areas for improvement
- Develop and implement strategies to streamline billing, coding, and collection processes
- Ensure compliance with healthcare regulations and standards
- Provide training to staff
- Assist with the selection and implementation of revenue cycle management (RCM) software
- Optimize the use of electronic health records (EHR) systems
- Enhance patient billing and communication processes to improve patient satisfaction
INCLUDED HEALTH/DOCTOR ON DEMAND, Remote February 2023 – March 2024
SENIOR DIRECTOR REVENUE CYCLE MANAGEMENT
Responsible for developing and implementing innovative solutions to maximizing overall billing and collections, leading the in-house and outsourced revenue cycle teams, collaborating with teams from various departments across the Company, and maintaining excellent relationships with third-party payers.
Leader of the Revenue Cycle Management team and responsible for ensuring the success and accuracy of our internal and external billing and collection operations. Provide strategic guidance and direction regarding best practices. Guiding the company towards scalable solutions that delight our patients and clients, as well as enable the growth of our business.
- Successfully reduced AR days from 24 to 16
- Successfully reduced denials from 25% to 14%
- Successfully reduced Self pay by $2.5M
- Successfully increased Self Pay collections by $1.8M annually
- Successfully increased POS collection by $1.3M annually
- Successfully developed teams in Manila and India through vendor relationships
- Drove technology improvements to provide efficiency to end to end revenue cycle.
- Lead the in-house RCM and Provider Enrollment teams as well as our outsourced revenue cycle vendor
- Identify and solve billing and collection issues in a timely manner.
- Partner with Client Success, Legal, Implementation, Product and Finance to maximize billings and collections efficiency.
- Operationalize new Payer contracts and changes to existing contractual agreements.
- Act as the Company’s subject matter expert regarding coding/billing questions
- Represent and lead the team and company on all initiatives, modifications, and priorities. I.e.: System transitions and/or updates,
- In-depth knowledge and understanding of Medicare, Medicaid and Managed Care regulation guidelines.
- Lead and communicate effectively operational changes/initiatives/priorities while being mindful of cross functional impact to internal and external teams.
HEALTHRECON CONNECT, Remote April 2022 – February 2023
VICE PRESIDENT OF REVENUE CYCLE MANAGEMENT OPERATIONS
Responsible for the operational oversight of several clients to improve the revenue cycle performance. HealthRecon Connect provides technology-enabled Revenue Cycle Management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes and enable peace of mind for their clients
- Drove performance of Revenue Cycle KPI’s for all clients
- Successfully implemented Joint Operations Committees with largest payers across all client base
- Drive revenue cycle efficiencies utilizing technology to improve client performance
- Strategic planning and execution to enhance profitability, productivity, and efficiency throughout Operations
- Handle all areas of operations for assigned clients
- Developed high performing team in Sri Lanka, India and Manila.
- Provide direction and structure for operating units under purview
- Manage RCM operations by directing and coordinating activities consistent with established goals, objectives, and policies.
- Develop effective relationships with and confirms operational leaders can execute day-to-day responsibility for operations
- Closely monitor operational metrices to ensure service levels are met
- Evaluate, re-evaluate processes and KPI achievement for optimizing efficiency
- Identify and resolve technical, and operational and organizational problems
- Monitor required reporting and provides direction on findings
- Direct others to resolve business problems that affect multiple functions or disciplines
- Provide leadership to and is accountable for the performance of staff
- Consult with all segments of management responsible for policy or action.
- Make recommendations for improving effectiveness of policies and procedures
- Ensure compliance within area of responsibility
- Provide oversight and challenge to senior management on decisions and processes regarding strategy and compliance
- Hold self and team accountable for compliance
- Resolve operational bottlenecks in solution development
- Lead and influence team by fostering teamwork and collaboration, and driving employee engagement and leveraging diversity and inclusion
DAMERON HOSPITAL ASSOC, Stockton, CA May 2020 – March 2022
DIRECTOR OF REVENUE CYCLE
Responsible for daily operations of all Billing/Follow up, HIM/Coding and Patient Access functions, including coordination with hospital departments affecting Billing/Collections, HIM/Coding and Patient Access processes for 200 bed acute care facility and clinics, including Pacific Heart.
- Meet HFMA standard KPI – Reduced AR days from 35 to 19, Reduced denials to 12%
- Establish and implement controls to ensure appropriate Registration through Billing and Payment.
- Interprets policies and procedures, recommends changes as appropriate, and provides relevant feedback to leadership.
- Meet department and organizational goals with respect to revenue cycle recognition and collection.
- Ensure an adequate balance between the legal and financial responsibility to ensure compliance with external laws and regulations
- Coordinate activity across organizational lines to ensure a unified and proactive revenue cycle process within the organization.
- Oversee the Patient Access and Patient Financials services are for both the Main Hospital and clinics, including Pacific Heart and Vascular.
OPTUM360 / DIGNITY HEALTH, Rancho Cordova, CA June 2015 – January 2020
DIRECTOR OF OPERATIONS
Managed daily operations of all billing and collections functions for patient financial services including coordination with hospital departments affecting billing and collections processes for 19 Dignity Health hospitals. Oversaw 300 team members, including managers and supervisors. Responsible for $4billion in overall AR,
- Successfully drove processes to improve KPI’s and meet SLA’s
- Successfully reduced AR by $1B
- Successfully reduced denials by 15%
- Successfully reduced AR days from 45 to 22
- Met HFMA standard KPI and was recognized by several facilities receiving MAP awards from HFMA.
- Interpreted policies and procedures, recommended changes as appropriate, and provided relevant feedback to Sacramento Center of Excellence leadership.
- Met department and organizational goals with respect to revenue recognition and collection.
- Ensured an adequate balance between the legal and financial responsibility to ensure compliance with external laws and regulations.
- Provided service to Sacramento Center of Excellence departments and staff.
- Coordinated activity across organizational lines to ensure a unified and proactive billing process within organizational units served by the Sacramento CBO.
- Served as a key promoter of the Sacramento Center of Excellence as a service organization which strives to meet and exceed the needs of its customers.
COMMUNITY HOSPITAL OF MONTEREY PENINSULA, Monterey, CA March 2010 – April 2015
ASSISTANT DIRECTOR OF PATIENT BUSINESS SERVICES
Oversee and provide direction and supervision for the day-to-day operations of the business office including systems, billing, cash applications, follow up and customer service. Maintained department practices and systems for a hospital with 207 acute beds, 13 inpatient rehab, 28 skilled nursing and hospice. Managed 4 supervisor direct report, each with 8-10 employees.