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Identify opportunities for revenue recovery. Review the Billing Departments and HIM Departments for correct and accurate compliance coding. Baylor Health Care System - Dallas, Texas Senior Consultant of Revenue Cycle Compliance 12 / 02 to 02 / 08 Brought Behavioral Health billing into compliancy when identifying incorrect billing through Medicaid and Medicare.
Identify opportunities for revenue recovery. Review the Billing Departments and HIM Departments for correct and accurate compliance coding. Baylor Health Care System - Dallas, Texas Senior Consultant of Revenue Cycle Compliance 12 / 02 to 02 / 08 Brought Behavioral Health billing into compliancy when identifying incorrect billing through Medicaid and Medicare.
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Identify opportunities for revenue recovery. Review the Billing Departments and HIM Departments for correct and accurate compliance coding. Baylor Health Care System - Dallas, Texas Senior Consultant of Revenue Cycle Compliance 12 / 02 to 02 / 08 Brought Behavioral Health billing into compliancy when identifying incorrect billing through Medicaid and Medicare.
Copyright:
Attribution Non-Commercial (BY-NC)
Verfügbare Formate
Als DOCX, PDF, TXT herunterladen oder online auf Scribd lesen
11/08 to 11/09 Health care Division – Account Manager Manage business operations for the HealthCare Division for RAC Audits by reviewing, correcting and updating Clients Charge Master. Identify opportunities for revenue recovery. Review the Billing Departments and HIM Departments for correct and accurate compliance coding. Key Achievements: – Identified key areas of overpayments and underpayments prior to RAC Auditors – Identified possible risk areas in the HIM Departments – Worked closely with Billing Compliance Departments ensuring correct and up to date coding and policies and procedures were in place. – Interim manager several PAS areas while training
Memorial Herman Medical Center – Houston, Texas
02/08 to 11/08 CDM Manager Complete responsibility for all hospital departments Charge Master. Reviewed, researched and updated all charge masters. Key Achievements: - Identified major areas to be updated with current CPT codes. - Created Charge Masters for newly created departments.
Baylor Health Care System – Dallas, Texas
Senior Consultant of Revenue Cycle Compliance 12/02 to 02/08 Facilitate revenue cycle compliance solutions for Baylor Health Care Systems containing 12 Acute Care facilities and 7 Senior Clinics, and 5 IDTF facilities. Proactively develop, implement, and monitor revenue cycle compliance policies and procedures. Conduct research of federal and state regulations, perform chart audits, generate executive reports and create presentations. Analyze risks and trends pertaining to OIG Work Plan and coordinate revenue cycle compliance activities between BHCS Corporate departments and facilities to ensure compliance plans are implemented and maintained on a current basis. Key Achievements: - Brought Behavioral Health billing into compliancy when identifying incorrect billing through Medicaid and Medicare. This correction generated approximately 2 ml in revenue. - Complete review of DME drugs for Transplant patients who were billed to Medicaid/ Medicare without the completed physician form. Based on the correction to the claims being billed, an additional $300,000 per month was obtained. - Coordinated the review procedure for identification of write-offs for various departments to maintain compliancy for government claims. Physician claims were also reviewed for possible write-offs for both timely billings and non-compliant procedures. The review identified an additional $50,000 per month just by checking signatures and credentialing.
KMT Group, L.L.C. – Royal Oak, Michigan (Corporate Headquarters)
Director of Billing Operations 07/01 to 12/02 Completely updated and established new policies and procedures for the collection of outstanding receivables for several clients; assisted in the development of a corporate compliance department. Clients included: Syncor in Woodland Hills, California and The Detroit Medical Center of Detroit, Michigan. Key Achievements: – Reestablished a new billing team through hiring, training and accountability for meeting company goals. – Brought in 1.2 Mil of aged receivables by reprocessing and appealing denied claims. – Directed and managed several Physicians’ billing offices with specialties in Cardiology and Radiology with an average of 25 staff members. Under my direction the Physician’s offices – increased revenue by 17% the first two months. Improved proficiency in billing was one of the major or key components of the increase. – Managed many PSAs with as little as 5 staff and as many as 95 staff.
Education:
Belford University Bachelor’s Science Business Administration