• Increased Net Revenue and improved cash flow.
• Reduced Denial Rates and faster denial recovery.
• Lower Days in Accounts Receivable (A/R).
• Higher Clean Claim Rates (submitted correctly the first time).
• Improved Patient Satisfaction with the financial experience.
• Enhanced Compliance and reduced audit risk.

Some key highlights and qualifications include:

• Financial Performance: Achieving substantial improvements in benchmarking goals (national/regional/local) & effective KPI’s to drive revenue and reduction in days in accounts receivable (AR) & net collections, significantly impacting the financial health of organizations.
• Strategic Leadership: Spearheading initiatives to streamline revenue processes, effective & aggressive AR collections, reduce billing with proper charge capturing, front end edits, immediate resolution & trend developments with all forms of denials (Elig, Auth, Billing & Coding), and enhance cash flow through innovative solutions and process improvements.
• Contract/Pricing Strategy: Develop and lead strategic analytic pricing amongst all payers including, e.g., Blue Cross/Shield, Aetna, Cigna, UHC, etc… Design, execute, negotiate & or amend (new/existing) contracts at the max reimbursement possible to further increase gross profit/revenue goals. Proactively analyzing market trends, competitor pricing, internal cost/GP rates & reimbursement landscapes to strategically optimize pricing & ensure the payer’s reimbursement is according to the fee schedule or at the maximum out of network rate.
• Lead workforce management: Forecasting, budgeting, cost effective work allocation, capacity planning, scheduling (working in close partnership with sales, finance and clinical).
• Strong Reporting Capabilities: Ability to produce, generate & leverage automated essential reports, e.g., product & payer profitability trends, payer data analytics (i.e., pricing, reimbursement & denial mix trends), top 10 denial/trends by Payer & Procedure, AR gross collection monitoring, charge lag delay tracking, etc.… Significant deep down analysis expertise, trending and problem resolution.
• Team Development: Building and mentoring high-performing teams with minimal turn over, fostering a culture of collaboration and continuous improvement.