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Click here or scroll down to respond to this candidateCandidate's Name
PHONE NUMBER AVAILABLEEMAIL AVAILABLEEastvale, CAC E R T I F I C A T E SCalifornia Department ofSocial ServicesResidential Care for the Elderly Administrator CertificationID #6051915740TexasAssisted Living CertificateE X P E R T I S ERevenue Cycle ManagementQuality AssuranceResident Trust FundsRegulatory ComplianceAccounting & BudgetingRelationship BuildingBilling & CollectionsMicrosoft Office SuiteData Processing & AnalysisStrategic Planning & ExecutionContract Negotiation & AnalysisAccounts ReceivableTask PrioritizationProblem SolvingMedicare & HMOsCritical ThinkingCross-Functional LeadershipTraining, Coaching, & MentoringPolicy & Procedure DevelopmentEvaluation & AssessmentProcess ImprovementDecision MakingP R O F E S S I O N A L S U M M A R YA self-motivated, resourceful, and analytical consultant with a proven track record of achieving successful outcomes for Behavioral Health and Assisted Living, Skilled Nursing centers through fostering positive business relationships. Detail-oriented with exceptional written and verbal skills. Provides excellent service through developing rapport and providing solutions that best-fit individual needs. Possesses a high degree of creative aptitude with the ability to lead diverse teams while ensuring compliance with all federal regulations, ethical standards, and organizational protocols. Highly organized, accurate, and reliable Accounts Receivable with over 28 years of service and experience in the healthcare industry and a commitment to the highest standards of professionalism,integrity, and performance.P R O F E S S I O N A L E X P E R I E N C EAccounts Receivable ConsultantGenesis Healthcare 1995 to Present.Provide leadership and guidance to Business Office Managers while overseeing all revenue cycle management processes and collecting accounts receivable.Successfully managed 6 centers over extensive career for multiple Behavioral Health centers and Assisted Living & Skilled Nursing Home centers as a strategic consultant.Verify revenue month end close process, monitor credit balance accounts, approve resident refund requests, and conduct regional meetings.Engage in cross-functional collaboration with diverse teams by serving as a primary point of contact for internal and external requests, audit inquiries, and GL variances.Review and oversee all trust accounts while partnering with centers as needed to resolve errors and ensure accurate completion of quarterly statements per federal regulations.Ensure all cash collections are 100% completed on a monthly basis.Complete comprehensive financial reviews to ensure facilities control pharmacy expenses, resulting in increased approval rates for center residents.Conduct monthly visits to verify and follow up on billing and collections requests.Served as a Subject Matter Expert (SME) in all areas of medical claims billing for Medicare, Medicare Advantage, Medical, Hospice, HMOs, and Workers CompensationReview and analyze account receivable, aging and weekly cash flow reports. Coordinates and monitors plans with facility staff.Supports facility with resolving specific billing questions, problems and or difficult claims.Coordinates routine account receivable management calls and or aging reviews no less than monthly with each facility.Visits facility routinely throughout the month. Notifies facility staff of schedule, completes a facility site visit report, and monitors the plan for improvement for identified non-compliance.Validates key systems are in place that are critical to cash collections such as, but not limited to, TARS, managed care authorization tracking, weekly ACS billing, Triple Check, certs and re-certifications, follow up systems for tracking outstanding claims, etc.Reviews monthly accounts receivable balance sheet account issues and works with the facility to fix issues and improve cash posting process.Reviews and approves refunds.Reviews submitted request to write-off delinquent accounts. Reviews collection efforts and returns write-off if opportunities to collect have not been pursued. Approves write-off and submits for additional approval or to accounting per policy.Reviews the resident trust reconciliation monthly and completes a quarterly resident trust audit. Coordinates improvement plan with the facility.Provides the facility Business Office staff with support in responding to audit requests including but not limited to cost reports denial reports, resident trust, reconciliation of bad debt, etc.Provides assistance to Administration on special projects to the extent resources/priorities permit.Participates in the interviewing of Business Office personnel. Provides evaluation information as requested. Makes staffing recommendations for facilities as warranted.Coordinates Business Office employees training with available resources. Provide both initial and ongoing training in all pertinent areas with particular emphasis on billing, collection, and accounts receivable management procedures.Respond to revenue questions from accounting during closing. |
