Adelani (Lany) Wahab

· System wide leader on all Revenue Cycle operations including patient access services across 5 hospital campuses and 4 Wellness Centers for both Medical & Dental Services.

· Lead all access related activities across Ambulatory Service Division to ensure access for our patients from a clinical and revenue cycle patient access standpoint.

· Led a system wide project on the implementation of the Charge Capture and Reconciliation policy across Alameda Health system.

· Led EPIC Cadence security project across Ambulatory Services

· Co-implementor of service line creation at Alameda Health System.

· Led a system wide project on the implementation of Erroneous encounter prevention that led to revenue loss across the system.

· Led a re-optimization of our Revenue Cycle in Ambulatory Service Division to ensure best practices are adhered to i.e., ensuring industry benchmarks/KPIs are adhered to, reviewed all existing workflows to comply with best practices for both Medical & Dental Revenue Cycle services.

· Co-implementor of Pricing transparency project across Alameda Health System.

· Co-implementor of BEST initiative program on Revenue Cycle at Alameda Health System.

· Co-implementor of Advance Beneficiary Notice (ABN) project across Alameda Health System.

· Oversee the activities of Alameda Health System Ambulatory Call & Referral Center to ensure patients access to healthcare is achieved across our system.

· Created an Ambulatory Training & Quality Assurance team to address the training and QA needs of staffs and providers in the Ambulatory service division on Rev. cycle/Access related functions.

· Worked closely with Department & Clinical Chiefs/Heads to ensure access to patient care and proper billing services are implemented across all our clinics.

· Provide leadership to over 152 FTEs.

· Partnership with our Quality Improvement team to ensure all State quality measures and Care gaps metrics are met.

• Provides oversight and participate in compliance related activities on behalf of Ambulatory Service division.
• Key stakeholder in the Alameda Health System Revenue Cycle Steering Committee which oversees the organizations strategic plan from an IT/EPIC & Revenue Cycle standpoint

· Key partner in Union relationship with our teams across the Ambulatory Division for SEIU & ACMEA MOU implementation.

· Spearheaded all Revenue Cycle End to End services/operations for Providence Health system hospitals & Urgent care clinics in Southern California- LA County region.

· Led the overall strategy and optimization of revenue cycle operations as it relates to billing, account receivables, collection, customer service, coding, denials, payment solutions, registration, insurance eligibility & benefit verification, credentialing, payment posting, charge capture, client management.

· Improved AR by about 18%

· Improved collection by about 14% monthly from $25M to about $29.4M. (Annual collection over $350 M)

· Improved collection rate from 79% to 98% (NCR 98%).

· Improved denial rate by 17%.

· Improve bad debt by about 2.6%.

· Experience with continuous optimization of EPIC Physician Revenue Cycle system targeted to maximize revenue yield and identify revenue cycle errors prior to billing.

· Led a project on optimization and restructuring of the Revenue Cycle department in the LA region.

· Present Monthly Performance summary to all our clients in the LA County region of Providence Health & Urgent Care leadership team.

· Provide leadership to over 140 FTEs currently both onsite & remote and still growing (4 Direct reports- managers).

· Report to the Vice President of Revenue Cycle Services.

· Management responsibilities including training, directing, operations, fiscal accountability, staffing, personal management and staff development.

· Developed and implemented Revenue Cycle Initiatives, strategic goals and Key Performance Indicators (KPIs) consistent with organizational vision and industry best practice.

· Continuous improvement in net collection rate at >98% consistent with the organizations collection rate across the enterprise.

· Led all Physician Revenue Cycle functions (onsite and remote) involving account receivables, billing, credentialing, pre-certification, coding and charge entry, payment posting, credit and collections.

· Developed a new Revenue Cycle department from a small billing office (now front end and back-end Revenue Cycle) and the pioneer Director of Revenue Cycle Patient Financial Services.

· Improved AR collection from over $12M to about $6M in (about 50% reduction).

· Increased cash collection by about 28% monthly.

· Increased charges posted by about by about 25%.

· Provides leadership to team of 20 FTEs both onsite and remote.

· Mentors and coach staffs to ensure success and career growth utilizing experience and background in guiding staffs to achieving their potentials.

· Created strategic initiatives to gain efficiency and increase collection margin.

· Build action plans to achieve Key Performance Indicators (KPIs) based on industry best practice.

· Report to the CEO of the organization.

· Experience with Athena/Centricity

· Management responsibilities including training, directing, operations, fiscal accountability, staffing, personal management and staff development.

· Ensure timely billing, manage cash collections and collections of accounts receivables.

· Increased patient satisfaction by reorganizing our customer service department and introducing lean methodology to eliminate waste and redundancy by designing and implementing new workflows.

· Develops and implements RCM initiatives that achieve strategic goals consistent with the Chief Executive Officer and Chief Financial Officer's priorities and vision.

· Develop and execute strategies and/or provide advice to external clients or internal consultants in area of expertise including revenue cycle/finance projects and program implementation.

· Participate in business development-related discussions with clients as a clinical population health management for providers subject matter expert in Healthcare Finance/Revenue Cycle.

· Establishing credibility and developing relationship with all levels of client managers (both clinical and non-clinical) in a health setting.

· Manages process improvement effectively, leveraging existing implemented solutions to achieve better performance and outcomes.

· Establish performance expectations, provide coaching/mentoring, performance monitoring and appraisals.

· Provide on-site consultation to clients in developing performance improvement strategies.

· Manages process improvement effectively, leveraging existing implemented solutions to achieve better performance and outcomes.

· Managed Physician and hospital revenue cycle functions.

· Provides leadership to team of 105 FTEs both onsite and remote.

· Report to the Director of Revenue Cycle, Patient Financial Clearance department.

· Member of the Denial Prevention committee at Stanford Healthcare that resulted in reduction in authorization/access-based denials which saved our organization about $450,000 monthly and about $5.4M annually.

· Reduced denials and write-offs by about 4.5% annually over the course of 3.5 years saving organization over $20M.

· Responsible for authorization, collections, registration, pre-registration, vendor management, insurance verification and eligibility and customer service teams for all insurances in California and nationwide (Govt. plans, commercial insurance and self-pay).

· Manages the customer service team & communication center to a fully functional center with standard workflow and improved daily metrics i.e., average of 0-2% call abandon rate, improved speed and call volume to answer at 98 %.

· Key stakeholder in major projects and program implementation across Revenue Cycle and Hospital Administration, which includes PFC Optimization project, ABN project across Stanford Healthcare etc. These projects have major impact across the organization impacting over 5000FTEs workflow.

· Designed a new workflow that eliminated waste and redundancy by capturing most surgery & infusion cases/appointments thereby ensuring all cases/appointments are authorized before services are rendered at SHC infusion clinics resulting in about 72% authorization for infusion & surgery appointments while averaging between 27-30 days-out and reducing denials and write-off.

· Manages the Pre-registration (Pre-Service Outreach), Registration and collection team which consistently exceeds its daily, monthly and yearly estimates & collection goal by over 56% with yearly collection goals set at $3.7 million.

· Managed and coordinated all vendor management activities of the department in the Revenue Cycle Division which includes RFP, decision making, contract negotiation, advising the department and division on selection of a vendor.

· Created and managed the Prior Authorization review position responsible for reviewing the clinical documentation/referrals prior to sending to the plan, denials and Peer to Peer for SHC clinics.

· Created an insurance timeline matrix used by the Patient Financial Clearance department and clinics at Stanford Healthcare as a guideline to schedule patient for clinic visit and authorization process.

· Work closely with clinical partners (MDs, PAs & NPs), billing, patient registration, coding and Self-pay Management Office (SMO) departments to ensure patients are screened to see if they qualify for charity, process refunds after billing, ensure correct coding of procedures & diagnosis and appropriate clinical documentation.

· Proven ability to lead, plan and direct overall clearance functions which includes pre-registration, payer authorization (outpatient and hospital), clinical documentation/coding, customer service and insurance verification successfully.

· Experienced professional who develops physicians and other healthcare providers’ education resulting from the analysis of clinical and financial information from internal and external sources for accurate documentation.

· Performed concurrent medical documentation reviews of complicated clinical cases.

· Utilized the knowledge of MS-DRGs and the Inpatient Prospective Payment System (IPPS), including new CMS guideline of key elements including clinical documentation of what constitutes an inpatient admission and Patient Safety Indicators (PSI).

· Utilized ICD-9 & ICD-10 hospital coding policies and procedures, Federal and State coding reimbursement guideline and reviewed Clinical documentation and coding for Inpatient services.

· Coordinated abnormal test findings and ambiguous clinical documentation by physicians when they occur and query physicians on current basis.

· Cultivated communication with other departments like HIM, Coding, Quality and Revenue departments to ensure.

· Key stakeholder/member of the ICD-10 implementation and 3M maintenance project team.

· A specialist with a unique combination of practical knowledge and understanding of official physician E & M guidelines and documentation requirements in support of proper E & M assignment, establishment of medical necessity and CPT/HCPCS coding for reimbursement.

· Implemented improvement in clinical documentation/health record to reflect quality outcomes and increased reimbursement by 25%.

· Developed an interacting tool for the use of physicians, healthcare providers and health information management personnel to ensure accurate coding using the DRG, Hierarchical Coding Category (HCC) and Risk Adjustment Scores for Outpatient services.

· Experience with NextGen, Meditech EHR.

· Contributed to raising concurrent appropriate queries which improved complete documentation, patient health management, proper reimbursement and reduced denials significantly.

· Educated, trained and guided physicians and other providers on ICD 9 & 10 coding guidelines and usage of HER and compliance regulations by CMS.

· Key stakeholder/member of the EPIC and 3M implementation project team.

· Research aim: Determine “Predictors of Lymph node positive disease in Renal cell carcinoma (RCC)”.

· Report to the Chair of Urology department.

· Determined non-Renal cell carcinoma combined data set for manuscript.

· Analyzed and evaluated data of 1500 patients that helped determine lymph node positive disease in RCC.

Collected data, analyzed and interpreted using STATA for publication of study’s findings.

Federal Capital Territory Health & Human services. Abuja (September 2008 – August 2010)

Kolstaf Medical Center. Abuja, Nigeria (July – September 2008)

National Directorate for Employment staff clinic. Abuja (September 2007 – June 2008)

Nigeria National Assembly Clinic. Abuja, Nigeria (March 2007 – February 2008)

University of Abuja Teaching Hospital. Abuja, Nigeria (March 2006 – February 2007)

United Nations Millennium Dev. Goal (MDG). Abuja, Nigeria (August – December 2009)

United States Agency for International Dev. (USAID) through Mgt. Sciences for Health (MSH) (June – August 2009)

World Health Organization (WHO) (November 2008)