Alden Joe
Glendale,United States
Summary
Experienced Revenue Cycle Director, Finance & Accounting knowledge with a demonstrated history of working in the healthcare industry. Skilled in management, Healthcare Executive Management, Excellent Customer Service, Human Resource, Case Management leadership, Accounting, and Payer contracts/negotiations. Experienced in management reporting, external & regulatory reporting, profitability and costing projects, financial analysis, audit-risk-internal controls, long term planning & budgeting, financial statement preparations, revenue recognition and work-in-progress accounting, US GAAP, and information systems upgrades & implementations. Advanced A/R experience working in denial management. Knowledgeable of all revenue cycle operations in the healthcare system. Proactive Leader with strong background in financial analysis, budgeting and forecasting. Develops and implements financial plans and delivers strategic financial advice. Results-driven Revenue Cycle Director experienced in financial statement review, auditing and reporting. Well-versed in producing reports, evaluating department operations and handling month- and year-end closings. Meticulous, conscientious and methodical in approach.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Director of Revenue Management
Robert Half
05.2023 - Current
- Revenue Cycle oversight and consult with leadership on overall policies, objectives, and initiatives of the organizations revenue cycle and financial activities
- Optimize the patient financial interaction along the care continuum
- Reviews, designs, and implementing processes surround revenue cycle departments
- This includes billing, third party payer relationships, compliance, collections, and other financial analyses to ensure that clinical revenue cycle is effective and properly utilized
- Duties include tracking metrics related to patient engagement cycle including coding error rates and billing turnaround times to develop sound revenue cycle analysis and reporting
- Manages relations with payers and providers to generate high reimbursement rates and low level of denials
- Report all revenue cycle activities to C-Suite leadership and other necessary departments
- Duties also include provider and hospital credentialing with payers and developing strategies to enhange revenue stream Oversee A/ R and denials and appeals.
Director, Revenue Cycle Management (Consultant)
medSR
02.2022 - 05.2023
- Support daily operations in the Outpatient division of revenue cycle, billing, follow-up, posting, and collections
- Worked closely with front-end and HIM to streamline procedures that ensures correct billing, evaluates staff knowledge of Meditech Expanse, month-end reporting, credit balance reporting, Medicare credit balance reporting, assisting departmental operations in Outpatient, ongoing training with staff members including Skilled Nursing Divsion Business office, monitor daily productivity of denial management and claims
- Work with Managed care to identify payer issues and resolution, reporting to Executive CFO on revenue cycle reporting
- Regularly providing executive management with revnue cycle status including reporting, metrics and presentations
- Ensuring compliance with all payer contracts with payor-specific billing requirements, monitor AR effectively and ensuring that staff and consulting services are working accounts within established goals
- Identifying issues in aging acounts and resolving them with team-approach
- Discuss strategies with team members to ensure everyone is educated on the direction of the department/Brooks Rehab policy
- Any and all other projects, goals, issues surrounding the revenue cycle as assigned by the CFO or Executive team members
- Performing Assessments and evaluation of workflows to provide updating of processes for new EHR, reviewing coding audits and records, implementing changes in the EHR for Coding procedures and management of organizational processes
- Understanding workflows comparing it to industry standards and worked with team in formulation, development of workflows and processes for projects, revenue cycle and operational experience, maintaining engagement projects for the team in analysis and interacting with staff members.
Appointed Chief Executive Officer
Navajo Health Foundation - Sage Memorial Hospital
01.2021 - 12.2021
- The revenue generated from SMH was about 50.5 million dollars in revenue from federal contracts, federal grants and revenue cycle (insurance payer) revenue
- This needed to be maintained by the Executive team which I spearheaded with the Interim Chief Financial Officer who reported to me
- In this role I oversaw the hospital with 250 employees, all Directors reporting to me including the CFO, Chief Operating Officer, Chief Nursing Officer and Chief Medical officer
- In addition to my time as the CEO I worked with closely with the CFO to maintain revenue streams and secured a 150-million-dollar financing project for a new hospital to be constructed that started November 1, 2021 and is being built now with completion date of 2024
- Partnered with the Board of Directors in implementation of new processes which included an Electronic Health record implementation, and automating the Finance system with assistance from I.T
- Planning
- Assist in formulating the company's future direction and supporting tactical initiatives
- Monitor and direct the implementation of strategic business plans
- Develop financial and tax strategies
- Manage the capital request and budgeting processes
- Develop performance measures and for strategic direction
- Participate in key decisions as the CEO
- Manage the CFO and financial departments, Oversee the financial operations
- Manage any third parties to which accounting or finance functions have been outsourced
- Oversee the company's transaction processing systems
- Implement operational best practices
- Report financial results to the board of directors
- Compliance with legal and regulatory requirements
- Ensure that record keeping meets the requirements of auditors and government agencies
- Report risk issues to the audit committee of the board of directors
- Maintain relations with external auditors and investigate their findings and recommendations
- Monitor cash balances and cash forecasts
- Arrange for debt financing and equity financing.
Director Of Revenue Management
07.2019 - 12.2021
- Manage the departments; Registration/Admissions, Health Information Management (HIM), Patient Accounting, Healthcare Management, and System Analyst duties pertaining to State reporting for billing
- Responsible for the revenue cycle, accounts receivable, payables, cash receipts, payroll, fixed assets, and general ledger oversight
- Ensure claims processing comply with federal and state billing regulations and payer requirements
- Collaborate with the department supervisors to develop revenue forecasts and budget projections
- Manage budgeting process for all departments under the Revenue Cycle wing
- Compile/ review data for reporting regulation requirements to government agencies, i.e., Medicaid and Medicare cost reports
- Processed year-end financial closing entries, and account reconciliations of capital request from departments
- Coordinates monthly closing processes
- Prepares monthly financial package for the Governing Board and Administration
- Provides status of financial condition of the organization by collecting, analyzing, interpreting, and reporting financial data
- Financial statement preparation includes Income Statements, Balance Sheets, Statements of Cash Flows, A/R Reserve Analysis
- Protects the assets of the organization by developing, implementing financial controls
- Directs/manages A/R, provides leadership, developmental opportunities, guidance, and support to Accounting staff, including planning, directing, monitoring, and controlling
- Coordinates various annual audits, including the Financial Audits
- Develops best practices to track and analyze data throughout the year
- Directs accounting-revenue in accordance to meet the needs of the Governing Board, CEO, CFO, Sr
- Management, Independent Auditors, outside regulatory agencies, and financial partners
- Human resources management for recruitment.
Healthcare Management Supervisor (Hospital Operations, Medical and Human Resources)
05.2016 - 12.2021
- An experienced Healthcare program Manager in Managed Care, Claim analyst, Revenue Cycle, Pharmaceuticals, Accounts Receivable/Payment posting, Expert in Hospital Insurance follow-ups, Insurance Billing
- Appeals and Denial coordinating
- Managing the Managed Care organization within a Federal government program for Indian Health Services
- Provider and Hospital credentialing was a huge responsibility of this role
- The Managed Care department handled all provider credentialing with insurance payers, CMS and Medicaid plans
- Credentialing played a large role in this department because our department handled over 200+ facilities that our doctors had to refer to
- Human resources operations was a huge part of this role, we handled recruitment of Physicians, nursing and hospital personnel
- Recruiting, interviewing and hiring, Benefits enrollment, Compensation, Training Employee relations, Interpret and explain policy, procedures, law, standards and regulations
- Employee review and remediation
- This position handled all worker compensation cases as well for the staff at the hospital
- Performed assessments for the processes in Change management to support deployment of existing softwares and EHR to align with health record system in referrals management and managed Care
- Addressing all concerns to change managements engagements to leadership and team orientated approaches
- Deploying KPIs and reporting to use for analysis for positive outcomes in company revenue and contracting with payers
- Integrated a new EHR system into the department to facilitate the processes of current workflow to update change impacts
- Worked with the entire leadership team to serve a large population of patients and vendors for satisfaction and results.
Revenue Cycle Manager
Rural/Metro Corporation
07.2007 - 12.2013
- Provided oversight and management of multiple facilities Revenue Cycle Teams
- My responsibilities include oversee build-out of new regional business office in Los Angeles, along with directing two existing regional offices
- Develop and implement policies and procedures related to all aspects of the revenue cycle process
- Monitor and research regulatory changes and propose actions to respond to changing legislation/regulations
- Evaluate and direct efforts to improve revenue cycle
- Perform operational reviews of revenue cycle processes and publish recommendations
- In conjunction with other department leaders, implements strategic and operational initiatives in Accounts Receivable Management and participate in continual education programs and activities that pertain to healthcare management, as well as specific functional areas.
Education
Executive MBA - Business Administration and Management, General
Cornell University
11.2025
Bachelor of Science - BS - Health/Health Care Administration/Management
Grand Canyon University
11.2022
Skills
- Revenue Cycle Management Professional Coding
- Coding experience
- Reporting and analytics
- Hospital operational
- Data Analytics
- Revenue Growth
- CMS Medicaid & Payer regulatory compliance
- Contract Negotiations
- Financial Planning
- Critical Thinking
- Decision-Making
- Team Building Leadership
- Relationship building and management
- Planning and coordination
- Financial analysis and reporting
- Client Relationship Management
- Staff Management
- Business Relationship Management
- Work Planning
- Quality Assurance
- Accounting management
- Process Implementation
- Workflow Coordination
- Financial Reporting
- Internal Controls and Reporting Systems
- Budget Planning
- Risk Analysis
- Operational Reporting
- Financial Management
- Strategy Development
- Revenue Generation
- Budget Forecasting
- Collections Actions
- Cost Data Analysis
- Data trending
- Financial Resource Management
- Insurance Negotiation
Personal Information
Title: Revenue Cycle Management, Healthcare Operations, Executive Leadership, Finance/Accounting.
Certification
Member of American College of Healthcare Executives (ACHE).
Timeline
Director of Revenue Management
Robert Half
05.2023 - Current
Director, Revenue Cycle Management (Consultant)
medSR
02.2022 - 05.2023
Appointed Chief Executive Officer
Navajo Health Foundation - Sage Memorial Hospital
01.2021 - 12.2021
Director Of Revenue Management
07.2019 - 12.2021
Healthcare Management Supervisor (Hospital Operations, Medical and Human Resources)
05.2016 - 12.2021
Revenue Cycle Manager
Rural/Metro Corporation
07.2007 - 12.2013
Executive MBA - Business Administration and Management, General
Cornell University
Bachelor of Science - BS - Health/Health Care Administration/Management
Grand Canyon University