Summary
Overview
Work History
Education
Skills
Professionalandcivicaffiliations
Timeline
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Heather A. Bathen

Heather A. Bathen

Mt. Juliet,TN

Summary

Results-driven healthcare executive with extensive experience at HCA PARALLON, recognized for enhancing patient access operations and elevating patient satisfaction to 4.8/5 stars. Proficient in healthcare revenue cycle management, with a strong ability to lead transformative initiatives that drive operational efficiency. Expertise in forging strategic partnerships and workforce planning contributes to sustained revenue growth and operational excellence.

Overview

20
20
years of professional experience

Work History

Corporate Vice President of Patient Access Operations

HCA PARALLON
Nashville, USA
03.2015 - Current
  • Company Overview: HCA Healthcare is the nation’s largest provider of healthcare services, comprising 186 hospitals and 2,400 sites of care in 20 states and the United Kingdom
  • Promoted to role at the height of the COVID pandemic to lead and ensure patient access to care continued without disruption in spite of the pandemic by developing and implementing virtual and patient led solutions for registration enterprise-wide
  • Reduced the non-clinical footprint in sites of care while ensuring HIPAA compliant means to connect patients to care while maintaining all JCAHO, DHS, and CMS Conditions of Participation & Conditions of Coverage requirements
  • Led organization patient access operations through Pricing Transparency, No Surprise Act, Provider Relief Funding as well as numerous state mandates related to hospital pricing, privacy, and citizenship data collection programs
  • Implemented Virtual Registration program to over 168 hospitals over three-year span while maintaining best in class patient satisfaction ratings of 4.8/5 stars
  • Streamlined patient registration process, eliminated bottlenecks, and implemented a process to reduce redundant requests for patient information per episode of care thereby resulting in average outpatient registration turnaround time of 3 minutes or less
  • Implemented No Surprise Act across all hospitals and providers in enterprise to include: Timely Good Faith Estimates (GFE), signage and distribution of patient rights to a GFE, adherence to balance billing prohibition, patient notices on network status and appropriate resolution of payment disputes
  • Improved efficiency by introduction of automated tools for all hospital pre-access processes to include Insurance Eligibility Verification, Notice of Admission (NOA), Authorization requirements for Medicare, Medicaid & Commercial payers resulting in significant reduction in labor cost and reduction in avoidable claim denials
  • Designed and rolled out Financial Counselor Program utilizing integrated work tool to the HIS that afforded all inpatients a timely explanation of insurance benefits, point of service collections prior to discharge resulting in increased patient satisfaction scores
  • Increased capture of primary care physician by over 8 percentage points year over year resulting in reduction in readmissions for lack of follow-up with family physician
  • Introduced program to identify uninsured patients and trigger screening for Medicaid and other benefits at time of discharge
  • Improved patients’ throughput in enrollment process and reduced Medicaid enrollment denials for ‘failure to provide’
  • Developed annual budget and met or exceeded goals yearly while reducing staff turnover and improving patient and employee satisfaction
  • Implemented and enacted enterprise-wide business continuity plan during multiple regional and national emergency events including Hurricane Helen, Milton, Idalia, and Ian
  • Worked with hospitals and FEMA to expedite screening of patients to ensure sickest patients were prioritized while treating lower acuity patients in tents to decompress hospitals and conserve precious resources
  • Automated medical necessity screening for Medicare patients based upon physicians’ orders at time of scheduling to include creation and completion of Advanced Beneficiary Notice per requirements
  • Represented organization to internal and external stakeholders in relation to strategic planning, implementation of standards related to ever-changing healthcare regulatory environment
  • Ensured successful internal and external audits in relation to Sarbanes Oxley controls, CMS, DHS and JCAHO as it relates to patient access to care
  • HCA Healthcare is the nation’s largest provider of healthcare services, comprising 186 hospitals and 2,400 sites of care in 20 states and the United Kingdom
  • Created program to promote new managers from within, leading to cohesive leadership structure.
  • Oversaw the development of marketing campaigns, driving brand awareness and customer acquisition goals.
  • Led strategic planning and execution to enhance profitability and company growth.
  • Coordinated activities between executive leadership team members to ensure alignment with overall strategy.
  • Spearheaded initiatives to improve customer experience through technology innovation.
  • Analyzed data to assess progress towards organizational objectives and make necessary adjustments.
  • Championed efforts focused on improving employee engagement throughout the organization.
  • Fostered collaboration and development of new practices by business leaders.
  • Cultivated relationships with industry leaders to identify opportunities for collaboration.
  • Identified areas of improvement within existing systems or processes that could help optimize operations.
  • Leveraged trends in customer industries and marketplaces to shape solutions and approaches.
  • Hired, trained, and mentored staff members to maximize productivity.
  • Executed on-time, under-budget project management to adhere to project road map.
  • Provided organizational leadership and collaborated with executive partners to establish long-term goals, strategies and company policies.
  • Managed budgeting processes for the organization, monitoring spending and performance metrics.
  • Developed and implemented corporate-wide strategies to increase revenue and profitability.
  • Strategized and implemented plans to transform and revitalize operations, capitalizing on emerging industry trends.
  • Directed operations across multiple divisions, ensuring operational excellence and cost efficiency.
  • Oversaw technological improvements, successfully reducing waste and eliminating business bottlenecks.
  • Ensured compliance with government regulations related to corporate governance.
  • Established key performance indicators to measure success of projects, programs, and initiatives.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Utilized various software and tools to streamline processes and optimize performance.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Conducted comprehensive research and data analysis to support strategic planning and informed decision-making.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Worked effectively in team environments to make the workplace more productive.

Vice President of Revenue Cycle & Reimbursement Services

Carondelet Health Network (Member of Ascension Health)
Tucson, USA
03.2013 - Current
  • Company Overview: Nation’s second largest private non-profit health system
  • Specifically hired to serve as a key advisor to the CFO to assess and reengineer a struggling health system with year over year losses that were unsustainable in an extremely competitive market
  • Responsible for providing leadership and overall strategic oversight in the development, enhancement, and maintenance of a properly functioning revenue cycle for a robust health network of hospitals, clinics, and physician practices in a manner that contributed to the organization’s overall financial performance and sustenance while ensuring alignment with mission and regulatory requirements
  • Accountable for directing all operational functions of the revenue cycle including Health Information Services, Coding, Patient Access, Charity Care Program, Revenue Integrity, Denial Management and all areas of Patient Financial Services including charge capture, billing, collections, customer service, payer relations, and reimbursement auditing
  • Serves as chairperson for the Network’s Recovery Audit (RAC) Committee along with serving on several other key committees such as the Finance Board of Directors, Ascension Health Revenue Cycle Shared Services Oversight Committee, Corporate Responsibility and ICD-10 Readiness committees
  • Nation’s second largest private non-profit health system
  • Conducted a thorough assessment of the network’s revenue cycle, identified opportunities and processes leading to revenue leakage and systemic causes of long-term losses and established a robust A/R turn-around plan based upon a movement to best practices
  • Reduced Gross Days in Accounts Receivable by 11 days in one year through a payer targeted cash acceleration initiative
  • Designed an aggressive Medicaid Expansion Enrollment Campaign and successfully enrolled over 8000 loyal uninsured patients that frequented our network for healthcare services resulting in a reduction of over 8% in uncompensated care
  • Established Joint Operating Committee meetings with all major payers allowing us greater leverage in the marketplace and improved partnerships
  • Stabilized cash receipts at or above 100% of net patient service revenue
  • Implemented a comprehensive Patient Payment Assistance Program resulting in an increase in Point of Service Collections by 30% over prior year as well as improving access for underserved patients to public programs such as Medicare, Medicaid, and the Healthcare Exchange insurance plans as appropriate

Chief Operating Officer

HCA PARALLON
Nashville, USA
01.2015 - 01.2020
  • Company Overview: HCA Healthcare is the nation’s largest provider of healthcare services, comprising 186 hospitals and 2,400 sites of care in 20 states and the United Kingdom
  • Hired to lead culture change aimed at becoming the provider of choice in communities served by disrupting the current access to care and revenue cycle models through utilization of patient friendly, streamlined technology at all points of service resulting in reduced patient turn-around time, improved point-of-service collections, and increased overall patient satisfaction scores as well as improvement in labor productivity
  • Directly responsible for the overall operational direction, strategic planning and budgeting for 31 HCA hospitals as it relates to revenue cycle functions including Patient Experience, Employee Engagement, Patient Access, Billing, Collections, Appeals, Revenue Integrity, Payment Compliance, and Medicare and Medicaid regulations
  • Highly engaged in leading case management processes aimed at reducing denials through appropriate assignment of level of care in alignment with medical necessity guidelines and effective peer to peer processes between staff physicians and contracted health plans
  • Worked directly with hospital CEOs and CFOs to ensure the revenue cycle delivery model was in alignment with strategic plans of individual hospitals and markets served
  • HCA Healthcare is the nation’s largest provider of healthcare services, comprising 186 hospitals and 2,400 sites of care in 20 states and the United Kingdom
  • Brought 4 new hospitals up into an integrated service delivery model for all revenue cycle functions resulting in 5% year over year improvement in cash to net patient service revenue, reduction in total uncompensated care and marked improvement in the cost to collect
  • Redesigned the access to care model for patients and physicians served resulting in an improvement of over nine percentile points on Press Ganey Patient Satisfaction scores over a period of five months
  • Re-established Joint Operating Committee meetings with all major payers allowing us greater leverage in the marketplace and improved partnerships resulting in streamlined processes for authorization of care and concurrent review processes that provided Case Management staff additional time to serve patients, families, and physicians
  • Partnered with high volume physician practices in larger markets to offer concierge program and one-stop shop for all pre-service functions from centralized scheduling, insurance verification and authorization
  • Improved year over year point of service collections by 20% through the implementation of a robust patient payment assistance model, which included an expansion in the charity care program, prompt pay discount and increased payment options to meet patients’ needs from various demographics and income levels
  • Implemented robust pre-bill denial unit focused on avoiding potential denied days through a collaborative process with contracted and non-contracted health plans post patient discharge and prior to final bill drop resulting in an over 90% success rate
  • Designed and implemented a hard-wired approach to leadership rounding utilizing both Studer and Ritz-Carlton fundamentals aimed at fostering a renewed culture of excellence surrounding patient experience and return and recommend commendations from patients served
  • Increased overall Employee Engagement Scores to 16 percentage points over the industry average over the IBM Healthcare Benchmark by fostering an ‘employee first’ approach and commitment
  • Successfully completed internal and external audits and reviews to ensure adherence to CMS, Medicare/Medicaid and state regulations as well as Sarbanes Oxley controls

MARKET CBO DIRECTOR– CHANDLER REGIONAL / MERCY GILBERT MEDICAL CENTERS

Common Spirit Health/Dignity Health
Chandler, USA
08.1998 - 02.2013
  • Company Overview: Nation’s Fifth Largest Hospital System and Largest Private Non-Profit System
  • Promoted to provide strategic planning and oversight for Shared Service Center as well as revenue cycle management for two hospitals and eight clinics
  • Direct all functions including patient access, revenue integrity, central scheduling, E/M, and procedure coding
  • Manage all business functions of patient visit from point of access to patient account closure
  • Chair Market Recovery Audit Contractor (RAC) Committee and served on Corporate Compliance, Grievance, and Corporate Revenue Services Standards and Oversight committees
  • Lead five-person management team with 170 indirect reports
  • Nation’s Fifth Largest Hospital System and Largest Private Non-Profit System
  • Established consistent and standard Admissions, Discharge, and Transfers (ADT) process across entire organization as Senior ADT Advisor for enterprise-wide EHR implementation
  • Exceeded cash receipt budget by $12M, reaching $547M for FY12, and reduced A/R days from 65 to 40 by utilizing Six Sigma principles to streamline processes at all stages of revenue cycle, implementing seven-day-per-week billing, and collaborating with health plans, physicians, patients, and providers
  • Generated organization’s highest point-of-service collections year-over-year with nearly $18M in FY12 by educating patients on financial liability at point of first contact, moving pre-collect process to time of patient scheduling, and implementing industry’s most generous, robust payment assistance program
  • Achieved top quartile patient satisfaction for revenue services, ranking among highest in organization, by incorporating industry best practices and modifying patient billing statements based on direct feedback
  • Contributed to design, planning, and launch of Mercy Gilbert Medical Center by participating in strategic planning process and spearheading establishment of patient access, business office, and all revenue cycle operations
  • Improved coding accuracy from 85% to nearly 99%, while reducing labor expenses by $200K+ through redesign of emergency department charge capture and coding process
  • Provided real-time data access, enhanced decision-making process, and reduced time of bill drop from discharge date by one full day by migrating Patient Access and Central Business Office to automated paperless environment
  • Boosted outpatient volumes 20% in one year by implementing automated central schedule model for outpatient services in multi-facility environment
  • Increased direct admits by 20% in first year of developing and managing centralized inpatient transfer center and financial screening process
  • Met OIG standards by designing hospitals’ first corporate compliance program based on OIG guidelines

Education

Master of Science - Leadership

Grand Canyon University

Bachelor of Science - Communication

Clarion University of Pennsylvania

Skills

  • Healthcare Revenue Cycle
  • State & Federal Healthcare Regulations
  • Global Operations
  • New Service Line Development & Implementation
  • Pricing Transparency
  • Physician & Employee Relations
  • Hospital Operations
  • Patient Satisfaction
  • Charity Care Programs
  • Medicare & Medicaid
  • Commercial Insurance Reimbursement
  • Utilization Review/Case Management
  • Team Building
  • Servant Leadership
  • Change Management
  • Health Information Management
  • Budgeting
  • Key Performance Indicator Management
  • Business Continuity Planning
  • Medical Necessity
  • Global operations
  • Strategic partnerships
  • Workforce planning
  • Acquisition integration
  • Innovation management
  • Cost reduction
  • Revenue growth
  • Corporate governance
  • Business process reengineering
  • Succession planning

Professionalandcivicaffiliations

  • Gilbert Public School Finance Board Community Budget Committee
  • Highland High School Varsity Cheerleading Treasurer

Timeline

Corporate Vice President of Patient Access Operations

HCA PARALLON
03.2015 - Current

Chief Operating Officer

HCA PARALLON
01.2015 - 01.2020

Vice President of Revenue Cycle & Reimbursement Services

Carondelet Health Network (Member of Ascension Health)
03.2013 - Current

MARKET CBO DIRECTOR– CHANDLER REGIONAL / MERCY GILBERT MEDICAL CENTERS

Common Spirit Health/Dignity Health
08.1998 - 02.2013

Master of Science - Leadership

Grand Canyon University

Bachelor of Science - Communication

Clarion University of Pennsylvania

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Heather A. Bathen