James Constein

• Responsible for overall budget of ~14 million dollars and 440 employees
• Responsible for admission process and operation support for 3,300 + clinics
• Centralized and standardized US verification process which was spread across 8 locations
• Implemented and designed verification / financial clearance platform (Sales Force) to manage 150,000 requests annually
• Implemented and automated technology to capture insurance changes which resulted in first year benefit of 30 million dollars in revenue and reduction in write- off's
• In 2020 moved entire verification operations to remote environment
• Centralized Admissions and Verification organizations, 380FTE's, to standardize entire US admission / Intake process
• Support and or drive key initiatives with Operations related to assuring organizational growth targets and goals are achieved
• Manage centralized team that has responsibility for organizational oversight, development of billing and verification processes managed through Change Healthcare. This includes automation, integration, reporting, vendor management
• Have direct oversight, responsibility of Elevate 365 which is a third party billing organization which supported revenue cycle functions for internal / external physicians. This amounted to 75 internal employees supporting 67 physician practices and ~ 400 physicians.
• Identified opportunities to improve business process flows and overall departmental productivity.
• Evaluated product development strategies and prepared alternative approaches to exceed goals.
• Increased workflow by analyzing data and maximizing opportunities for improved productivity across several areas.
• Increased company growth through collaboration with Operations and streamlined workflow processes
• Spearheaded cross-functional initiatives across departments to achieve business goals for bottom-line profits.
• Directed technological improvements, reducing system limitations, process breakdowns and reducing cost and timelines to achieve targeted goals.

• Focus was centered on developing, managing and delivering on multi year transformation journey related to front end processes that would allow us centralize, standardize and optimize revenue cycle services across 30 locations.
• Managed cross organizational alignment on targets, goals, timelines and implementation
• Responsibility for alignment, delivery related to US and Global efficiency initiatives
• Creation of centralized Electric Data support team to manage payer enrollments for 3,000+ clinics, clearinghouse enrollments for ERA and EFT
• Redesigned billing and verification processes to single clearinghouse. Standardized and automated processes and oversight resulting in staff reduction of 115 FTE's and 3 year savings of ~$15 million.
• Creation of centralized vendor management team to support enterprise services being developed
• Retired multiple vendors during process standardized that resulted in additional ~1.8 million dollars in annual savings
• Implemented new technology to support identification, notification and collection of deceased patients resulting in initial benefit of ~$500K annually before handing off
• Managed, developed, supported numerous technology enhancements during transformation journey that reduced RCM service footprint from 38 locations to 4.
• Aligned front end vision, goals and objectives with company strategy to achieve consistently high results.

• Worked as independent consultant for Fresenius Medicare Care before being hired on as full time employee
• Served as temporary director for Central and East Division RCM operations
• Supported RCM consolidation and standardization efforts
• Direct responsibility for several regional RCM operational locations

• Strategically coordinated operations according to objectives and capabilities, effectively allocating resources to meet demands
• Increased company profits through performance optimization strategies and efficiency improvements.
• Identified opportunities to improve business process flows and overall departmental productivity.
• Evaluated product development strategies and prepared alternative approaches to exceed goals.

Operations

• Managed third party outsourcing operations that routinely handled ~$300 million in net receivables . Clients consisted of Hospitals, Dialysis providers, Skilled Nursing Facilities, Nephrologists, Radiology Centers and other physician specialties.
• Responsible for operations support staff ranging from 120-150 FTE (including practice facing staff)
• Directly responsible for all major client support including results / KPI's, meetings and reporting while supporting business development
• Overall responsibility for client portfolio results
• Directly responsible for policy, procedure and compliance adherence for staff and client portfolio

Consulting

• Assisted in developing and implementing business strategy for consulting division
• Business lead for Hospital based consulting clients
• Initiated Dialysis billing and consulting business line which allowed us to become preferred vendor of all major Dialysis providers
• Business owner for all Dialysis operations support
• Conducted RCM client assessments
• Developed client specific consulting plans
• Provided onsite management to drive / implement process improvements
• Sales / Marketing responsibility and support for large group clients
• Increased consulting division growth over first 3 year period by 315% , specifically being driven through dialysis business growth
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• Responsibility for day-to-day production activities in accordance with business objectives.
• Management of onsite RCM billing / outsourcing staff of ~ 100
• Worked collaboratively with functional leaders to implement new procedures and corrective actions to improve quality.
• Defined, implemented and revised operational policies and guidelines.
• Monitored office workflow and administrative processes to keep operations running smoothly.
• Kept up-to-date with industry trends and identified areas of opportunity to drive improvements.
• Provide client business support via reporting, data analysis , onsite meetings
• Marketing support for new business
• Led change and transformation across business areas to deliver benefits and align company resources.
• Monitored budget and utilized operational resources.

• Management of facility based outsourcing clients
• Onboarded new employees with training and new hire documentation.
• Cross-trained existing employees to maximize team agility and performance.
• Maximized performance by monitoring daily activities and mentoring team members.
• Adjusted job assignments and schedules to keep pace with dynamic business needs, factoring in processes, employee knowledge and customer demands.
• Developed and maintained relationships with customers and suppliers through account development.
• Established and updated work schedules to account for changing staff levels and expected workloads.
• Delivered feedback to decision-makers regarding employee performance and training needs.
• Reviewed performance data to monitor and measure productivity, goal progress and activity levels.