Summary
Overview
Work History
Education
Skills
Accomplishments
Work Phone
References
Certification
Timeline
Generic

Janice Smith

Mesa,Arizona

Summary

Skilled Executive with 39 years of revenue cycle management expertise. Adept at understanding and navigating the complexities of healthcare reimbursement with the ability to identify and implement opportunities to improve efficiency in business operations. Hands-on proactive manager and analytical problem-solver, as well as excellent aptitude in customer relations and relationship building skills.

Overview

31
31
years of professional experience
1
1
Certification

Work History

AVP, RCM

Pediatrix Medical Group
11.2021
  • Facilitated oversight and monitoring of outsourced RCM vendor in evaluation of RCM targets and metrics on AR in excess of $1 billion monthly.
  • Promoted and led performance enhancement culture by actively coaching and mentoring direct reports.
  • Collaborated with internal Corporate Departments in resolution of RCM specific issues/concerns.
  • Communicated business concepts and expected functional behavior to outsourced RCM vendor and other stakeholders.
  • Participated in organic growth initiatives and acquisitions to ensure compliance with State and Federal guidelines in set up of RCM specific functions and processes.
  • Collaborated with internal Legal Department in incorporating language into hospital agreements to ensure provisioning access with our hospital partners.
  • Facilitated update of RCM policies and procedures to address changes in healthcare environment, ie NSA, financial assistance, etc.
  • Participated in software implementation supporting internal NSA arbitration team.
  • Responsible for management and oversight of 4 internal back end collection related teams supporting quality audit, external vendors, market operations and NSA implementation.

CBO Director

Pediatrix/Obstetrix Medical Group
10.1999 - 10.2021
  • Responsible for management of the billing and collection activities on $840 million in annual revenues
  • Typical monthly accounts receivable runs in excess of $100 million dollars
  • These revenues are generated from approximately 50 multi-specialty physician practices in 13 states
  • Oversight for 157 direct and indirect reports comprised of 10 Managers who provide day to day supervision and direction of all insurance collection activities, payment application processes, front-end data collection/validation processes, provider enrollment activities, reimbursement variance collection activities, and financial reporting
  • Participate in meetings with payers to ensure correct/timely payment of accounts and resolution of claims issues
  • Prepare, operationalize and effectively manage annual CBO budget of just under $7 million
  • Work closely with the management team of the practices supported by the Phoenix CBO to identify areas to improve efficiencies within the billing and collection processes
  • Implement procedures for front end hospital based associates to facilitate correct front-end data collection
  • Partner with local Managed Care Department to ensure contracts negotiated are fair and manageable
  • Responsible for administering Corporate Policies/Procedures and ensuring adherence to Corporate Compliance Program as well as HIPAA standards
  • Participate in organizational Government Relations Committee in review and analysis of proposed legislation and regulations potentially impactful to our practices and operations
  • Lead cross departmental committees to assess current operational processes, develop and implement strategies to facilitate increased efficiencies, and monitor progress to ensure achievement of goal.

A/R Director, Western Region

Tenet Physician Services
06.1996 - 09.1999
  • Responsible for $40 million dollars in accounts receivable for 150 multi-specialty, multi-state physicians
  • Oversight for 98 direct and indirect reports comprised of 8 Managers providing direct support in the billing and collections process
  • Participated in regular meetings with physicians to discuss A/R concerns, problem payers, and focuses
  • Acted as a liaison between practices and regional office to ensure needs of the practices were met timely
  • Coordinated with local Managed Care Manager to address problem payers and resolve billing issues.

Practice Manager

Cochise Health Alliance
07.1991 - 12.1995
  • Responsible for day to day operation of a busy, 3 physician Primary Care/Internal Medicine Clinic
  • Handled accounts receivable for the practice to include posting of charges, payments and adjustments
  • Tracked A/R to ensure timely payment made on accounts
  • Assured flow of patients in the clinic was consistent
  • Oversaw clinic operations for eight visiting specialists from the Tucson area
  • Supervised all nursing and office personnel
  • Managed the hiring process as well as any employee issues.

Patient Accounts Coordinator

Cochise Health Alliance
06.1990 - 06.1991
  • Entered, posted, printed and submitted charges for billing to numerous insurance carriers
  • Responsible for timely follow up on each account
  • Posted payments to patient accounts, prepared deposit and maintained weekly reports.

Education

Medical Secretary AAS Degree -

Pima Community College
Tucson, AZ
01.1984

General Studies -

Cochise College
Sierra Vista, AZ
01.1982

Buena High School
Sierra Vista, AZ
01.1982

Skills

  • Typing 70 wpm – Word – Excel – Powerpoint – PCN, Next Gen and IDX Practice Management Softwares – Understanding of Provider Contracting – 39 Years in Healthcare, Certified Professional Coder

Accomplishments

Successfully consolidated 2 central business office locations with AR exceeding while maintaining key RCM metrics and cash collections.

Work Phone

(954) 666-4517

References

Available Upon Request

Certification

American Academy of Professional Coders,

Timeline

AVP, RCM

Pediatrix Medical Group
11.2021

CBO Director

Pediatrix/Obstetrix Medical Group
10.1999 - 10.2021

A/R Director, Western Region

Tenet Physician Services
06.1996 - 09.1999

Practice Manager

Cochise Health Alliance
07.1991 - 12.1995

Patient Accounts Coordinator

Cochise Health Alliance
06.1990 - 06.1991

Medical Secretary AAS Degree -

Pima Community College

General Studies -

Cochise College

Buena High School

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