Results-oriented Healthcare Operations Manager with over 15 years of experience in healthcare financial operations with an excellent reputation of finding and maintaining the strategic balances between delivery of the highest quality of care and reimbursement while sustaining patient satisfaction across the continuum.
Directs the day-to-day financial operations for three clinical practices daily strategically, by coordinating the delivery of the care through robust revenue cycle management and personnel management.
Works with the Chair of the Department of Oral Diagnostics and Sciences to focus on attainment of key business metrics and continuous improvement initiatives for direct reports.
Monitors employee productivity and optimized procedures to reduce costs by increased clean claims submission, timely payment collections and effective denial processing.
Builds and maintains external providers while creating product line expansion using financial reviews with oversight.
Ensured the accurate billing of Radiology procedures for FORS/OMFS and Implant Center clinics. Reconciled radiology requests with missing charges reports and daily sign-in sheets
Implemented revenue collection protocols for Radiology, Oral Medicine and Pathology Accounts Receivables. Recovered over $450,000 in Pathology receivables
Created and maintained master database for PECOS (ordering and referring providers by Medicare) and validated 133 ordering/referring providers;
Reviewed, adjusted and implemented billing protocol for Hialeah and St Petersburg Clinics in relation to interpretation of CT scans;
Recovered payments incorrectly allocated for these 2 clinics to 36hrs; Improved collection rates of receivables for the Radiology, Pathology and Oral Dept in the last 12 months;
Sustained billing turnaround time in Oral Medicine in the last 12 months;
Assisted in the credentialing of Radiology providers. Provided timely updates on all new Medicare and industry regulations and changes to Faculty;
Strategized and created support structures and logistics for all lines of DNA typing with advanced PCR Primer;
Formulating and designing educational materials for distribution to provider network by the assigned geographic area;
Established positive, professional relationships with participating providers;
Coordinated with surgery departments, attending doctors and scheduling department on referrals and patients schedules;
Verified the financial and medical status of patient cases for surgery; Reconciled of the daily OR elective surgery schedule;
Registered ambulatory surgery patients in Unity 23 system;
Reconciled the monthly preoperative care patient lists;
Daily sales of prescription glasses
Daily reconciliation of Sears Optical accounts with parent company Luxottica International
Conceived and implemented budgetary measures to increase profits
Analyzed market information to implement strategic market positioning
Managed a team of 12 sales and marketing associates
Analyzed market information and implemented strategic market positioning
Prepared mark-up on imported products
Valued inventory and prepared cost reports for auditors
Healthcare Administration
undefinedCertified Physician Practice Manager (CPPM)
Single handedly collected approximately $375,000 in the last 3 years of outstanding accounts for the Pathology Department
Conceived, designed and implemented the PECOS/Medicare Enrollment protocol which has shown dividends in reducing claim denials for referring providers from Medicare by $120,000 annually in the last 4 years
Reduced the Radiology and Oral Medicine accounts receivables by double digit percentages of 25 and 20 percent respectively
Certified Physician Practice Manager (CPPM)
Certified Revenue Cycle Professional (CRCP)
Certified Professional Coder (CPC)