Kristin Macedo
Valencia,CA
Summary
Innovative and proactive Area Central Business Office Director at Concentra. Successfully led strategic evaluation, planning, and implementation of healthcare revenue cycle improvements for over 225 locations across multiple states. Oversees two regional billing offices processing over $60 million in revenue per month. Consistently achieved cost reduction, increased cash flow, and improved efficiency. Core competencies in strategic analysis, budget development and planning, business process re-engineering, payor relationship management, and team leadership. Leverages strong background in software and database development to enhance service, drive automation, and increase transparency. Certifications in product management by AIPMM and PMP demonstrate ability to deliver value-added solutions for complex and dynamic healthcare challenges. Experienced leader with strong background in strategic planning and operational management. Skilled in team collaboration, driving results, and adapting to changing needs. Expertise in staff development, budget oversight, and process improvement. Known for reliability and fostering cohesive work environment.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Area Director of Revenue Cycle and Central Business Office
Concentra
02.2018 - Current
- Company Overview: End to end revenue cycle management governing the states of CA, WA, OR, HI and AK for over 225 locations including stand-alone clinics, on-sites and outsourced surgery centers
- End to end revenue cycle management governing the states of CA, WA, OR, HI and AK for over 225 locations including stand-alone clinics, on-sites and outsourced surgery centers
- Facilitate clean billing for thousands of providers and specialists through hundreds of contracted networks, specialty networks, and thousands of insurance carriers and employers
- Revamped the mailroom and deposits process to withstand the influx of transactions
- Defined the requirements for the transition to the new document management system to drive technology efficiencies
- Redefined the daily cash reconciliation processes to aid Finance
- Identified and designed EDI billing system improvements and integration to proprietary billing software that have considerably improved DSO reducing DSO to a company low of 38 in comparison to companywide average of 49
- Redefined reporting structure to enable the teams to be measured, and to identify payer trends and deficiencies
- Transitioned all revenue cycle staff, systems and processes for the US Healthworks acquisition by Concentra
- Closed out the $70M receivable, working with Finance to satisfy all state audit and reporting requirements
- Took on an additional business office boosting staff from 60+ to 160+
- Managing teams currently 50% in-office and 50% remote
- Re-structured the teams, re-engineered processes and created the tools, dashboards and new SOP’s for the staff to handle a 6 fold increase in Revenue from $8+million per month to $50+million per month over a period of 10 months
- Maintain the lowest cost to collect - related to personnel and non personnel costs (in the most expensive area in the country), the lowest % of aged receivable, unapplied and bad debt ratio in comparison to all other offices while meeting and exceeding goals year over year
- Successfully rolled out the new team structures, processes, reporting and analytics to the other business offices to aid in the contribution to EBITDA and attainment of quarterly and annual goals
- Skillful with strategic and financial planning - utilizing proforma analysis, reporting and data modeling reflecting lean process and agile methodologies to present new and revolutionary concepts and systems to executive leadership
- Maintain knowledge of all applicable state reimbursement regulations
- Create and maintain relationships with multiple large payers nationwide, including specialty networks, employers, trading partners and bill reviews
- Mentor and teach the management staff to use the data to measure, analyze and identify areas of potential improvement in all facets of the revenue cycle on an ongoing basis consistently
- End to end revenue cycle management governing the states of CA, WA, OR, HI and AK for over 225 locations including stand-alone clinics, on-sites and outsourced surgery centers
Vice President of Corporate Services
U.S. HealthWorks
06.2017 - Current
- Company Overview: Responsible for the strategic evaluation, planning and implementation of improvements for more than 220 clinics and two regional billing offices processing $45-$50 million in revenue per month
- Responsible for the strategic evaluation, planning and implementation of improvements for more than 220 clinics and two regional billing offices processing $45-$50 million in revenue per month
- Guide all components of technology to increase transparency, drive automation and improve service
- Evaluate and realign workforce as needed to reduce employee turnover and achieve greater stability
- Reduced costs by over $1.5 million which exceeded the expenses incurred in transitioning to a paperless billing process and boosted efficiency allowing existing systems to process $2 million more per month
- Oversee teams of up to 120 members that implement new systems for revenue reconciliation, refund processing, transfer of care, referrals and the collections aging process
- Own and direct the operations of the Valencia office which houses over 230 employees
- Responsible for the strategic evaluation, planning and implementation of improvements for more than 220 clinics and two regional billing offices processing $45-$50 million in revenue per month
Director of Revenue Management
U.S. HealthWorks
08.2016 - Current
- Reduced billing costs by over 25% in the first year
- Improved and delivered a 2 point increase in cash to revenue on 90 days trailing
- Delivered 8% reduction in the time between date of visit to the receipt of payment
Director of Product Development and Operations
ICM Document Solutions
01.2015 - 08.2016
- Envisioned and implemented organizational changes to finance, including the conversion of accounts receivable to Microsoft Dynamics suite, the redesign of the general ledger to align with the updated profit and loss structure, and the integration of accounts payable
- Result: freed up 50% of staff time
- Managed the contracts for federal and state services with onshore and offshore teams
- Redesigned financial forecasting and reporting to boost scalability and ensure consistency
- Negotiated contracts and managed agreements
Director of Sales and Marketing Operations
ICM Document Solutions
01.2013 - 01.2015
- Delivered year over year growth on target and managed the sales and marketing budget
- Hired new and mentored all members on the sales and marketing team
- Cultivated key relationships with major accounts and vendors
- Lead generation and management through automation and integration to vendors
Director of Information Technology
ICM Document Solutions
01.2007 - 01.2013
- Managed day to day operations and executed budgets for product development and architecture, network infrastructure, and professional services
- Utilized SDLC and Agile methodology to execute projects such as enterprise content and document management, workflow implementation and upgrades, accounts payable automation and to launch portal technologies
- Supported and replicated the customers SaaS environment
- Provided professional services including sales engineering, implementation planning, data conversion and integration services, consulting and customer support
Programmer, Business Analyst
U.S. HealthWorks
01.2003 - 01.2007
- Reengineered the business processes for MRO, Random Selection Services Program and Medical Surveillance Program to create a paperless and scalable environment that complied with regulations
- Decreased labor costs by $750,000 annually, and increased staff efficiency by 55%
- Improved federal compliance by 65%
Education
Bachelor of Arts - Economics
Northern Illinois University
DeKalb, IL08.1994
Skills
- Revenue Cycle Transformation
- KPI design and development
- Contract Negotiations and Implementation
- Financial Forecasting
- Collections & denials management
- Budget creation & review
- SQL Server Management
- Digital Transformation
- Strategic Planning & Analysis
- Process Improvements
- Regulatory Compliance
- Performance Benchmarking
Certification
- AIPMM, Certified Product Management
- PMP, Product Management Professional coursework
Timeline
Area Director of Revenue Cycle and Central Business Office
Concentra
02.2018 - Current
Vice President of Corporate Services
U.S. HealthWorks
06.2017 - Current
Director of Revenue Management
U.S. HealthWorks
08.2016 - Current
Director of Product Development and Operations
ICM Document Solutions
01.2015 - 08.2016
Director of Sales and Marketing Operations
ICM Document Solutions
01.2013 - 01.2015
Director of Information Technology
ICM Document Solutions
01.2007 - 01.2013
Programmer, Business Analyst
U.S. HealthWorks
01.2003 - 01.2007
- AIPMM, Certified Product Management
- PMP, Product Management Professional coursework
Bachelor of Arts - Economics
Northern Illinois University
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