Lisa Huschka
St. George,Utah
Summary
Revenue Cycle expert adept at implementing procedural improvements and executing revenue metrics and analysis to drive corporate financial objectives. Eager to apply 20+ years of Healthcare Contract Management experience to increase revenue and added value.
Overview
22
22
years of professional experience
Work History
AVP, Revenue Integrity
Steward HealthCare (FKA) Iasis Healthcare
01.2017 - Current
- Program hospital agreements into 3 Contract Management systems (Allscripts Pathways Contract Management, Meditech Proration & FinThrive Contract Management) which calculates the expected revenue for each hospital at the patient account level for 22 hospitals
- These Contract Management Systems estimate the projected Revenue for each hospital and are used across our organization by our CFO's and hospital leadership
- Responsible for Programming and maintaining all Government Program payment methodologies and rates such as Medicare, Medicaid, Tricare, and Workers Comp rates for all 22 hospitals
- Review Daily Reports to ensure the integrity of the system and to help identify payer trends in relation to contractual agreement issues as well as identify issues in all areas related to the revenue cycle such as Registration, Billing, and Coding to endure the accuracy of the AR
- Manage a team responsible for providing all Revenue Modeling Projections during hospital contract negotiations
- Provide ongoing support and training to hospital staff and hospital administration on the Contract Management Systems and Reporting
- Oversee all Financial/Revenue Modeling for managed care negotiations.
National Director, Revenue Integrity
Steward HealthCare (FKA) Iasis Healthcare
01.2012 - 01.2017
- Manage the Allscripts Pathways Contract Management system for 22 hospitals, including system software updates and upgrades, programming and loading of all hospital agreements
- Assist the AVP with Medicare and Medicaid rate updates
- Manage a team that provides Financial/Revenue Modeling for all 22 hospitals during hospital contract negotiations
- Managed Patient Cash Collections tool
- Perform Hospital Onsite Audits to identify Revenue Cycle Issues and Provide Resolution
- Review Daily Reports to ensure the integrity of the system and to help identify payer trends in relation to contractual agreement issues as well as identify issues in all areas related to the revenue cycle such as Registration, Billing, and Coding to endure the accuracy of the AR.
Director, Managed Care Analysis
Steward HealthCare (FKA) Iasis Healthcare
01.2008 - 01.2012
- Manage the Allscripts Pathways Contract Management system for 22 hospitals, including system software updates and upgrades, programming and loading of all hospital agreements
- Assist the AVP with Medicare and Medicaid rate updates
- Manage a team that provides Financial/Revenue Modeling for all 22 hospitals during hospital contract negotiations
- Managed Patient Cash Collections tool
- Perform Hospital Onsite Audits to identify Revenue Cycle Issues and Provide Resolution
- Review Daily Reports to ensure the integrity of the system and to help identify payer trends in relation to contractual agreement issues as well as identify issues in all areas related to the revenue cycle such as Registration, Billing, and Coding to endure the accuracy of the AR.
Supervisor, Revenue Reconciliation
Eisenhower Medical Center
01.2007 - 01.2008
- Manage and oversee the Managed Care Contract Analyst position
- Manage and oversee the Allscripts Pathways Contract Management System which calculates the expected revenue and the patient account level and maintains the Hospital AR
- Manage and Oversee the Managed Care Contract Analyst responsibilities during contract negotiations for the hospital
- Manage the Cash Posting Department for the hospital which includes the posting of all insurance payments, patient payments, adjustments, and refunds for the hospital
- Project Manager for the implementation of the hospital electronic RA system, which allows insurance payments to post electronically into the patient accounting system
- Project Manager for the Denials and Appeals implementation used to track and manage payer denials.
Managed Care Contract Analyst
Eisenhower Medical Center
01.2003 - 01.2007
- Maintain, Update, and Monitor All Pathways Contract Management System (PCON) Environments, which include Production, Revenue Modeling and Test
- Responsible for loading all managed care contracts into PCON
- Perform Daily Audit between the Patient Accounting system and PCON as well as troubleshoot and resolve any system issues
- Review PCON Daily Reports to ensure the integrity of the system and to help identify payer trends in relation to contractual agreement issues as well as identify errors in all areas related to the revenue cycle such as Registration, Billing, and Coding
- Perform Testing for all Pathways Contract Management System Updates and Upgrades
- Responsible for keeping up with the Hospital Charge Master Updates and the impact to Revenue and Hospital Agreements
- Perform Revenue Modeling for the Managed Care Dept
- During contract negotiations to determine the financial impact the rates will have on the hospital
- Maintain, & Update all the Managed Care Public Folders which include updating all the Managed Care Contract Rates, Medicare Rates, and other various learning tools used by the Business Office/Patient Financial Services Department
- Maintain and Update the Manage Care folders on IKENET which include all Managed Care Contracts and Insurance Manuals
- Perform all training as needed for the PFS department on the Pathways Contract Management System
- Build and maintain all Vender/Contract Account tables in the STAR patient accounting system
- Perform Monthly AR Audit for the hospital controller.
Auditor
Accent Recovery Solutions
12.2002 - 01.2003
- Travel to Hospitals throughout Southern CA to perform patient accounting audits
- Assist the hospital by identifying insurance underpayments and overpayments, patient overpayments, & incorrect contractual adjustments
- Teamed with other auditors on hospital projects to reduce credits balances by millions of dollars
- (Projects included Loma Linda, St John’s Pleasant Valley, & Cedar Sinai) Continue to exceed monthly recovery goals by up to 456%
- Expert Knowledge of Hospital contracts, CPT codes, ICD9 codes, DRG’s, and REV codes.
Regional Account Manager
Aim Healthcare Services
06.2002 - 12.2002
- Traveled to hospitals throughout CA and WA performing patient accounting audits while maintaining and building relationships with many providers
- With a team of auditors helped reduce the credit balances of many hospitals by millions
- HIPAA – certified and trained
- Attended and Passed Hospital Revenue Cycle Training Course & Test.
Education
Bachelor of Science - Business Administration, Accounting
University of California, Riverside (UCR)
06.2002
Skills
- MS Office
- MS Teams
- Allscripts Patient Accounting Systems
- Allscripts Contract Management Systems
- Cerner Patient Accounting
- Meditech Patient Accounting
- FinThrive Contract Management Systems
- FinThrive Carepricer/Patient Estimator
- Meditech Proration
- Hospital Revenue Cycle
- Hospital Billing/Collections
- Hospital Coding
- Project Management
- Hospital Contract Negotiations
- Expert Knowledge of Hospital contracts
- Expert on hospital payment methodologies including Commerial, Medicare Medicaid, Tricare, Workers Comp
- CPT codes
- ICD codes
- DRG’s
- REV codes
Timeline
AVP, Revenue Integrity
Steward HealthCare (FKA) Iasis Healthcare
01.2017 - Current
National Director, Revenue Integrity
Steward HealthCare (FKA) Iasis Healthcare
01.2012 - 01.2017
Director, Managed Care Analysis
Steward HealthCare (FKA) Iasis Healthcare
01.2008 - 01.2012
Supervisor, Revenue Reconciliation
Eisenhower Medical Center
01.2007 - 01.2008
Managed Care Contract Analyst
Eisenhower Medical Center
01.2003 - 01.2007
Auditor
Accent Recovery Solutions
12.2002 - 01.2003
Regional Account Manager
Aim Healthcare Services
06.2002 - 12.2002
Bachelor of Science - Business Administration, Accounting
University of California, Riverside (UCR)
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