LORRAINE LUDWIGSEN
C-suite Healthcare Executive And Compliance Subject Matter Expert
Port Jervis,NY
Summary
Results-driven Chief Operating Officer with a proven track record of driving performance improvements and leading strategic initiatives. Skilled in managing cross-departmental activities and effectively communicating organizational objectives. Develops and executes innovative strategies to stimulate growth and enhance service quality. Demonstrates expertise in strategic planning and execution, staying abreast of industry developments to identify their relevance to the organization. Excels in formulating policies and implementing streamlined processes that optimize operations, staff, patient, physician, and clinical staff experiences. Consistently leads teams to achieve optimal productivity and advocates for a collaborative and consultative service-oriented approach to organizational activities. Holds certifications as a Certified Paralegal (CP), Certified Professional Coder (CPC), Certified Compliance Officer (CPCO), Certified Healthcare Compliance Consultant (CHCC), and Certified Healthcare Compliance Officer (CHCO).
Overview
27
27
years of professional experience
Work History
Chief Operating Officer
Empower Healthcare and Compliance Partners
9 2022 - Current
- Operational oversight and staff management
- Compliance activities oversight, client management and strategic planning
- Regulatory compliance subject matter expert
- Revenue Cycle compliance Subject matter expert.
Chief Operating Officer and Executive Vice President of Compliance
Healthcare Compliance Network, LLC
08.2021 - 04.2024
- Operational oversight and staff management
- Compliance activities oversight, client management and strategic planning
- Regulatory compliance subject matter expert
- Revenue Cycle compliance Subject matter expert.
Vice President of Operations and Compliance
08.2016 - 08.2021
- Operational and Compliance activity oversight and client management consulting
- Regulatory compliance subject matter expert
- Revenue Cycle compliance Subject matter expert.
Director of Revenue Cycle and Compliance
Robert Wood Johnson Physician Enterprise, PA
01.2013 - 07.2016
- Significant Accomplishments: Successful onboarding and transitioning of 116 providers/39 practice sites in 40 months
- Including legacy EEHR and PM software conversion to RWJPE EEHR and PM
- Transitioned billing agency from a California based billing company to an East Coast agency in 2015 without revenue disruption
- In 12 months, effectively increasing the collection rate across all practices by no less than 15% and decreased days in AR from 65 to 44
- Successfully selected and implemented electronic charge capture application for all facility billing, decreasing charge lag from 30 days to 4 days
- Successfully selected and implemented a rules based scrubber which increased the first pass clean claim rate to 98.9%
- Implementation of A/P process and protocol which enabled the organization to work in conjunction with the RWJUH finance A/P workflow and facilitated the process to effectively track expenses by practice
- RESPONSIBILITIES: Provide compliance, risk management, HIM, credentialing and RCM leadership, direction and management for all RWJPE staff and RWJPE practices for a total of 400 FTE’s
- Gap analysis, transition and on-boarding of all new RWJPE providers and practice staff
- A/P
- Oversight and management of all risk issues
- Employee training/development, staff competency based evaluations
- Medical record management
- Managed care contract negotiation
- Coding and compliance oversight, risk factor analysis, priority rankings of annual OIG work plans, annual and ad hoc staff and provider compliance education, compliance monitoring and audit program.
Administrator
Beth Israel Medical Center
08.2004 - 03.2012
- Significant Accomplishments: Planning, design and construction oversight of Institute for Head, Neck and Thyroid Cancer at BIMC in 2004
- Hired and developed a cohesive team of clinical and clerical support staff to affect the success of the Institute for Head, Neck and Thyroid Cancer
- Through marketing and new program establishment, increased patient volume 19% annually
- Increased practice revenue by optimizing CPT and ICD-9 coding through use of pre billing documentation audits and physician coding education
- Established an Oral and Maxillofacial residency in 2008
- Designed, planned and launched a successful satellite facility in Westchester, NY in 2010
- Effectively orchestrated BIMC’s accreditation for Microvascular Fellowship Program in 2010
- Improved inpatient and outpatient facility revenue by implementing provider focused DRG assignment program in 2011
- RESPONSIBILITIES: Provided leadership, direction, management and administration of the Institute and Departments
- Physician and employee recruitment, physician contract negotiation and on-boarding, A/P, observership program, fellowship program, , employee training/development, staff competency based evaluations, quality improvement activities, JCAHO, annual budget preparation and management, strategic planning, project management, construction oversight and planning, procurement liaison, operational policy and protocol creation and implementation, program fundraising, program marketing, medical record management, operational statistics reporting, managed care contract negotiation, direct revenue process oversight, revenue protection, coding and compliance oversight, risk factor analysis, priority rankings of annual OIG work plans, staff and provider compliance education, compliance monitoring and audit programs.
Practice Manager
Mount Sinai Hospital
01.2004 - 08.2004
- RESPONSIBILITIES: Financial, operational and administrative aspects of the Department.
Compliance/Billing Manager
Mount Sinai Hospital
01.2000 - 01.2004
- RESPONSIBILITIES: Creation, implementation and ongoing monitoring of the departmental compliance program including; HIPAA compliance; correct coding initiative; CPT–4 and ICD-9 coding for office and surgical services; policy and procedure creation/revision; ongoing monitoring/chart auditing; coding and compliance education to all physicians, residents, fellows and ancillary personnel; insure adherence to the Institution’s Corporate Integrity Agreement including but not limited to all federal laws and regulations regarding HIPAA, PATH, CMS, physician billing and collections.
Practice Administrator/Consultant
Linden Schild, MD Psychiatric Services of Orange and Sullivan
01.1998 - 01.2002
- Significant Accomplishments: Established a new practice/generated new patient base to support one full time provider
- Planning, design and construction oversight of new office in 1998
- Hired and developed a cohesive team of billing and clerical support staff to affect the success of the practice
- Created and implemented all practice policy and procedures
- Increased practice revenue by optimizing CPT and ICD-9 coding through use of pre billing documentation audits and physician coding education
- RESPONSIBILITIES: Oversight of daily operations of the physician's office including; compliance implementation, chart auditing, A/R, A/P, coding, billing, staff supervision.
Compliance Resource Specialist
Mount Sinai Hospital
08.1999 - 01.2000
- RESPONSIBILITIES: To provide compliance, PATH and billing regulation oversight and education to physicians of the Faculty Practice Associates at MSSM
- Ongoing physician education and chart auditing as set forth by the CIA agreement and policy established by FPA Compliance Officer
- CPT-4 and ICD-9 coding oversight and monitoring for both E&M and surgical services for all specialties.
Education
BS Business/Health/Human Services Administration -
SUNY Empire State College
PhD Holistic Healthcare Practitioner - undefined
Quantum University
undefined
Healthcare Compliance Resources
undefined
Healthcare Compliance Resources
undefined
American Academy of Professional Coders
undefined
National Academy of Paralegal Studies
Skills
C-Suite Operations and Organization Oversight
Health Care Administration/Organizational Leadership
Project and Program Management
Quality Improvement: Administrative/ Clinical Monitoring
Healthcare Compliance, Regulatory Affairs and Reporting
Budgeting, Finance Management and Cost Control
Provider Credentialing and Contract Management
End to end Revenue Cycle Management/ Professional and Facility
Third Party Payer Contract Analysis and Negotiations
Customer/Employee Satisfaction
Staff Development
Team Building
Employee Retention Strategies
Strategic/Tactical Planning
IDX (including DBMS)
Medical Manager
Mendent
Medware
Medisoft
Microsoft Office
SRS EMR
Eagle
Oracle
eClinicalworks
Total MD
Dentimax
Allscripts EEHR Touchworks and PM
Rcx Rules
IngeniousMed
Intellicode
Membershipsandassociations
- American Academy of Professional Coders
- Healthcare Compliance Resources
- Association for Healthcare Administrative Professionals
Timeline
Chief Operating Officer and Executive Vice President of Compliance
Healthcare Compliance Network, LLC
08.2021 - 04.2024
Vice President of Operations and Compliance
08.2016 - 08.2021
Director of Revenue Cycle and Compliance
Robert Wood Johnson Physician Enterprise, PA
01.2013 - 07.2016
Administrator
Beth Israel Medical Center
08.2004 - 03.2012
Practice Manager
Mount Sinai Hospital
01.2004 - 08.2004
Compliance/Billing Manager
Mount Sinai Hospital
01.2000 - 01.2004
Compliance Resource Specialist
Mount Sinai Hospital
08.1999 - 01.2000
Practice Administrator/Consultant
Linden Schild, MD Psychiatric Services of Orange and Sullivan
01.1998 - 01.2002
Chief Operating Officer
Empower Healthcare and Compliance Partners
9 2022 - Current
BS Business/Health/Human Services Administration -
SUNY Empire State College
PhD Holistic Healthcare Practitioner - undefined
Quantum University
undefined
Healthcare Compliance Resources
undefined
Healthcare Compliance Resources
undefined
American Academy of Professional Coders
undefined
National Academy of Paralegal Studies
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