Michael Bethune, MBA
Wakefield,MA
Summary
Experienced professional with expertise in healthcare finance, specializing in net revenue, budgeting, modeling, forecasting, and cost reporting. Proven ability to enhance efficiency and improve methodologies through collaboration. Focused on leveraging skills and experience to drive financial and operational leadership.
Overview
21
21
years of professional experience
Work History
Manager, Reimbursement Finance
Beth Israel Lahey Health
Boston, Massachusetts
09.2023 - Current
- Directs comprehensive assessment and evaluation of net revenue for BILH facilities.
- Constructs comprehensive net revenue valuation and KPI models grounded in transparent and effective methodologies.
- Executes monthly and annual reserve estimates, journal entries, general ledger account reconciliations, variance analyses, etc. for hospital and professional entities.
- Implements strategic solutions that improve reimbursements by utilizing comprehensive expertise in government and commercial payment systems.
- Delivers comprehensive Medicare, Medicaid, and payment system insights supporting BILH provider and system strategic and operational objectives.
- Generates annual net revenue budget and aids in forecasting activities for net revenue projections for hospital and professional business units.
- Directs the submission of annual Medicare and Medicaid cost reports, surveys, and questionnaires, guaranteeing timely and accurate completion.
- Leads and orchestrates third-party audits, encompassing both financial and governmental assessments, acting as primary liaison for external auditors and internal teams.
Senior Manager
Myers & Stauffer
Kansas City, Missouri
10.2022 - 07.2023
- Operated as lead consultant for healthcare facilities, conducting thorough evaluations of Medicare cost reports and LIP (Low Income Pool) / DSH submissions.
- Directed team of five direct reports in the reconciliation process of Medicare Cost Report, Worksheet S-10, and Low Income Pool / DSH for out-of-state healthcare facilities.
- Executed full audit process encompassing strategic planning, in-depth research, risk evaluation, field examination, and detailed findings reporting.
- Facilitated financial analysis, reimbursement calculations, and composed written documents that underpin professional decisions.
- Evaluated uninsured charity care charges for hospitals in Florida, identifying variations in reporting practices.
Engaged with Florida Agency of Administration (AHCA) to discuss analytical findings and insights.
Directed projects aimed at understanding reporting logic for charity care within Florida healthcare facilities.
Facilitated communication between stakeholders to address inconsistencies in charge reporting.
Manager of Reimbursement
Lawrence General Hospital
Lawrence, Massachusetts
05.2022 - 10.2022
- Administered net revenue evaluation, computing net revenue via a model that estimated contractual allowances, reserves, and other deductions.
- Led monthly close meetings, pinpointing discrepancies in accounts receivable and revenue accounts.
Delivered thorough explanations regarding monthly net patient service revenue variations. - Monitored Federal, State, and third-party regulations, implementing necessary adjustments promptly.
Calculated reimbursement impact due to changes in Medicare (CMS) IPPS/OPPS rules. - Managed HSN model ensuring accurate predictions of true HSN revenue and corresponding revenue adjustments for hospital.
- Administered annual budgeting process, guiding formulation of organization's net revenue budget to fulfill strategic and operational targets.
Senior Reimbursement Analyst
Boston Children's Hospital
Boston, Massachusetts
11.2014 - 04.2022
- Prepared, analyzed, and submitted Medicare cost reports and UCCR filings. Reviewed and addressed third-party audits and inquiries to ensure compliance.
- Supervised submission of monthly, quarterly, and annual reports to government (State and Federal) and external agencies.
- Compiled statistical and financial data for monthly close, encompassing volume reporting and net revenue calculation, alongside analytical reports for executive management.
- Facilitated annual budgeting process, collaborating with department managers and leadership.
Established financial and volume budgets for ancillary departments, ensuring alignment with organizational goals.
Administrative Associate
Boston Children's Hospital
Boston, Massachusetts
10.2009 - 11.2014
- Managed administrative logistics for hospital departments, enhancing daily processes and elevating operational effectiveness.
- Secured billing compliance and facilitated coding and charge entry to enhance revenue cycle management.
- Organized files, developed spreadsheets, faxed reports and scanned documents, maintaining front desk and reception area in neat and organized fashion.
Customer Account Representative
MFS
Boston, Massachusetts
05.2007 - 10.2009
- Managed customer inquiries and resolved account issues efficiently.
- Processed account updates and maintained accurate client records.
- Provided accurate guidance on retirement plan options, contributions, and distributions.
Sales Representative
New York Life Insurance Co
Waltham, Massachusetts
07.2006 - 05.2007
- Assisted clients in understanding insurance products and services.
- Developed and maintained strong relationships with clients.
- Prepared presentations for potential clients highlighting benefits of policies.
Cook
Michael's Italian Restaurant
Breckenridge, Colorado
11.2004 - 05.2006
- Prepared authentic Italian dishes following traditional recipes and techniques.
- Managed inventory and ensured timely restocking of kitchen supplies.
- Enforced proper sanitation practices to prevent spoiling or contamination of foods.
Education
MBA - Business Administration And Management
Plymouth State University
Plymouth, NH05-2010
Bachelor of Arts - Communication Arts
Allegheny College
Meadville, PA05-2002
Skills
- Financial modeling
- Revenue analysis
- Regulatory compliance
- Cost report preparation
- KPI development
- Budget forecasting
- Data analysis
- Effective communication
- Problem solving
- Documentation and reporting
- Time management
- Relationship building
- Clear communication
- Trend analysis
- Revenue management
- Team leadership
Timeline
Manager, Reimbursement Finance
Beth Israel Lahey Health
09.2023 - Current
Senior Manager
Myers & Stauffer
10.2022 - 07.2023
Manager of Reimbursement
Lawrence General Hospital
05.2022 - 10.2022
Senior Reimbursement Analyst
Boston Children's Hospital
11.2014 - 04.2022
Administrative Associate
Boston Children's Hospital
10.2009 - 11.2014
Customer Account Representative
MFS
05.2007 - 10.2009
Sales Representative
New York Life Insurance Co
07.2006 - 05.2007
Cook
Michael's Italian Restaurant
11.2004 - 05.2006
MBA - Business Administration And Management
Plymouth State University
Bachelor of Arts - Communication Arts
Allegheny College