Michael SEMIAO
Revenue Cycle Executive
North Andover,MA
Summary
LinkedIn North Andover, MA Offering over 2 decades of success leading and executing optimization of revenue cycle performance for leading healthcare practices, clinics, and federally qualified health centers across the country. Highly accomplished and results-oriented professional with extensive experience in revenue cycle management, seeking a challenging position as Director of Revenue Cycle. Demonstrated expertise in driving financial performance, optimizing revenue streams, and leading cross-functional teams to achieve organizational goals. Adept at implementing revenue cycle best practices, streamlining processes, and ensuring compliance with industry regulations.
Overview
31
31
years of professional experience
6
6
years of post-secondary education
3
3
Certificates
Work History
Project Manager
ASK Consulting
Boston, MA
02.2023 - 05.2023
- Created Strategy
- Provided detailed analysis
- Completed cost analysis associated for each healthcare facility under program.
- Managed book of business totaling $2,000, 000 in accounts receivable, applying insurance expertise and exemplary customer service
- Managed time efficiently to complete all tasks within deadlines
- Skilled at working independently and collaboratively team environment
- Identified issues, analyzed information, and provided solutions to problems
Director of Revenue Cycle
Joseph Addabbo Family Health Center
Brooklyn, NY
07.2022 - 10.2022
- Lead and oversee all aspects of revenue cycle, including billing, coding, collections, and patient financial services
- Develop and implement revenue cycle strategies, policies, and procedures to optimize financial performance and ensure compliance with regulatory guidelines
- Managed team of revenue cycle professionals, providing guidance, training, and performance evaluations to drive productivity and accountability
- Collaborate with key stakeholders, including finance, operations, and clinical departments, to identify opportunities for revenue enhancement and process improvement
- Conduct regular financial analysis, monitor key performance indicators (KPIs), and generate reports to track revenue cycle metrics and identify areas of improvement
- Implement technology solutions and automation to streamline revenue cycle processes, reduce errors, and enhance efficiency
- Oversee revenue cycle vendor relationships, negotiate contracts, and monitor service level agreements (SLAs) to ensure optimal performance and value.
- Analyzed business processes to identify cost savings and operational efficiencies
- Supported financial director with special projects and additional job duties
- Created financial dashboards to provide insights into key performance indicators
- Utilized financial software to prepare consolidated financial statements
Project Manager
Community Health Center
New Bedford, MA
07.2021 - 10.2021
- Created job description for Director of Revenue Integrity position with budget allocation of $80M for finance and billing departments and team deployment of thirty-five full-time employees
- Uncovered 20% gap in reconciliation payment and contracted rates posted to accounts receivable by reviewing Charge Description Master (CDM) and related audits
- Accomplished identification of 40% of business areas non-compliant to contract requirements, regulations, and laws by reviewing systems and processes to identify potential compliance issues
- Optimized end-to-end medical billing operations by designing workflows for Central Billing Office (CBO) while producing claim that was clean, free of errors, and decreased by 25%
- Ensured attainment of three critical organizational imperatives to include operational efficiency, regulatory compliance, and optimal earned reimbursement/payment using ethical business practices and policies
- Advised finance and accounting teams to anticipate and recognize stakeholder needs
- Accomplished improvements within revenue cycle by 30% by identifying opportunities to establish standardizations throughout organization
- Standardized operational practices and procedures across business office
- Created white paper highlighting those areas of improvement
- Empowered senior leadership in making conscious management decisions by highlighting existing challenges
Director of Revenue Cycle
East Bay Community Action Program
East Providence, RI
10.2020 - 05.2021
- Managed day-to-day operations of revenue cycle department, including billing, collections, and accounts receivable
- Developed and implemented revenue cycle policies, procedures, and controls to ensure accurate and timely claims submission and payment posting
- Led team of billing and coding professionals, providing training, performance evaluations, and fostering culture of continuous improvement
- Monitored denials and appeals, implemented corrective actions to reduce denials, and collaborated with clinical and coding staff to improve documentation and coding accuracy
- Conducted regular audits and quality assurance reviews to ensure compliance with coding guidelines, payer regulations, and revenue integrity standards
- Collaborated with IT department on system enhancements, upgrades, and implementation of new revenue cycle technologies.
- Supported clinical team members with revenue cycle procedures and addressed issues
- Monitored and guided revenue cycle operations
- Completed financial reporting and analysis for billing revenue cycle
- Collaborated with C-level executives and stakeholders to develop long-term financial plans
Project Manager
Public Consulting Group
05.2020 - 08.2020
Director
Revenue Integrity Codman Square Health Center
02.2019 - 01.2020
Director Revenue
Cycle North Shore Pain Management
03.2018 - 01.2019
Project Manager
BDO South Boston Community Health Center
09.2017 - 12.2017
Interim Director of Revenue
Integrity Morris Heights Health Center
02.2016 - 06.2017
Project Manager
12.2015 - 02.2016
Project Manager
Dorchester House
10.2015 - 02.2016
Project Manager
Codman Square Health Center
06.2015 - 10.2015
Project Manager HealthCare
Revenue Strategies Southern Maine Medical Center
03.2015 - 06.2015
Project Manager
Harbor Homes
12.2014 - 03.2015
Director
Revenue Integrity Codman Square Health Center
01.2014 - 11.2014
Interim Manager
Physician Network Southern Maine Health Center
10.2012 - 01.2014
Project Manager
University Medical Group Adult and Pediatric Dermatology
06.2009 - 11.2012
Supervisor
The Mentor Network
02.2012 - 04.2012
Billing Manager
Insulet Corporation
01.2007 - 01.2009
Director of Insurance & Patient Billing
Repromedix
01.2005 - 01.2007
Manager, Patient
Registration Quest Diagnostics
01.2002 - 01.2005
Billing Manager
Laboratory Services Elliot Hospital
01.2000 - 01.2002
Supervisor / Third Party
Hebrew Rehabilitation Center For The Aged
01.1992 - 01.2000
Education
BBA - Finance
Bryant College
North Smithfield, RI 09.1980 - 06.1986
Skills
Practice RCM Workflow Optimization
Revenue Cycle Management SolutionFinancial Risk Assessment/MitigationProcess Automation/ImprovementRegulatory ComplianceStrategic PlanningCompliance and Regulatory KnowledgeData Analysis Reporting
AR Oracle, Biscom, IDX, GE Centricity, MediTech, eCw, eCw (EMR), Epic (EMR), Epic, Epic (OCHIN), NextGen, Athena Diagnostics, MediBill, Fastrack, Hl7, EDI, MidMark IQ, Emdeon, Anodyne Health Partners, Microsoft Dynamics ERP, Zirmed, SalesForcecom, QuickBooks, Microsoft Office (Word, Excel, Outlook, Access, and PowerPoint), VeriPoint and Uniform Data Systems (UDS), Analytic Tools Tableau and Metabase, The Uniform Data System (UDS), SQL, HL7, EDI, CDM, Google Sheets
Policy analysis
Certification
Certified Six Sigma Black Belt
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Project Manager
ASK Consulting
02.2023 - 05.2023
Director of Revenue Cycle
Joseph Addabbo Family Health Center
07.2022 - 10.2022
Project Manager
Community Health Center
07.2021 - 10.2021
Director of Revenue Cycle
East Bay Community Action Program
10.2020 - 05.2021
Project Manager
Public Consulting Group
05.2020 - 08.2020
Director
Revenue Integrity Codman Square Health Center
02.2019 - 01.2020
Director Revenue
Cycle North Shore Pain Management
03.2018 - 01.2019
Project Manager
BDO South Boston Community Health Center
09.2017 - 12.2017
Interim Director of Revenue
Integrity Morris Heights Health Center
02.2016 - 06.2017
Project Manager
12.2015 - 02.2016
Project Manager
Dorchester House
10.2015 - 02.2016
Project Manager
Codman Square Health Center
06.2015 - 10.2015
Project Manager HealthCare
Revenue Strategies Southern Maine Medical Center
03.2015 - 06.2015
Project Manager
Harbor Homes
12.2014 - 03.2015
Director
Revenue Integrity Codman Square Health Center
01.2014 - 11.2014
Interim Manager
Physician Network Southern Maine Health Center
10.2012 - 01.2014
Supervisor
The Mentor Network
02.2012 - 04.2012
Project Manager
University Medical Group Adult and Pediatric Dermatology
06.2009 - 11.2012
Billing Manager
Insulet Corporation
01.2007 - 01.2009
Director of Insurance & Patient Billing
Repromedix
01.2005 - 01.2007
Manager, Patient
Registration Quest Diagnostics
01.2002 - 01.2005
Billing Manager
Laboratory Services Elliot Hospital
01.2000 - 01.2002
Supervisor / Third Party
Hebrew Rehabilitation Center For The Aged
01.1992 - 01.2000
BBA - Finance
Bryant College
09.1980 - 06.1986
Custom
I am currently in the process of writing a memoir. I am a strong advocate for work life balance and exercising each day is part of that commitment.