PETE MARTINEZ

Provide revenue cycle management consulting, solution implementation and interim revenue cycle management to physicians, multi-facility integrated business offices, and large multi-specialty physician groups with a focus on optimizing processes and technology.

• Established streamline workflow solutions within revenue cycle operations to increase margins.
• Automated manual processes to improve functions within revenue cycle disciplines.
• Consult on opportunities to improve financial margins with offshore expansion.

Recruited to develop and lead the client relationship function for a global revenue cycle shared services outsourcing model. Provided direction, supervision and training to a team of 5 direct reports serving as client liaisons for support and achievement of Revenue Cycle Service Level Agreements (SLAs) of an offshore team of 800+ in the Philippines. Conducted executive-level performance and operations reviews with clients.

• Maintained client relationships to assist in expanding market footprint by 30%.
• Increased net margins by 25% with RCM operational redesign and implementation of technology.
• Maintained quality rating of 95% or better.
• Reduced staff turnover by over 10% through team leadership and change management within culture.

Responsible for developing and implementing a scalable enterprise-wide end-to-end physician revenue cycle business model and oversight of daily operations for growing multi-state PE anesthesia group. Partnered with physician leaders to optimize reimbursement focusing on documentation review and technology implementation increasing collections by more than 50% in the first year.

• Increased daily cash collections by 45%.
• Increased EOB posting automation from 38% to 99%.
• Reduced cost to collect from 12% to 3%.
• Achieved and maintained highest NPS scores for both customer and staff in company history.
• Implemented technology to optimize A/R recovery time and increased automatic payment posting function from 2% to 99% creating efficiencies and cost savings.

Recruited to develop and incorporate more than 25 large scale clinical delivery organizations (CDO)'s onto an enterprise wide model for a multi-specialty ambulatory revenue cycle operation consolidating more than $2.8B in accounts receivable.

• Created and implemented revenue cycle staffing models that include total workforce of 1000+ employees both on and offshore.
• Improved Net Collections Rate to Optum360 standard > 98%.
• Enhanced revenue cycle capabilities via technology reducing days in A/R to industry best 90th percentile per MGMA standards.
• Built and led high functioning team to execute all facets of fast growing RCM platform in a highly matrixed environment.
• Recognized as 2019 Everest Group PEAK Matrix RCM Business Process Services Leader as a part of leadership team.

Responsible for strategic planning, growth and leading of multi-state oncology RBO staff of 300+ that aligned Mountain West region for multiple locations to improve reporting capabilities and streamline communication. Generated budget and goals for RBO and maintained P&L accountability for $4.2B in accounts receivable including meeting annual budget requirements.

• Led a multi-national team comprised of 70% onshore staff and 30% offshore.
• Exceeded annual collection goals by 16%.
• Reduced time to bill by 50%.
• Decreased bad debt write offs by 25%.
• Reduced Denials by 51%.

Promoted to develop and lead enterprise-wide physician revenue cycle business model and implementation of strategies to drive customer value across areas such as acute and physician integration, technology, and site operations. Increased margins by > $7M in first 2 years building a Value Based Care model for the multi-specialty physician group that included more than 19 different service lines.

• Increased Net Collections Rate from 88% to 99%.
• Reduced days in A/R from 37 days to 22 days (41%).
• Decreased Average A/R days over 60 by 50%.
• Automated entire revenue cycle resulting in speed of charge capture from date of service to date of entry (lag) to average of 2 days.
• Led team to perform at 90th percentile per MGMA standards.

> Previously Memorial Health Systems

Manager of Business Development to Director of Business Services, RCM

Responsible for the strategic planning, growing and leading the end-to-end revenue cycle enterprise model for Memorial Physician's Network primary care and multi-specialty group. Built a highly functional leadership team leading to best in class operation.

• Integrated physician partners onto CBO platform increasing group from 0 to 20+ in under 1 yr.
• Increased collections by 20%.
• Developed physician relationships, collaborating to improve culture and communication.
• Maximized revenue by 25% providing proper documentation education to clinicians and physicians.

• Developed physician-based EDI operation platform that included clearing house transactions and 24/7 B2B customer support.
• Established 200 seat call center operation that ran 24/7, 365 that included both on/offshore resources.
• Constructed system from inception to full implementation that supported >1M transactions per day.