Peter McCauley
Wharton,NJ
Summary
Results-oriented revenue cycle executive with 10+ years of success leading optimization initiatives across academic medical centers, private practices, and nonprofit health systems. Demonstrated expertise in denial prevention, automation, vendor management, and operational analytics. Adept at leading cross-functional teams, managing multimillion-dollar clinical departments, and driving measurable improvements in revenue cycle KPIs. Advanced technical skill set in SQL and Power BI to support real-time insights, strategic decision-making, and performance tracking.
Overview
11
11
years of professional experience
Work History
Revenue Cycle Optimization Manager
Columbia University Irving Medical Center
02.2023 - Current
- Lead enterprise-wide optimization and automation projects across 20+ clinical departments within one of New York’s largest academic health systems.
- Directed the end-to-end transformation of the paper correspondence workflow, integrating OnBase and Epic systems to fully automate document indexing, resulting in a 30% reduction in FTEs.
- Developed and maintained complex SQL queries to analyze revenue performance, claim denial trends, and workflow gaps, leading to strategic interventions that reduced primary denials by 20% and select denial categories by over 50%.
- Designed and implemented Power BI dashboards that visualize A/R aging, high-dollar outliers, scrubber edits, and root causes of payment delays.
- Collaborated with leadership across clinical departments, IT, Compliance, and Finance to scope and deliver impactful optimization projects under aggressive timelines.
- Authored monthly executive performance reports summarizing trends, savings, and workflow bottlenecks.
Revenue Cycle Manager
Columbia University Irving Medical Center
08.2021 - 02.2023
- Oversaw all revenue operations for a $100M+ clinical department, managing 50+ vendor staff across outsourced A/R and billing functions.
- Redesigned aging account workflows and improved claim resolution prioritization, significantly increasing first-pass resolution and reducing unnecessary write-offs.
- Partnered with departmental leadership to establish fiscal goals and align revenue cycle performance with budgetary expectations.
- Delivered data-driven performance scorecards to track vendor SLA compliance, denial trends, and net collections.
- Initiated denial prevention projects targeting imaging-specific coding and authorization issues.
Accounts Receivable & Clinical Informatics Analyst
CarePlus NJ
06.2020 - 08.2021
- Built custom SQL scripts and Excel-based analytics tools to support executive-level presentations and board reporting.
- Partnered with operations leadership to identify and correct inefficiencies in claims submission, insurance follow-up, and denial workflows.
- Conducted deep-dive analyses into claim lag, service authorization delays, and reimbursement discrepancies.
- Provided interim support to the billing department during staffing transitions.
Director of Revenue Cycle Management
New Jersey Center for Oral and Maxillofacial Surgery
05.2018 - 06.2020
- Directed all revenue cycle functions for a surgical practice, including front-end collections, coding, and back-end A/R management.
- Supervised billing and insurance staff, optimized front-end eligibility checks, and implemented coding accuracy audits.
- Reduced outstanding A/R through targeted payer-specific resolution strategies.
- Transitioned practice to a new practice management system, improving claims processing, reporting, and staff training.
Obstetrical Coordinator
Premier Women’s Healthcare
Boca Raton, USA
12.2016 - 12.2017
- Coordinated patient scheduling to optimize clinic operations and reduce wait times.
- Assisted healthcare providers by preparing necessary materials for patient appointments.
- Facilitated communication between patients and medical staff to address inquiries promptly.
- Developed patient education materials to promote understanding of health services offered.
- Resolved customer complaints in a timely manner while upholding company standards.
Medical Biller and Coder
Premier Women’s Healthcare
Boca Raton, USA
08.2015 - 12.2016
- Processed medical claims using electronic billing systems efficiently.
- Reviewed patient records for coding accuracy and compliance.
Front Desk Receptionist
Premier Women’s Healthcare
Boca Raton, USA
01.2015 - 08.2015
- Managed phone calls, scheduling, and inquiries with professionalism and care.
- Greeted patients warmly and checked them in for appointments efficiently.
- Maintained patient records accurately using electronic health record systems.
- Coordinated with medical staff to streamline patient flow and communication.
- Assisted patients with insurance questions and verification processes effectively.
Education
Master of Science - Healthcare Administration
Texas Tech University
Lubbock, TX03.2021
Bachelor of Science - Biology
Florida Atlantic University
Boca Raton, FL12.2017
Skills
- Enterprise revenue cycle optimization
- SQL development
- Power BI dashboards
- Claim denial management
- Automation and workflow redesign
- SQL and advanced data analytics
- Power BI dashboarding and data storytelling
- Vendor oversight and SLA enforcement
- Financial forecasting and KPI performance
- Strategic cross-functional leadership
- Performance reporting
- Project leadership
References
References available upon request.
Timeline
Revenue Cycle Optimization Manager
Columbia University Irving Medical Center
02.2023 - Current
Revenue Cycle Manager
Columbia University Irving Medical Center
08.2021 - 02.2023
Accounts Receivable & Clinical Informatics Analyst
CarePlus NJ
06.2020 - 08.2021
Director of Revenue Cycle Management
New Jersey Center for Oral and Maxillofacial Surgery
05.2018 - 06.2020
Obstetrical Coordinator
Premier Women’s Healthcare
12.2016 - 12.2017
Medical Biller and Coder
Premier Women’s Healthcare
08.2015 - 12.2016
Front Desk Receptionist
Premier Women’s Healthcare
01.2015 - 08.2015
Master of Science - Healthcare Administration
Texas Tech University
Bachelor of Science - Biology
Florida Atlantic University
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