Todd Richardson
Summary
Healthcare reimbursement professional with 25 years of experience in Medicare reimbursement and cost report preparation. Proven expertise in revenue cycle analysis, regulatory compliance, and audit management. Achievements include enhanced financial performance and optimized processes within healthcare environments.
Overview
26
26
years of professional experience
Work History
Reimbursement Manager
Northern Light Health
Brewer, ME
06.2014 - Current
- 25+ years of experience in healthcare reimbursement with high proficiency in Medicare reimbursement, cost report preparation and its components, including Medicare DSH, Wage Index, S-10, Medicare Bad Debts, MAC audit assistance and appeals, Critical Access Hospital reporting
- Cost Reporting: Prepare and file Medicare, Medicaid, and Tricare cost reports, reconciling financial data with CMS regulations.
- Acted as liaison during third-party payor and government audits, facilitating appeals and reopenings to safeguard facility reimbursements.
- Analyzed changes in healthcare legislation and payer rules, modeling financial impact on facility funding and service lines to inform strategic decision-making.
- Net Revenue Budget: Completion of yearly net revenue budget for multiple hospitals
- Supported month-end close through calculation of contractual allowances, management of third-party receivables, net revenue forecasting, and explanation of budget variances, ensuring accurate financial reporting.
- Team Leadership: Train, supervise and evaluate three Reimbursement Analysts in the month-end close process, creating yearly net revenue budgets and filing cost reports
- Advanced Microsoft Excel proficiency, strong analytical reasoning, and familiarity Health Financial Systems Medicare Cost Report Software MCRIF32, Besler OMNIA Cost Report Software (formerly EZ WorkPapers), Infor CloudSuite Financials, Siemens Medical MedSeries 4 on AS400 System
Reimbursement Analyst
St. Joseph Hospital
Bangor, ME
12.2000 - 06.2014
- Revenue cycle analysis: Developed monthly contractuals and maintained third party logs for hospital, physician practices, and home health agency. Conducted contribution margin analysis, trend analysis, and created financial dashboards. Responsible for data files uploads and verification in Allscripts’ Sunrise EPSi Enterprise Analyst.
- Cost reporting: Prepared and filed hospital and home health agency Medicare and Medicaid Cost Reports, ensuring compliance and accuracy.
- Audit & Appeal Management: Coordinate all Medicare Cost Report audits, wage index and occupational mix reviews.
- Net revenue budget: Produced yearly revenue budget for hospital and home health agency, aligning financial goals with operational needs.
- Proficient in Microsoft Office XP (Excel, Access, Word, PowerPoint, Outlook).
- Experience with Siemens Medical MedSeries 4 on AS400 System, Health Financial Systems Medicare Cost Report Software MCRIF32 ver. 1.19.0.4, Sunrise EPSi Enterprise Analyst ver. 7.2, Crystal Reports ver. 10, and BeyondNow Technologies HomeWorks.
- Use of customer service skills in communicating with physicians, patients, and co-workers daily.
Education
M.S. - Business Administration
Husson University
Bangor, ME01-2005
B.S. - Business Administration
Husson University
Bangor, ME01-1994
Skills
- Medicare reimbursement
- Revenue cycle management
- Cost report preparation
- Audit oversight
- Regulatory compliance
- Financial forecasting
- Analytical thinking
- Attention to detail
Timeline
Reimbursement Manager
Northern Light Health
06.2014 - Current
Reimbursement Analyst
St. Joseph Hospital
12.2000 - 06.2014
M.S. - Business Administration
Husson University
B.S. - Business Administration
Husson University