Dynamic leader with a proven track record at OPTUM Insight, excelling in revenue cycle management and performance improvement. Spearheaded AI solutions that saved $1 million annually and enhanced operational efficiency. Skilled in data analysis and client relationship management, fostering innovation and collaboration across teams to drive revenue growth.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Director of Revenue Cycle Automation and Performance Improvement
OPTUM Insight
Eden Prairie
05.2022 - Current
Led and optimized revenue cycle operations by implementing best practices, enhancing technology solutions, and developing key performance metrics.
Built & maintained deep relationships/partnerships with clients to ensure continuous improvement and growth within large hospital system revenue cycle operations.
Established and managed performance improvement measures to enhance financial performance.
Led the design and deployment of AI-powered solutions that addressed critical business needs.
Developed a culture of innovation and collaboration across teams (engineering, data science, product management, Revenue cycle operations).
Achievement: Identified and restructured an eligibility tool, resulting in $1 million per year savings.
Achievement: Analyzed and automated facility claims follow-up process using a conversational AI tool to retrieve status, document claim status, and resubmit claims not on file, leading to $200k FTE savings and a 10% cash increase.
Achievement: Developed a vendor audit tool to track contract SLAs and payment terms, leading to a vendor paying back $1.5M in fees within the first six months.
REVENUE CYCLE MANAGER
CADUCEUSHEALTH
Jersey City
01.2021 - 05.2022
Member of company leadership team, leading revenue cycle for a large hospital and physician group.
Led the strategy for revenue cycle departments to include coding, AR follow-up
Collaborate with the board and executive leaders to align revenue cycle objectives and initiatives with the strategic objectives of each Company
Achievement: Implemented a production and auditing process for the revenue cycle staff that tracked production and quality across revenue cycle staff that was implemented companywide for all client teams.
Achievement: Improved client cash collections within the first six months of employment
Achievement: Analyzed and implemented more defined revenue cycle operations within the large health system internal claims representatives. This caused a reduction in accounts receivable from 56 to 23 in 3 months.
Industry: 3rd Party Billing, Revenue Cycle / Multi-Disciplinary | Direct Reports: 12
REVENUE CYCLE MANAGER
Diligent Billing & Management
Charlotte
08.2015 - 01.2021
Member of company leadership team, leading revenue cycle for two physician owned entities (i.e., Carolinas Pathology and Celligent Diagnostics)
Direct and lead the strategy for revenue cycle departments to include coding, charge entry, cash management, AR follow-up and patient services. This includes both US and offshore.
HR Responsibilities include staff recruitment, training, supervision, and development for staff of up to 28 revenue cycle employees
Collaborate with the Board and executive leaders to align revenue cycle objectives and initiatives with the strategic objectives of each Company
Achievement: Reduced AR days from 65 days to 31 days in 9 months and maintained a 30-day DAR for 4 years straight.
Achievement: Established a provider documentation audit process that was used by the board of directors as QA process and educational class development. This resulted in an independent coding audit of 97% or higher 3 years in a row.
Achievement: Worked with HR to create a criteria based annual review system for revenue cycle teams.
Achievement: Implemented a production and QA program within each department and educational classes for those who did not consistently meet the requirements.
Achievement: Developed a team-based revenue cycle educational process. Each area of the revenue cycle process was given a monthly lunch and learn on each topic with the office so information and updates could be shared more effectively. In addition to lunch and learns I established a monthly “Did you know” newsletter that each department contributed to, and the information was shared to all providers and revenue cycle staff.
Achievement: Worked with local hospital revenue cycle team to uncover coding errors and recovered $750k owed to our physicians
Achievement: Identified coding issue with how clinical lab charges structured and educated both the providers an internal revenue cycle team. This change resulted in a 10% increase in cash
Achievement: Restructured the coding and charge entry department and streamlined their processes which resulted in a 2-day production turnaround; down from 15 days (3 weeks)
Industry: 3rd Party Billing, Laboratory & Pathology | Direct Reports: 28
Skills
PMS: NextGen, Athena Health, IDX
Revenue cycle management
Performance improvement
Data analysis
AI solutions
Client relationship management
Process automation
Team leadership
Revenue optimization
Operational efficiency
Revenue growth planning
Revenue reporting
EMR: NextGen (built), Athena (built)
HRIS: Paylocity and Paycom
Other: Microsoft office, Visio, MS Projects, Microsoft 365, SharePoint, Citrix, WebEx, GoToMeeting