New York City Metropolitan Area
With over 25 years of experience as a Healthcare Revenue Cycle & Integrity Professional and Consultant, I have the knowledge and skillset to build high performance cross-departmental teams through effective leadership, training, motivation and coaching. I am a highly motivated, tenacious, detail-, goal-, and results-oriented, bottom-line driven Leader with a strong work ethic, customer focus and a diversified healthcare industry background. I have worked in both the hospital provider and healthcare vendor environments. Utilizing my outstanding interpersonal and communication skills, I develop sustainable business relationships, and provide effective sales presentations to potential healthcare providers. These skills also allow my clients to feel secure, comfortable and confident that they will experience positive outcomes for their projects. My analytical skills are very strong allowing me to be extremely effective when conducting payor and provider billing and payment audits and negotiations, operational needs assessments, cash forecasting, account reconciliations, performance benchmarking, accounts receivable troubleshooting and process improvement evaluations. Due to my project implementation and management abilities, I ensure new projects get off the ground efficiently, quickly and within budget, meeting established deadlines and operational goals. It was always my passion to utilize the healthcare expertise that I had developed through the years in helping individuals that are in need of assistance with navigating this complex and frustrating world of medical and hospital billing. Therefore, I decided to form a company in 2017, "Billing Angel". I work this business part time, while working full time as a Healthcare Consultant. My clients at Billing Angel include Seniors and their care givers, as well as individuals that find themselves with astronomical healthcare bills that they are unable to understand or negotiate. I find this work extremely rewarding. Additional areas of expertise include: -Patient Financial Services -Resource Utilization -Client Relationship Management -Revenue Projection -Key Performance Indicators (KPI’s) -Healthcare Compliance -Cash Flow & Bad Debt Forecasting -Budget / P&L Management -Payor Denial Trends -Policy & Procedure Development -Executive Reporting -Medicare / Medicaid / Blue Cross -Managed Care -Microsoft Word, Excel, PowerPoint, Visio, Access -SMS, QuadraMed, HBOC, Keane/Ferrante, RAS, Definitive, AS400, RASI, Accuro, KREG Contract, Saint Express, WorkFlow Gen, CITRIX SFTP, TRCS IS, Florida Shared
• Assist in deciphering bills relating to doctor (specialists, pediatrics, general practitioners), hospital, dentist, and pharmaceutical services. • Minimize stress and build confidence for patients and caregivers by providing education and guidance regarding medical insurance and claims. • Review medical bills for clients ensuring payor and provider allowances have been applied appropriately to total charges and patient responsibility balance reflects accurately. • Manage Client Flexible Spending Accounts (FSA) and Health Care Accounts (HCA) by keeping track and processing all applicable claims before year end.
• Promoted to Director of Revenue Integrity in February 2022. Assumed additional leadership responsibility and accountability for Service Line Teams, and achievement of Besler’s established goals and strategic core business objectives. • Oversee operational delivery for Besler, assist in the operation of a newly formed service line and manage the ongoing operation of the Revenue Integrity Team. • Support and monitor data uploads for all clients in Revenue Integrity to ensure business continuity. Raise data concerns, as appropriate. • Lead the development of strategic Revenue Cycle methodologies and project plans to consistently implement complex client contracts across multiple platforms and lines of business. Spearhead client project kickoff meetings. Successfully perform to contract deliverables and exceeds client expectations. • Collaborate with Sales and Operations Leadership, Legal Department, IT, Service Practices, Finance and clients to ensure commitment to methodology and engagement specific milestones. • Assist in the refinement of Besler’s proprietary technology to identify claims at-risk for revenue integrity issues. • Research pertinent healthcare industry news and write articles and post content through blogs and podcasts. Participate in the development and updates of marketing materials. Support HFMA (Healthcare Financial Management Association) Peer Review Process needs. Conduct speaking engagements and educational webinars. • Hire, train and develop a diverse staff to effectively meet performance requirements of Revenue Integrity and Client Onboarding & Delivery operations.
• Directorship responsibility for the overall billing, collection and payment reimbursement functions. • Held leadership and membership roles for many multidisciplinary committees and activities to achieve process efficiencies and reduce third party payer denials for the organization. • Spearheaded complete review of the Charge Master and full utilization of a Charge Master tool to ensure charge accuracy and billing compliance.
• Management oversight for 5 major Clients. Projects included Third Party and Self-Pay Billing and Reimbursement Follow-up for Acute and Post-Acute facilities. • Designed, implemented and maintained project plans for each client and product line. Created staff workflow procedures to ensure optimal productivity and recoveries for each project. • Prepared Client Project Reports for CEO and Client Leadership sharing pertinent information and presenting recommendations for policy changes and process improvements.