Remotely Established startup partnerships with outpatient clinic leadership in Texas and skilled nursing staff providing professional guidance on staffing needs required to complete workflows, supporting hiring and onboarding efforts, and serving as the primary liaison between clinics and billing operations to ensure timely, accurate, and compliant claim submission, payments and support month-end close reconciliation.
Provided AR support to outpatient teams, assisting with claims data review and process improvements to address outstanding balances over 60+ days.
Collaborate with outpatient clinical and administrative leadership staff at facility locations to resolve billing and documentation issues that cause denials or delayed payments.
Served as a liaison between vendors and outpatient clinics by addressing system issues, and supporting clinics with clearinghouse contracts, payer claim submissions, and rejection resolution to ensure accurate and timely revenue cycle operations.
Assisted outpatient staff and performed regular internal audits to ensure coding accuracy, complete encounters, and compliant documentation, resulting in improved claim acceptance rates.
Work closely with EHR vendors on Electronic Data Interchange (EDI) troubleshooting and system upgrades to maximize billing system efficiency.
Partnered with Finance to review system reporting, with month-end close and reconcile cash.
Manager of Accounts Receivable
David Lawrence Center
06.2020 - 11.2023
Directed revenue cycle operations for inpatient and outpatient behavioral health services, managing a team focused on billing, collections, appeals, payment postings, authorizations, and utilization management. Worked closely with the accounting department to ensure all payments were reconciled monthly and month end close completed within three business days.
Lead root-cause analysis of denials across service lines, providers, payers, and departments
Identify systemic process failures related to registration, authorization, documentation, coding, billing, and utilization review
Implement corrective actions to prevent recurrence of denials.
Establish feedback loops to operational and clinical teams.
Reduced outstanding AR significantly by proactively identifying payer denials, providing ongoing training on documentation compliance, and streamlining internal processes.
Collaborated with the credentialing department to ensure all providers were properly credentialed with payers to support accurate billing and timely reimbursement.
Collaborated closely with clinical staff, including Case Managers and medical providers, to ensure medical necessity was properly documented for all services, leading to improved claim acceptance.
Led Utilization Management team in evaluating level of care, ensuring appropriate authorization and timely appeal submissions to optimize reimbursements and patient outcomes.
Scheduled and conducted weekly payer review meetings and conference calls with managed care organizations (Blue Cross Blue Shield, Medicare, HMO's) to resolve reimbursement and policy issues.
Developed and maintained strong relationships with external vendors (SSI, Waystar) to troubleshoot claim denials and system inefficiencies.
Maintained up-to-date knowledge of regulatory changes and payer policy updates to ensure compliance and timely adaptation of billing practices.
Oversaw scheduling and management of peer reviews and appeal processes to maximize reimbursement and ensure regulatory compliance.
Business Office Director
UHS Central Florida Hospital
11.2011 - 06.2020
Managed comprehensive business office operations, including accounts receivable, billing, collections, patient census management, payroll, and daily cash reconciliation.
Developed and implemented strategies to reduce aging AR and increase point-of-service collections by optimizing front-end processes such as patient eligibility verification, authorizations and financial counseling.
Director, Billing & Collections
Drew Medical – Outpatient Radiology
06.2009 - 08.2011
Oversaw day-to-day operations of billing, collections, coding, and payment posting across seven outpatient radiology facilities.
Coordinated with outpatient verification and scheduling teams to confirm patient eligibility, obtain authorizations, and ensure accurate and timely scheduling to support clean claims.
Spearheaded initiatives that reduced AR days and improved cash collections through workflow restructuring, enhanced payer communication, and staff training programs.
Built relationships with insurance payers, conducting conference calls and negotiations to resolve complex claim issues and denials.
Directed month-end closing activities and ensured accurate financial reporting for the department.
Provided leadership, motivation, and coaching to a team of twenty-eight billing and collections staff to maintain high morale and operational excellence.
Business Office Manager
Park Place Behavioral Hospital
02.2005 - 06.2009
Managed daily business office operations including authorizations, billing, AR, patient census, verifications, and collections within a behavioral health facility.
Scheduled and conducted regular onsite meetings with payers to address claim issues, resulting in a substantial decrease in outstanding AR over 60 days and successful recovery of prior-year reimbursements.
Performed detailed data analysis of billing and aging reports to identify trends, develop work plans, and resolve collection challenges.
Led internal audits of claims and payments to ensure procedural compliance and accurate reimbursement.
Coordinated payer educational sessions and organized conference calls to proactively address reimbursement challenges.
Trained, cross-trained, and evaluated staff performance to ensure adherence to policies and achievement of departmental goals.
Collaborated with other departments to improve workflows, enhance financial outcomes, and support new service implementations.
Operations Manager
Physicians Outpatient Services
10.1996 - 03.2002
Contributed to the launch and growth of multi-specialty outpatient operations, including rehabilitation. Handled Medicare Part A and Part B billing and reimbursement using Direct Data Entry (DDE), ensuring compliant and timely claim submission. Directed front- and back-end revenue cycle workflows.
Established and sustained productive relationships with fiscal intermediaries, contractors, and payers to streamline claim processing and resolve discrepancies.
Led weekly calls and coordinated onsite reviews with Medicare representatives to address
claims under medical review and confirm completion of required supporting documentation.
Guided providers and clinical staff on documentation requirements to substantiate medical necessity and support reimbursement.
Monitored compliance with certification surveys and Medicare audits to maintain accreditation and regulatory standards.
Evaluated and revised facility policies and procedures to enhance compliance and operational efficiency.
Promote accountability and awareness across the organization.