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Director of Health Care Services

Demonstrated extensive education, Radiation Oncology departmental experience, a highly motivated work ethic and results-driven professionalism, recognized for commitment to excellence, with demonstrated expertise in communicating and collaborating with, peers, and clients. Portrays excellent business acumen, able to administer dependable and strategic medical coding/billing, finance, and collections, focused on customer-centric service and support initiatives, and successfully achieves targeted company goals. Self-motivated professional, able to work independently or in a team environment, demonstrating broad based administrative and operational qualifications.
CORE STRENGTHS

 Healthcare Insurance/Finance
 Radiation/Oncology
 Medical Coding/Billing
 Collections/Reimbursement Management
 Customer Service/Support
 Electronic Medical Records
 Regulatory Compliance
 Billing/Invoicing
 Staff Training/Development
 Appeals Documentation

PROFESSIONAL EXPERIENCE
1995 to Present: Billing/Reimbursement Manager – Roswell Park Cancer Institute, Buffalo, NY
 Manage all aspects of Administrative Services for the Radiation and Oncology Department and serve as Senior Corporate Coding Specialist for the department.
 Superior communications and organization skills with both internal and external personnel and divisions.
 Provide extensive billing training and leadership covering multi-specialty healthcare areas on appropriate billing practices and documentation requirements.
 Develop and implement critical training initiatives on electronic templates using MS Word within Mosaiq, and rolled out departmental Electronic medical records within Mosaiq.
 Train various department personnel on billing and compliance regulations and host weekly compliance meetings.
 Created and maintain compliance database of patients completing treatment and develop final billing and documentation audits on charts that ensure compliance with correct industry governance and Federal and State regulatory compliance.
 Collaborate with Senior Department Administrator on numerous contracting issues, business development initiatives for new affiliate and case rate negotiations.
 Efficiently maintain and update department CDM charge master within Mosaiq and update with any CPT or ICD-9 changes in Mosaiq and ARIA for affiliate centers.
 Provide onsite training for Roswell’s affiliate sites in Ithaca, Jamestown and Olean, NY, and open communications with satellite administration and managers to facilitate daily issues and billing concerns.
 Perform periodic chart documentation audits for compliance at all affiliated centers and assist in institution of electronic templates and forms.
 Continuously manage departmental denials and assist professional billing company in optimizing reimbursement, and coordinates appeals and information/documentation requests from facilities.
 Manage the pre authorization process for the department of radiation oncology for IMRT and various procedures.
 Extensive knowledge of Medicare and third-party payer billing requirements and rules.
 Utilize Invision Hospital Billing software, Sunrise Electronic Health Record, Mosaiq, ARIA (Varian radiation management software), and multiple dictation programs.
 Active member of the Departmental Leadership team, compliance team, EMR committee, etc., and work closely with Roswell IT to develop electronic billing processes, with hospital billing system, and upgrades to Mosaiq.
 Develop, implement, maintain, review and adjustment of Departmental Compliance Plan and Policies and Procedures, and maintain accreditation for RHIT and ROCC certification by professional development initiatives, conferences, Webinars, and seminars.
Early Career: Health Information Technologist – Medical Management Services, Williamsville, NY – 1993 to 1995

EDUCATION / AFFILIATIONS
B.A., Business Management/Economics – State University of New York/Empire State College – 2011
A.S., Health Information Technology – State University of New York, College of Technology at Alfred – 1993
Member – SROA │ROCC Certified │AHIMA Registered Health Information Technologist

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