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Work Background
4S ConsultingBusiness Owner
Feb. 2025Montana, United States• Developed strategies with clients to streamline revenue cycle management processes, improving claims processing times.
• Led development teams to successfully rollout new processes, enhancing outcomes for clients.
• Evaluated current client processes and implemented improvements in payer and provider enrollment processes.
EMS Management & Consultants, Inc.Director of Revenue Management
Dec. 2023 - Jan. 2024Winston Salem, NC, United StatesSpearheaded payer relations and eliminated a backlog of 600+ Medicare revalidations within 3 months, ensuring compliance and reducing administrative bottlenecks. Enhanced client satisfaction by reducing claim processing turnaround times by 40% through workflow automation, streamlined credentialing, and proactive payer communication.
• Optimized backend revenue cycle operations, reducing accounts receivable (AR) days by 4, minimizing claim denials, and improving cash flow efficiency.
• Identified and resolved revenue leakage, recapturing $8M in unpaid/underpaid claims within the first six months by deploying advanced analytics and training programs for billing teams.
• Developed and implemented new denial management strategies, reducing payer rejections by 30% through enhanced documentation and appeals processes.
• Established key performance indicators (KPIs) to track claim processing efficiency, leading to an improvement in revenue cycle accuracy.
• Expanded partnerships with key payers, renegotiating contracts that led to an additional reimbursement increase across multiple service lines.
Smart Data SolutionsSr Clearinghouse Director
Feb. 2023 - Dec. 2023United States• Negotiated sales contracts with payer sources and providers, resulting in an additional $17.4M in annual revenue.
• Enhanced client satisfaction by fostering stronger connections through service improvements and development projects, driving loyalty and repeat business.
• Successfully delivered over 100 projects on schedule, ensuring high levels of client satisfaction and minimal delays.
• Streamlined internal operations by redesigning protocols and implementing comprehensive documentation for client services and developer teams, improving efficiency and accountability.
• Saved the organization over 1,000 work hours annually by optimizing processes and creating reusable documentation for recurring challenges.
Sidney Health CenterSr. Director of RCM
Dec. 2019 - Feb. 2023Sidney, Montana, United States• Negotiated payer source contracts with Medicaid in MT and ND, as well as 16 commercial payers, securing reimbursement rates at 320% above Medicare.
• Initiated and finalized contracts with all payer sources, including Medicare, to establish "Care Flight," a life flight service exclusive to the facility.
• Established a centralized Prior Authorization team, streamlining processes to improve efficiency and increase facility revenues.
• Achieved a 62% increase in clean claims within one year through targeted training and process optimization.
• Boosted monthly revenues for ACH facilities by 28% by reducing first-pass claim errors, decreasing AR days, and implementing front-end collection practices with accurate patient estimates.
• Renegotiated vendor contracts, saving the facility $56,000 annually by eliminating inefficiencies and securing better terms.
Patient Matters LLCDirector of Client Services
Oct. 2017 - Dec. 2019Helena, MT• Increased St. Peter’s Point-of-Service Collections by 128% within one year by implementing targeted staff training and enforcing updated process changes.
• Negotiated upselling of services with CEOs and CFOs of three regional facilities, including St. Peter’s, leading to a $1.6M increase in annual revenue by the second year over the original contracts.
• Strengthened client relations by advocating for St. Peter’s needs, maintaining frequent updates, and fostering consistent communication channels.
• Directed a team of 87 employees, leading training programs and serving as the primary support resource for staff and team-related requests.
• Reduced AR days from 77 to 46 through staff retraining on billing accuracy and the development of an aged AR team, significantly improving cash flow.
• Decreased outstanding AR balances from $5.6M to $3.9M in one year by enhancing collection efforts and optimizing billing processes.
• Supported the CFO and CEO in contract negotiations with Medicare, Medicaid, and 31 commercial payer sources, transitioning most commercial payers from percentage-based to flat-fee agreements while maintaining reimbursement rates at approximately 300% above Medicare.
360care-OnHealthcareDirector of Medical Billing
Jun. 2016 - Oct. 2017Louisville, Kentucky• Negotiated contracts with 11 state Medicaid programs and 14 commercial payers, including Medicare supplemental and replacement plans, achieving competitive service pricing and maximized reimbursements.
• Conducted annual reviews of Medicaid and commercial payer contracts, renegotiating terms to secure reimbursement rates between 280% and 350% above Medicare.
• Designed and implemented comprehensive training programs for employees to enhance their understanding of billing processes and systems, increasing team efficiency.
• Built and led an eight-member credentialing team, successfully credentialing providers, nurses, and non-emergency medical transportation staff with 16 payer sources across 11 states.
• Collaborated with the Chief Financial Officer and Financial Director to optimize daily operational functions, ensuring adherence to best practices.
• Oversaw four distinct revenue streams across 11 states, managing a billing team of 43 employees and 2 managers to generate $3.2M in monthly claims.
MedAssistDirector of Client Services
Feb. 2009 - Jun. 2016Mobile• Increased MedAssist’s annual revenue by $2M in the third year by
upselling services to the company’s three largest clients based on data- driven insights.
• Strengthened client relationships and expanded service offerings through negotiations with CEOs and CFOs at Parallon, HCA, and LifePoint, culminating in the establishment of a new call center in Oklahoma.
• Directed a team of 512 employees across 68 facilities, managing accounts receivable and eligibility services through onsite managers to ensure operational efficiency.
• Launched a call center initiative with 288 employees to assist physicians unaffiliated with client facilities in billing for patient services, increasing service capabilities.
• Monitored and reported monthly revenue and accounts receivable for 69 facilities across 12 states, with revenue ranging from $2.3M to $31M.
• Drove overall client revenue growth by $2.3M in the first year and
$6.18M in the third year through strategic process improvements and service expansion.
• Oversaw the transition of pre-registration, prior authorization, and registration processes, generating $2.1M in additional revenue within two months of implementation.
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