1. RANDAL BLANC randal_blanc@yahoo.com http://www.linkedin.com/in/randalblanc http://www.visualcv.com/rblanc SUMMARY Revenue Cycle Management professional with 10+ years experience in the Healthcare Industry. Achieve enhancements in hospital revenue through utilizing background in Billing and Collections along with implementing Revenue Integrity initiatives. Demonstrate open communication skills along with a collaborative team approach. Partner with all levels of management in completing complex projects and accomplishing organizational goals. Detail-oriented complemented with consistent follow up and follow through ensures on-time, accurate results. Revenue Cycle Systems / Applications Experience: CareMedicHBOC StarMeditechCasnetImaging 24OAS Gold ClientConcuityIDXRASCompass MedAssets CDM MasterSignatureEReserveMedAssets Charge Capture ToolsSMS InvisionHorizon Patient FolderMedi FinanceVisionshare PROFESSIONAL EXPERIENCE LAKELAND REGIONAL MEDICAL CENTER, Lakeland, FL2008 - 2009 850 bed Level II Trauma Acute Care hospital Manager, Revenue Integrity Services Led team of 5 employees in oversight of facility charge master and managed auditing and revenue enhancement strategies, assuring best practices. Assisted Patient Financial Services with resolution of billing edits due to potential Charge master issues, NCCI or OCE edits. Researched billing and coding requirements when new procedures and/or supplies were introduced. Ensured all audit related responses were completed in required timeframes, including payer defense audits, patient complaints, Risk Management and regulatory audits. Served on the Value Analysis Committee for evaluating new products and supplies for the Main OR and Cardiovascular OR departments. Reduced Late Charges from $10.2 million to $2.9 million at the end of 9 months, thereby achieving best practice of less than 2% of Gross Revenue. Increased net revenues $350,000 in 6 months by implementing charge capture opportunity initiative for Nursing Procedures for outpatient and Observation patients under very tight deadline. Contributed to development of new revenue streams by identifying coding-related and charge capture losses and variances, as well as compliance-related issues through consistent auditing. Reduced exposure / risk and ensured billing compliance facility-wide by communicating quarterly and annual APC coding and reimbursement updates from CMS to all departments impacted by changes. Realized savings of over $100,000 in payor refund requests through effective defense auditing techniques. Increased efficiencies, enabled better controls and minimized workload on affected departments by collaborating with PFS, Managed Care and HIM departments in revising Third Party Billing Audit Policy. Selected by senior management to provide critical feedback on identifying inefficiencies and streamlining processes for a revised Charge master Policy proposed by the CDM Oversight Committee. CLEVELAND CLINIC FLORIDA, Weston, FL 2005 - 2007 150 bed multispecialty facility. Manager, Patient Financial Services (2006 - 2007) Organized and oversaw the daily functions for staff of 13, including 2 analysts, 3 data entry, 2 payment posting and 6 financial counselors. Coordinated and monitored all cash functions and controls. Manager, Patient Financial Services, continued Maintained and communicated process and operational issues to Cleveland Clinic Ohio CBO units on a weekly basis that impacted all aspects of accounts receivable management to include contracting, reimbursement and collections. Improved patient satisfaction within 90 days by establishing a centralized Customer Service access area that assisted patients in resolving all hospital and physician questions and concerns. Reduced claim denials by working closely with the Patient Access Director in identifying and correcting trends in registration errors impacting billing and collections. Improved reporting of self pay and charity dollars, ultimately reducing bad debt write-offs, by assisting in the development and roll out of Financial Assistance Program. Decreased billing edits due to coding issues by collaborating with the charge master coordinator in identifying and correcting charge master errors. Increased collections by $350,000 and reduced account balances greater than 90 days by 30% by managing outside vendor collector staff on 6 month on site engagement. Manager, APC Compliance / Systems (2005 - 2006) Managed the data capture and reporting of monthly concurrent chart audits. Ensured EReserve protocols were performed accurately and within timeframe in accordance with the Tenet Healthcare System Month End processing. Monitored all IT systems / software applications in functioning effectively and ensured staff was well trained in all aspects to perform job duties and responsibilities. . Reduced bill hold times due to Medicare CCI edits by 40% through effective collaboration with clinical areas. Achieved improvements in documentation and charge capture practices by presenting statistical reports from concurrent audits in a monthly Chart Audit meeting with department heads. INSURANCE RECOVERY SPECIALISTS INC., Ft. Lauderdale, FL1991 - 2005 Third Party Vendor providing Extended Business Office Services to hospital and physician groups. Manager, IT / Compliance / Client Integration (1996 – 2005) Managed the electronic transfer of accounts from client hospitals and integration of accounts receivables projects. Oversaw interface of client systems and company’s mainframe in providing timely and accurate account status and reporting. Ensured necessary protocols were established and maintained with Medicare and Medicaid to permit the electronic submission of claims and claims adjudication for client hospitals. Evaluated, implemented and monitored standards for compliance with HIPAA mandates regarding privacy, confidentiality and security of health information. Developed, implemented and monitored Corporate Compliance program in line with OIG mandates for third party billing companies. Achieved economies of scale in claims adjudication by establishing web-based protocols for securing claims status and patient eligibility with payers for client hospitals. Identified and recovered approximately $500,000 of underpayments in 3 years by assisting in development of an electronic retroactive Managed Care Contract Compliance audit program for client hospitals. Increased timeliness and accuracy through automated processes that ensured key updates were made to accounts in hospital mainframe when returned to provider. Improved operational processes for both client and vendor by partnering with client hospitals in developing an electronic method for effecting a reconciliation of account balances and preparing monthly reports to clients. Hired as Supervisor - Operations/Administration in 1991 and promoted to Manager role due to strong performance, knowledge base and leadership skills. EDUCATION Bachelor of Science, Business Administration, University of the West Indies, Trinidad PROFESSIONAL AFFILIATIONS AAHAM HFMA