Kashmir Singh
Beaumont
Summary
Results-driven Revenue Cycle Expert with extensive experience in the healthcare sector, specializing in Patient Access Services, Information Technology, and Patient Financial Services. Proven track record of leading teams to exceed net accounts receivable collection goals exceeding $60 million while managing total accounts receivable over $250 million. Comprehensive hands-on experience combined with a deep understanding of government regulations such as JCAHO, DHCS, Title 22, and DMHC enhances organizational effectiveness and leadership capabilities. Committed to driving operational excellence and improving financial performance within healthcare organizations through efficient process development and a collaborative approach.
Overview
20
20
years of professional experience
Work History
Denials Management
Optum 360
09.2015 - Current
- Track and trend Initial and Final Denials
- Gap analysis and mitigation opportunity
- Collaborate with stakeholders to develop and implement process improvement
- Monthly denials report out to Denials Management Team
- Carc and Rarc code mapping
- Audit final denials write off
- Monthly payer JOC
PFS Collections Manager
St Bernardine Medical Center (Optum 360)
07.2014 - 09.2015
- Manage follow up/collections of AR of over $250 million
- Interdepartmental collaboration and process improvement efforts to assure clean revenue cycle flow
- Monitor staffs Quality Assurance and Productivity Standards. Implement Standardized processes within PFS
- Performance Evaluations and disciplinary actions. Team building through mentoring, training and coaching
Director Patient Access Business Services
Corona Regional Medical Center
10.2013 - 01.2014
- Managed Patient Access Department including PBX, ER, Front line Registration, Centralized Scheduling, Insurance Verification, and Financial counselors. Assured adequate department coverage.
- Revenue Integrity – Made sure CDM was set up correctly, researched and resolved charge and CDM related issues
- Census Balancing and Charge Reconciliation oversight to ensure adherence to SOX audit.
- Department Budget and Monthly Operations Report. Month end close with CFO.
- Provided training and assistance to staff individually and in teams to maximize knowledge, production, goal achievement and quality improvement.
- Worked collaboratively with leadership, department directors, and physicians to improve processes and client satisfaction.
QA Analyst III
Dignity Health
06.2012 - 10.2013
- Ensured all testing deliverables were produced in a timely manner and were in alignment with the project goals and objectives. Developed overall project test approaches, plans, schedules, and estimates. Provided input to program level testing deliverables.
- Assisted in identifying and forecasting testing resource needs. Led testing team validation of requirement and design deliverables.
- Ensured test coverage through quality review (HP QC) and use of risk analysis. Coordinated test execution and proactively monitored and reported trends. Communicated testing status, managed testing issues and resolution process throughout the life cycle of the project
- Led cross functional teams to achieve project objectives, facilitated testing team participation, conflict resolution, mentoring, delegating, and consensus building. Managed defect and communicated lessons learnt.
Commercial Billing and Follow Up Manager
Dignity Health
11.2010 - 06.2012
- Managed Billing and Follow up Teams for Commercial, GMCP (Medi-cal HMO), and Capitated providers/insurance for 6 hospitals within the system. Successfully achieved monthly collection goal of over $60 million.
- Reduced AR aging by 10% within first year.
- Review of all other business office metric and assured adherence.
- Successful in reducing denials by 10% the first year by having JOC with payors and setting pay or specific edits to assure clean claims were submitted initially.
- Collaborated efforts with different departments such as Case Management, Registration, and Revenue Integrity to implement and fine tune process’s that impacted revenue cycle.
- Implemented Standardized processes within each unit and PFS. Monitored staffs Quality Assurance and Productivity Standards
Business Office Liaison (Interim Director Patient Access Services)
Corona Regional Medical Center
06.2008 - 11.2010
- Monitored and trained Census balancing and charge reconciliation.
- Worked closely with CFO with month end close.
- Chaired Revenue Cycle meetings with departments impacting revenue cycle such as Case Management, Lab, and Radiology.
- Coordinated CDM load, updated departments of CMS yearly billing and coding changes.
- Coordinated testing and implementation of new applications and system upgrades in Invision, Sorian, Document Imaging. Monitored and resolved end user issues prior to go live and post go live.
- Performed contract interpretation and reimbursement analysis of Commercial, Medicare and Medi-cal payors.
- Monitored employees in Admitting, ER, PBX and Centralized Scheduling to ensure smooth daily operation with minimal disruption.
- Monitored and reported daily productivity and census to finance and CFO. Ensured
Managed Care Coordinator
Corona Regional Medical Center
10.2005 - 05.2008
- Managed patient account reps to ensure effective and timely follow up and collections is done, and monthly goal is met.
- Trending problem payers worked closely with the problem payers to resolve payment issues such as underpayment and unfair payment practices.
- Reviewed AR aging and other business office metric and maintained it within corporate guidelines of < 15%. Worked closely with other departments to guarantee claims are billed correctly. Resolved coding and charging issues.
- Assignment and monitoring of outsourced accounts. Monthly agency reconciliation and balancing.
- Wrote and updated department Policy & Procedures.
- Employee training, evaluation and progressive disciplining.
- In my position as Managed Care coordinator I was successful in reducing AR aging over 120 days by 5% within the 1st year by reporting payors with unfair payment practice to DHMC and eventually working with the payors in AR resolution.
Education
Diploma - Medical Assistant
National Education Center
01.1992
Diploma - General Studies
Cuvu High School Fiji Islands
01.1987
Skills
- Flexible problem-solving
- Cross-functional collaboration
- Consistent professional commitment
- Analytical reasoning
- Composed in high-stress situations
- Strategic issue analysis
- Detail-oriented approach
- Flexible and adaptable
- Effective organization skills
- Proficient in computer applications
- Effective verbal communication
Accomplishments
- Supervised team of 65 staff members.
- Collaborated with cross functional teams for denials reduction projects
- Achieved root causes for denial write off by completing final denial audits with accuracy and efficiency.
- Achieved AR reduction, cash acceleration by effectively managing AR
Timeline
Denials Management
Optum 360
09.2015 - Current
PFS Collections Manager
St Bernardine Medical Center (Optum 360)
07.2014 - 09.2015
Director Patient Access Business Services
Corona Regional Medical Center
10.2013 - 01.2014
QA Analyst III
Dignity Health
06.2012 - 10.2013
Commercial Billing and Follow Up Manager
Dignity Health
11.2010 - 06.2012
Business Office Liaison (Interim Director Patient Access Services)
Corona Regional Medical Center
06.2008 - 11.2010
Managed Care Coordinator
Corona Regional Medical Center
10.2005 - 05.2008
Diploma - General Studies
Cuvu High School Fiji Islands
Diploma - Medical Assistant
National Education Center