Jim Collins, CPC, CCC

Saratoga Springs, NY 12866

(518) 320-4376 – Jim@CardiologyCoder.Com

INTRODUCTIOn: Jim brings 30 years of hands-on experience achieving aggressive goals like:

·       securing favorable coverage and reimbursement for medical devices

·       educating physicians about reimbursement and compliance

·       working closely with sales teams to dovetail reimbursement and sales efforts

·       defending physicians in multiple Medicare, DOJ, and OIG lawsuits

·       explaining the financial opportunities of devices with interested investors 

EXPERIENCE                                                                                                                                   

Capital Cardiology Associates, Albany, NY                                               2024

Compliance & Medical Coding Expert

·       Physician and coder education, auditing, service line implementation

IronRod Health, Phoenix, AZ                                                                      2023 - 2024

Chief Compliance Officer

·       Managed all aspects of regulatory compliance

·       Assisted with the development of service lines and software platform

·       Responded to all payer and government audits

·       Education of staff and customers

Biotronik – Saratoga Springs, NY                                                               2021- 2023

Manager, Healthcare Economics and Reimbursement

·       Worked closely with leaders of each product line and each sales region to make sure healthcare system variables (coverage, revenue and compliance) were kept in the forefront of field and customer facing communications.

·       Analyzed coverage and revenue opportunities associated with devices under consideration for acquisition. 

·       Conducted in-person and virtual training programs for physicians to help them secure appropriate reimbursement and avoid regulatory exposure.

·       Developed hybrid protocols (clinical and billing guidance) for management of subcutaneous cardiac rhythm monitors.

The Cardiology Coalition, inc. & CardiologyCoder.Com, Inc.                 1999 – Present 

Consultant/Sole Proprietor

·       Consultant and public speaker for electrophysiology and cardiac rhythm management device companies, including: Abbott, Acutis, Biotronik, Boston Scientific, Cardiac RMS, Medtronic, LivaNova, Murj, Phillips, & Octagos

·       Lead efforts to secure new CPT codes for left ventricular lead surgeries, remote monitoring of cardiac rhythm management devices and heart failure, first-pass imaging, and conduction system pacing (a work in progress).

·       Authored the American Academy of Professional Coders (APPC) “Certified Cardiology Coder” (CCC) coding certification exam and study guide.

·       Co-authored Decision Health’s “Advanced Coding Specialist in Cardiology” (ACS-CA) coding certification exam and study guide.

·       Provided chart auditing, regulatory support, and several forms of consulting services to cardiology groups nationwide.

·       Wrote several articles that were published in: EP Lab Digest, Cath Lab Digest, Cardiology Coder’s Pink Sheet.

·       Conducted presentations for the American College of Cardiology and The Heart Rhythm Society (most recently featured at HRS 2022)

Mid Carolina Cardiology – Charlotte, NC                                                      2001 – 2003

Compliance Officer

·       Wrote, implemented, and managed the compliance program for cardiology group with 27 physicians and several non-physician practitioners. Conducted routine auditing and training for all healthcare providers, executed performance improvement plans for outliers, and answered billing related questions from all members of the group.

·       Conducted operational reviews of each practice location to facilitate full charge capture, operational efficiency, and regulatory compliance.

·       Created and implemented the Health Insurance Portability and Accountability Act (HIPAA) privacy compliance program. Recruited, trained, and supported the Privacy Officer of the group.

The Care Group – Indianapolis, In.                                                                 1999 - 2001

Compliance Analyst

·       Responsible for education, auditing, and payer communications pertinent to: peripheral vascular, electrophysiology, coronary, and cardiac rhythm management procedures.

·       Responded to payer audits, coordinated appeals of denied services, and implemented internal controls for payments received at the time of service.

·       Gained a wealth of experience in the cardiology field by viewing surgical procedures live, managing the high-volume of payer audits triggered by the groups size (124 cardiologists and several non-physician practitioners), and working with electrophysiology legend, Dr. Eric Prystowsky.

Heaton and Eadie – Indianapolis, In.                                                            1998 – 1999

Manager, Healthcare Compliance Service Line

·       Provided services to help physicians achieve and maintain compliance with documentation and billing rules.

·       Individual and group training programs at customer accounts in advance of, and in follow-up to, practice wide audits of procedures and patient visits.

·       Benchmarking billing and productivity data from customer billing systems to data from multiple databases. Areas of opportunity and areas of concern were frequently identified from this semi-macro data. 

The PM Group – Columbia, SC & Greenville, SC                                    1993 – 1998

Accountant/Consultant

·       Bookkeeping, payroll processing, physician bonus calculations, tax preparation, and retirement plan administration for privately owned physician groups.

·       Assisted with the development and management of an Independent Practice Association (IPA) to bring economies of scale to solo and small group practices. Key services included: insurance contract negotiations, group purchasing, physician education, credentialing, and communications with government payors.

·       Created and managed a coding and documentation consulting service line that included physician and billing staff education about applicable standards

EDUCATION & CREDENTIALS                                                                                                                                  

State University of New York (SUNY) at Brockport                                      1993

·       Bachelor of Science Degree in Marketing

§  President, Marketing Club

State University of New York (SUNY) at Alfred                                             1991

·       Associates Degree in Business Administration

§  Monitor, Computer Information Services

American Academy of Professional Coders (AAPC):

·       Certified Professional Coder (CPC)                                                          1998

·       Certified Cardiology Coder (CCC)                                                            2007

·       Certified ICD-10 Proficient                                                                      2014

Healthcare Compliance Resources

·       Certified Healthcare Compliance Consultant (CHCC)                              1996