Nathan Stern and the business of unfinished work

The beginning of Nathan Stern’s business story is a billing job. In 1998, he started as a billing manager at Future Care Consultants. There is a pleasing lack of ceremony in that origin. A bill is a small, stubborn object. Sending it creates a task for someone else; getting it paid can create several more for you. Stern’s career would grow around the business of making those tasks somebody’s responsibility.

He is now co-founder and CEO of Apex Global Solutions. The company brings billing, finance, purchasing and payroll into a shared operation for businesses with one location or many. Stern arrived there through administrative work, management and ownership. His route gives the executive title some texture: he has worked on both the numbers and the businesses depending on them.

In a founder’s story, the temptation is to look for a sudden revelation. Here, the more interesting pattern is repetition. The responsibilities broadened. The operation grew. Work that began at the billing desk became work that required offices, specialist teams and colleagues capable of leading other colleagues.

The first twelve

His early responsibilities expanded to managing a centralized office for ten facilities. The distinction between processing a bill and managing the office around it is substantial. An office manager has to organize the people handling the work and the process that brings it back when something goes wrong. Stern’s later business would extend that coordinating role across more locations.

In 2003, Stern established a centralized business office serving twelve facilities. The number is worth keeping in view. Twelve locations are enough to make a shared office meaningful: there are recurring jobs to organize, records to handle and people who need answers. They are also twelve separate places where an administrative delay can become somebody’s immediate problem.

Centralization changes where work happens. Its value depends on what happens after the move. A shared office still has to understand the location asking the question. It still has to distinguish a missing document from a missed payment. Putting people in one operation gives a business the opportunity to make that work more consistent. The organization has to earn the opportunity each day.

The office developed into Global Healthcare Services in 2007. By then, Stern’s career also included operating businesses himself. That experience matters because an owner encounters the consequences of administration from several directions at once. Receipts affect available cash. Cash affects upcoming payments. A report can explain yesterday while arriving too late to help with today.

His earlier operating record included owning and managing thirty facilities, alongside outsourced revenue-cycle work serving more than 140 locations in fifteen states. Ownership and outside service provision put him on both sides of a working relationship: responsible for a business’s operation, and responsible for delivering an administrative service to another business. Those are different obligations, even when they involve the same financial processes.

Those connections make the early office an instructive chapter. The undertaking was already larger than a single billing function. Stern was organizing work across locations, with the practical complications that come from having to serve more than one building through the same operation.

Two businesses, one operating problem

In 2017, Global Healthcare Services and Apex Healthcare joined forces. Stern and fellow co-founder Jacob Karmel brought their earlier businesses into a combined operation. The proposition was to gather financial administration and technology into one relationship, built around owners managing multiple facilities.

It is a business idea with a familiar customer problem. An owner can end up supervising a collection of administrative departments on top of the business itself. Each department may be doing useful work. The owner still has to connect their answers. The books say one thing, the bank balance requires another conversation, and an upcoming payroll deadline supplies the suspense.

Apex’s combined offering addresses that coordination problem. Its four service lines connect incoming money, outgoing money, the records of both and the recurring obligation to pay employees. Each has a specialist’s vocabulary. The owner needs them to describe the same business.

Stern’s experience gives that proposition a practical foundation. His earlier responsibilities included running a shared office and operating facilities, so the progression into a broader administrative business has a recognizable continuity. He had worked inside the activities that Apex would bring together. The combined company gave those activities a larger organizational home.

The office goes to American Dream

For a more sociable view of the operation, go to East Rutherford, New Jersey, in August 2021. Apex held its annual staff get-together at American Dream. Colleagues came from Tennessee, Florida, Maryland and Michigan. An organization spread across offices had arranged an afternoon in the same place.

Michael Mocton emceed the event. He thanked Stern and Karmel for supporting the team, and the gathering included a raffle with a distinctly practical sense of extravagance: hoverboards, electric scooters, panini makers, coffee machines and other prizes. An office can spend the morning reconciling accounts and the afternoon considering whether it has room for a panini maker. This seems a reasonable distribution of effort.

The episode supplies something an organizational chart cannot. A service business consists of individual people whose work has to connect across distance. Bringing them together makes that network visible. A colleague in another state becomes someone at the next table, with a face, a conversation and perhaps a raffle ticket.

Nechama Grossman, now Apex’s chief people officer, welcomed the chance for colleagues from across the country to connect in person. That emphasis sits comfortably beside the description employees have given Stern: “a leader who creates leaders.” The phrase puts the attention on what other people become around him.

Put a name beside the number

Today, the responsibilities around Stern are explicit. Ben Kerstein is chief operating officer, overseeing how work is staffed and delivered. Hillel Novak leads revenue cycle management. Ken Milgraum leads finance and payroll. Dov Weller leads purchasing. The work that once fitted inside a smaller shared office now has distinct leaders.

The client-facing structure follows the same principle. A controller owns the financial close and reporting calendar. A billing specialist works with the client’s payers and locations. A purchasing lead watches spending. Relationship leaders oversee the broader partnership. A question should have a destination before it becomes a meeting.

“a leader who creates leaders”

How employees describe Stern’s leadership

For a founder, that structure changes the meaning of being useful. The company needs people who can exercise judgment within their own responsibilities. It also needs those people to recognize when their work touches someone else’s. An unpaid balance, for example, can belong to a billing specialist while affecting the controller’s cash forecast.

Stern’s path from billing to chief executive makes this a useful way to read his career. Each stage required a broader view of related work. A larger title brings more responsibility for the relationships between tasks, as well as the tasks themselves.

A longer view of the next action

Apex now combines managed services with connected software. Its technology offering includes finance and payroll systems, purchasing tools and revenue-cycle workflows. Clients can also license available software while keeping their own staff. That choice makes the distinction between providing a system and doing the work especially clear.

Apex lists Workday for core financials and OnShift for workforce management. It also uses TechFlow for revenue-cycle workflows. Alongside those systems, the company describes its own tools for preparing reports, processing receipts and organizing transactions for review. The everyday objective is to reduce repetitive preparation so the finance team can spend more time examining the result.

The systems support daily cash visibility, scheduled reporting and investigation of individual transactions. These are useful capabilities for an operation spread across locations. Their practical value emerges when somebody acts on what they reveal. A dashboard can display an overdue item indefinitely; a person has to decide what happens next.

Apex reports serving more than 450 facilities and more than 50 operating groups across more than 36 states. Those are company figures, describing the current operation rather than a measure of Stern’s individual output. They also show how far the organizational setting has moved from the twelve-facility office of 2003.

The company’s stated values include taking responsibility for outcomes, communicating before a client has to ask and listening to understand the client’s needs. In a business selling administrative work, those commitments concern the ordinary experience of getting an answer. They give the people around Stern a standard against which their daily work can be judged.

Outside the business, Stern lives in Lakewood, New Jersey, with his wife and five children. His stated professional priorities include helping employees, clients and colleagues succeed. Alongside the expanding operation, those priorities give the career a human scale: people doing their jobs, building confidence and relying on one another to finish the work.

Return to the billing desk, and the continuity becomes easier to see. A task arrives. It needs attention, a decision and follow-through. Stern’s career has taken him through different versions of that obligation, from an early billing role to a company with specialist leaders and a national client base. The next action still needs someone’s name beside it.