Strategic and results-driven Ambulatory IS Project Implementation Manager with 16 years experience in the healthcare industry. Well-versed in project management, application life-cycle management and business analysis. Proficient in managing cross-functional teams to implement technology solutions to improve practice and billing work flows, patient care, and satisfy organizational goals and regulatory requirements. Experienced implementing PM and EHR systems, clearinghouses, HL7 interfaces, conversions, hardware, training programs and process improvements. Extremely interested in gaining additional knowledge through further education and certifications.
Application life-cycle management of Misys PM, TIGER, EMR and Fast Services. Proactively monitored regulatory changes and requirements to ensure EHR and billing systems remained compliant. Provided application and desktop support for 150+ end users and 57 providers across 21 locations, 3 client sites, accounting and the billing department. Enhanced system utilization by implementing streamlined processes which supported the needs of the organization. Project managed all conversions, new technology and practice implementations. Managed cash posting team.
Established and Managed an internal IS support team for PBMS, Inc. Application life-cycle management for the anesthesia billing and electronic record scanning software. Researched and was proactive in maintaining billing compliance through database management for all 21 anesthesia and pain management clients. Implemented electronic submission of claims for 80% of payers and supported electronic data interchange connections. Reduced paper record storage costs by implementing a scan solution. Developed and maintained inbound patient demographic interface from client sites to the billing software to gain efficiencies in data entry.
Designed and implemented a standard business model to improve the overall business relationships between PBMS, Inc. and their clients. Prepared and reviewed monthly reports of key performance indicators and presented during on-site meetings with leadership of each client. Designed custom reports utilizing a data warehousing tool to meet the needs of management and clients. Assisted clients with negotiating payer contracts including terms and reimbursement rates. Responsible for managing payer escalations to address incorrect reimbursement and credentialing issues. Managed cross-functional teams involved in new client setup and special projects.
Managed a team of 13 individuals to ensure all cash posting functions were completed in a timely manner. Defined and documented procedures and policies to ensure accurate cash handling and posting. Managed special projects for reimbursement issues and assigned resources as necessary to meet all time lines. Created and implemented a cash posting training program for established and new employees. Developed and implemented monthly statistical reports benchmarking staff productivity and payer issues by client. Performed all contract updates for each client database to ensure proper reimbursement and fees were loaded into the application.
Posted Insurance and Self Pay payments for Anesthesia and Pain clients located in PA, DE, MD. Resolved all insurance denials, reimbursement and contract issues. Identified credits on accounts and reviewed and issued refunds as necessary to insurance or patient.Processed monthly reports and provided to finance for invoicing of each client. Assisted in issue tracking, supporting and training cash posting team members during conversion to new MSI system.
Certificates: Basic Lean Foundations & Leadership Lean Principle
General Studies with concentration in Accounting
*Majored in Accounting and Minored in Computer Information Systems
*Continuing Education to receive a Bachelors in Business Administration with a concentration in Information Technology.
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