Skilled medical program analyst with well-developed leadership skills and experience working with health plans, government agencies, medical providers, and stakeholders. Highly adaptable to change and works well under pressure. Has a logical and analytical approach to identifying and resolving situations with a high potential for conflict. Organized and creative, with a solid approach to comprehensive information gathering. Tech-savvy multitasker, learns and implements new information quickly. Possess excellent communication and inter-personal skills Proven ability to identify, analyze, and solve problems
*Highly reliable self-starter; can be counted on to complete assignments
*Proven competence in working independently as well as with others in a team effort
Excel, Word, and Access, Harris Care Tracker and Medisoft billing and Electronic Medical Record software, HIPAA,
09/1997 to 09/2015
Health Program SpecialistTELEMEDICINE SERVICES TMS － Elk Grove, CA
TMS oversees the Correctional Telemedicine Program providing 250,000 patients/inmates access to specialty medical care by way of video conferencing.
Facilitated the development and expansion of the statewide telemedicine provider network.
Coordinated, recruited, trained, and credentialed new providers, hospitals, and medical offices.
Implemented program modifications and assessed compliance of new and current policy and procedures.
Analyzed strategic data around institutional utilization, provider availability, patient outcomes, provider and hospital billing discrepancies, and verified the appropriate use of procedural and diagnostic coding.
Designed, produced, and presented monthly data reports for distribution to providers, health plan, institutional medical staff, and the telemedicine team.
2 Accomplishments: 65% Expansion of provider network including the addition of 6 new specialties,95 new providers, 4 new hospitals and 3 independent medical offices.
Improving patient/inmates access to medical care and reducing the danger of transporting patient/inmates out into the community for medical appointments.
Health Program SpecialistALLIED HEALTH SERVICES － Sacramento, CA
AHS oversees development, implementation, and management of medical service contracts for the Department of Corrections 35 institutions Analyzed institutional contract data to determine utilization and outcomes outlier, including root cause analysis for outliers and utilization patterns.
Managed relationships with contractors, institutional medical staff, and executive leadership mitigating issues before they escalate ensuring contractual obligations are being met and delivery of patient care is consistent with the Receiver's Plan of Action.
Monitored and tracked project amendments, scope changes, equipment delays, and advised leadership on strategies for resolution and avoidance of schedule and project completion delays.
Trained and assisted new unit associates in all aspects of contract management, compliance, and project oversite.
Accomplishments: Audited $ 85,000 of delinquent invoices, collaborated with Accounts Payable and within 7 days 90% of the invoices were scheduled for payment, saving the department $ 2,500 a month in late payment fees.
Developed and implemented invoice tracking database, revised the internal invoice approval process, and collaborated with Accounts Payable to expedite invoice payments.
As a result, the invoice processing time was reduced to 20 days eliminating the 3% late payment penalty saving the department an estimated $ 8,000 per month.
Office Assistant/Office TechnicianCALIFORNIA MEDICAL FACILITY CMF － Vacaville, CA
Population 2,500 inmates and includes a General Acute Care hospital, and Correctional Treatment Center Collected, compiled, processed, and made available to authorized users accurate health records in a manner consistent with medical administrative, ethical, legal, and regulatory requirements.
Prioritized, located, pulled, assembled, manually and electronically tracked, and appropriately transported records requested by health care providers in accordance with established standards.
Processed and coordinated patient/inmates requests for release of medical information.
Scanned, copied, and forwarded to appropriate parties in regulation with HIPAA guidelines.
Accomplishments: Organized, maintained, and tracked health records for 2,500 patients/inmates, 80% of who see a medical provider on a regular basis.
Daily completed 5 to 7 inches of loose filing maintaining a 97% document placement accuracy.
Medical Billing and Coding Professional Diploma
Course work Highlights: Medical Terminology, Medical office practices, Anatomy and Physiology, Accounting, Medical insurance coding, billing and claims processing, Electric Medical Record, Procedural coding, ICD-10MTI COLLEGE － Sacramento, CA
DEPARTMENT OF CORRECTIONS AND REHABILITATION
Accounting, Accounts Payable, Acute Care, administrative, Anatomy, billing, contract management, contracts, CPT, database, delivery, Electronic Medical Record software, filing, ICD-10, insurance, invoice processing, leadership, legal, Medical Billing, Medical Terminology, Medisoft, Access, Excel, MS Office, office, 97, Word, network, patient care, Physiology, Coding, strategic, video conferencing
Medical Billing and Coding Professional Diploma
Course work Highlights: Medical Terminology, Medical office practices, Anatomy and Physiology, Accounting, Medical insurance coding, billing and claims processing, Electric Medical Record, Procedural coding, ICD-10
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