Category: ADVOCATE

         SENIOR APPLICATION SPECIALIST       Professional Summary     Highly motivated, results and detail oriented leader with strong communication, leadership, and troubleshooting skills.  I have a proven track record in increasing staff development with a focus on quality improvement.  I am seeking a position that allows me to implement health care improvement processes and procedures.        Education and Training      Associate Degree  ,   Applied Science   June 1999     Robert Morris University   －   City  ,   State      Health Information Management          Healthcare Management    Devry University   －   City  ,   State      Course work in Healthcare Management        Skill Highlights          Staff training and development  Relationship and team building  Conflict resolution              Professional Experience      Senior Application Specialist     Mar 2014        Company Name   －   City  ,   State     Implement and support business office software solutions     Create and test application scenarios, including interfaces and device integration    Coordinate software version upgrades with various departments   Assists in project efforts related to charge capture, claims, remittance and cash management workflows  Support day to day maintenance of HB system. Includes daily checks, investigation, root cause analysis, remediation, and process improvement  Serves as the HB Data Courier lead   Provides on-call support during off hours           Revenue Cycle Trainer     Jul 2006   to   Mar 2014      Company Name   －   City  ,   State     Provided operational and technical support which enabled the business office to function efficiently and effectively.  Responsible for operational issues, resolution development and advanced integration through audit/review functions.  Conduct, deliver and arrange training programs for new employees and continuing education of current employees of the business office.  Evaluate old policies and procedures and update as necessary.  Acts as a liaison between the business office and technical staff in information systems to communicate issues and coordinate resolution.  Work with managers to develop job aids, improve accuracy and assist in improving best practices.  Conduct employee specific need and issue based assessments.  Participate in quality reviews of staff to identify issues and provide additional training.  Create and maintain training materials as well as Epic procedural guidelines and departmental workflows.  Deliver cross-training programs.  Analyze workflows and system functions to enhance the correct capture of patient information, clinical charges and diagnostic codes, in support of the electronic billing and collection processes.  Regularly evaluated employee performance, provided feedback and coached staff as needed.         Network Support Analyst     Nov 2005   to   Jul 2006      Company Name   －   City  ,   State     Customer service liaison to Nebo customers.  Traveled locally and regionally to train hospital business office personnel on the use of ECare CMS system.  Assisted new clients in setting up their billing processes utilizing ECare.  Worked with programmers/analysts on problem related issues concerning the installation and upgrades involving ECare.         Managed Care Claims Auditor     Apr 2002   to   Nov 2005      Company Name   －   City  ,   State     Led and directed managed care projects involving patient account activities.  Monitored billers and collectors workflow processes.  Assisted in improving departmental performance and outcomes.  Assisted in maximizing reimbursements and reaching departmental revenue goals.  Worked closely with staff to keep them abreast of current contracts, contract changes, billing criteria, reimbursement timeframes, and pre-certification requirements.  Developed job tools to assist billers, admitting and insurance verification staff.  Coordinated the appeal process for denied claims.  Coordinator for the refunds unit.  Participated on A/R, Utilization Review, Revenue Management and Patient Access task forces.         Provider Relations Representative     Jul 1997   to   Apr 2002      Company Name   －   City  ,   State     Responsible for recruiting physicians for the PHO (Physician Hospital Organization).  Resolved member and provider inquires.  Visit, and educate physician's office staff related to managed care changes.  Conducted physician staff orientation and in-services on a quarterly basis.  Communicated policy and procedure changes to physicians and their staff.  Identified and developed action plans for operational needs.  Handled resolution of credentialing issues from Managed Care Organizations.  Facilitated the resignation and termination of physicians with the Provider Health Organization.  Acted as an administrative liaison for seven Provider Health Organization's.  Oversaw the accuracy of operational issues related to providers, and members in relation to referral processing, claims payments, capitation payments, fee schedules, dictionary updates and provider listings.         Computer Skills      Epic certifications in Resolute Hospital Billing, Home Health and SBO  Allegra  IDX  MIDAS  Passport/ECARE  Microsoft Word, Excel, and Powerpoint        Certifications      Revenue Cycle Training through HFMA   Six Disciplines of Breakthrough Learning  Developing Others  The Basic Principles of a Collaborative Workplace  Giving and Receiving Constructive Feedback  Designing Effective Learning Experiences   The OZ Principle   Accountability Training