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Proven ability to create and deliver solutions tied to business growth, organizational development and systems/network optimization. Skilled problem identifier and troubleshooter comfortable managing systems, projects and teams in a range of IT environments. Investigate and track fraud, waste and abuse cases. *Create and maintain comprehensive project documentation, a comprehensive knowledge of health and administrative procedures, orthotic DME, Credentialing URAC, NCQA, CMS, CHIPRA, Management, entering code in the encoder and abstracting system, following all guidelines AHIMA, AAPC. • Computer Skills: Microsoft Office (Word, Excel, Access, Symantec Firewall and backup Exec Power Point Outlook), Data entry, advanced web researching and social media, programming, software and security.
• Healthcare Fraud Shield. Electronic Health Records (EMR’s) Spring Charts, SRS, SQL, ETL, Splashpad, QSI/QSHR, Altegra, OMS, HORIZON, CRM, AMISYS, ,MCKESSON, HEDIS, ACCESS, Microsoft Applications, MedInformatix, ONLINE PLUS,SCHEDULING, JIVA, JAVA, FACETS, SHARE POINT, MAX MC, MILLIMAN, AIM, SIEBEL, TruCare, BOCRIS, SAEKG’S, Cardio Science, CRM, Amisys, TruCare, Portico, Compliance 360, Emdeon, DataCap (FileNet) • Medical Terminology & Administrative Support, Medical Records, Data Entry. Coding & Billing, Medical Records Charting, Provider Complaints, Medical & Clinical Intake, Auditing, Written and Verbal, Appeals, Claims, Authorizations, AR, Adjustments Scheduling, Educator, Insurance, Denials, Grievances, Pre-Existing, Assessments, Version P6 Scheduler, Tru-code, MS-DRG & APC Reimbursements.• Coding & Billing, Abstracting Medical Records, Data collection, Worked with Vendors ,Provider Complaints, Solutions, Relations, Charting, Filing and Patient Intake, Medical & Clinical Intake, Auditing, Written and Verbal, Appeals, Claims, Authorizations, AR, Adjustments Scheduling, Educator, Insurance, Denials, Grievances, Pre-Existing, Assessments, Version P6 Scheduler, Tru-code, MS-DRG & APC Reimbursements. Coordinate with other departments. Involved in project analysis and configurations.
• IT Network Systems Administration, Technical Support, SQL, Front End Web Development, JAVA, HTML, Designed Websites, Technical, Solutions, Relations, Microsoft Project, Visio, Raptor, Microsoft Project Management, Access, Physician Practice Management, IT infrastructure, Multiple Platforms, LAN/WAN/NOC Administration, Workflow Planning, Systems Installation, Cyber Security, Configuration, Upgrading, Security Solution, Database Design and Management, NOS Patches & Updates.
Accomplished systems administrator with years of experience managing server infrastructures and data-center operations across multiple platforms (UNIX, Linux, and Windows). Effectively plan, install, configure and optimize the IT infrastructure to consistently achieve high availability and performance.
LAN/WAN/NOC Administration, Project Management, Workflow Planning, Productivity Improvement, Technical Support, Systems Installation, Configuration & Upgrading, Security Solutions, Database Design & Management, NOS Patches & Updates, Training & Mentoring.
*Develop a detailed project plan to monitor and track progress. Manage changes to the project scope, project schedule, and project costs using appropriate verification techniques. Measure project performance using appropriate tools and techniques. Report and escalate to management as needed. Successfully manage the relationship with the client and all stakeholders. Perform risk management to minimize project risks. Establish and maintain relationships with third parties/vendors
Worked in outpatient (retail) pharmacy services; assisting customers with insurance, billing, typing using/decoding health care coded prescriptions, helping drive thru customers using efficient as well as quick service to ensure understanding if confusion.
Worked in inpatient (hospital) setting; assisting nurses on multi floors and areas, filling automated dispensing machines, working in the emergency room talking with a patient (and or family/assisted living/pharmacy) to get medical history to work with doctors and surgical staff.
Working in Assisted Living Pharmacy Service which is a blend of assembly and all of the above. Every department works together. Currently filling based on orders for each patient in any of the over 400 facilities. Each order goes through customer service, Pharmacist needs to be verified, checked again, and sent to routing, any and all of them can also have medication bingo cards that need to be filled as well.
Multi-talented professional seeks perfect opportunity
Performance-driven with 20 years of professional work experience in competitive and rapid-changing environments. Ability to set tone and lead with a vision. Strong organizational and prioritization abilities. Known for problem-solving and independent decision making. High level of ethics, values, integrity, and trust.
Healthcare - Web & Mobile App Solution
Whether you’re launching for smartphones. tablets, desktops or notebooks, we bring our class-leading engineering skills to ensure the right app for the right platform and user Thanks for visiting the profile & going through the details, feel free to contact for a discussion on your requirement, queries, suggestion, value addition.
Revenue Cycle Manager
I founded Capital Revenue Consultants to help small private physicians maximize their revenue. There are so many changes in the healthcare industry forcing many doctors to sell their businesses and merge with hospitals and large medical groups. I want to work as an advocate for these physicians and help them regain their independence. Let me know how I can help!
I would love to offer a helping hand in any area that needs attention to maximize revenue. I’m a certified medical coder and auditor and have worked in the healthcare industry for over 6 years. In addition to managing the full revenue cycle, I also specialize in revenue recovery projects, where I work exclusively on lowering A/R to recoup revenue on all eligible outstanding claims. I can also reconcile and audit claims to identify discrepancies to increase revenue.
Skilled Registered Nurse with 18 years experience recognized for the consistent application of strong clinical judgment across a wide variety of cases and settings.
Highly proficient in administering direct nursing care in a 22-bed surgical/trauma ICU, including invasive hemodynamic monitoring, CRRT, IABP, ECMO, invasive and non-invasive ventilatory support, induced hypothermia, pharmacologic hemodynamic manipulation, palliative care, and specialty bed therapy.
Extensive experience as an Operating Room RN and scrub nurse providing direct patient for surgical procedures including trauma, emergency/general surgery, laparoscopic, cardiac, thoracic, vascular, transplant, plastic, neurosurgery, ENT, oral, ortho, and urology.
Continuous Improvement Leader
People, Process and Performance Leader
– Highly collaborative, people-centric leader with a proven record of elevating and sustaining associate and organizational engagement and productivity. – Expertise in motivating call center staff – Extensive domestic and international recruiting /talent acquisition experience, personally conducting over 1100 virtual and F2F interviews with domestic and international candidates focused on the Behavior Based Model. – I have played integral roles as a central POC for organizational talent acquisition initiatives onsite domestically and onsite overseas. – I’m a pioneer and build process from the ground up: It’s what I did for 5 years in El Paso, Manila and Hyderabad. It’s how I helped create the Dedicated Teams project service model, too.
Customer Service Management Professional
During my extensive Customer Service career, I have applied my proven expertise and ongoing professional development to meeting and exceeding all objectives put before me. The examples from my resume represent the absolute value I can deliver in this new role.
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