Healthcare Applications Consultant Resume

Title
Healthcare Applications Consultant

Primary Skills
20+ years Healthcare, medical computer software, revenue and clinical experience

Location
US-IA-Cedar Rapids

Posted
Feb-16-09


Qualifications:
Certified Professional Coder since 1998
20+ years Healthcare, medical computer software, revenue and clinical experience
Skilled in learning concepts quickly and under pressure
Strong Revenue Cycle and Decision Support / Management skills
Experience:
2006- Mar 2009 Client Services Consultant Keane, Inc Cedar Rapids, IA
Managing the overall product direction for the applications, requiring travel to client sites for implementation and training.
Support, analysis and design of Healthcare application software per client specifications.
QA testing and Implementation of 4 Beta Products simultaneously, acting as Project Manager.
Position requires a high degree of self-education to learn the software and understand the functionality to train and problem
solve it for the clients.
Installed and trained the Beta EMR, HIM, Refund, 835, 270/271 and Scheduling Products being self educated.
After 1 month was assigned Lead for Keane's largest client, after 2 months assigned responsibility for training new hire.

2005-2006 Project Asst Compliance University of Iowa Hospitals and Clinics Iowa City, IA
Analysis, auditing and compliance review for Physician Documentation and Coding, requiring knowledge and use of 15 software programs including IDX Flow Cast,/Care Cast, 3M, McKesson, software
Extensive claims and denial management knowledge to develop a decision support process
One on one education for Cardiology MDs / Interns on Compliance, Coding, Self Audit Process
Implemented claims appeals, a new concept for the dept. Used this concept for presentations for Board meetings.

2000-2005 Reimbursement / Office Manager Mercy Services Iowa City, IA
Management of the A/R and Reimbursement for 14 Physician clinics
Member of the PHO Contract Board Team that negotiated the Insurance Payer Contracts for our region.
Analysis of All claims and appeals for Mercy Services, implemented a process for the CBO staff to identify claim issues.
Provided Chart audits, compliance reports and monthly education for all 14 clinics (45 Providers and 120 staff).
Decreased AR days from over 120 days to less than 45 days in under 4 months.
Demonstrated how improved coding and claim management could generate $9,000 in 60 days.
Expanded clinic hours and increased staff from 5 MDs to 7 MDs
Became the go-to person for Medical Manager software support for clinics.

1998-2000 Billing Administrator Radiology Consultants Cedar Rapids, IA
Grew the Radiology Physician group from 9 to 14 sites statewide.
Increased physician base from 14 to 22 and increased staff from 9 to 19 in 2 years.
Performed credentialing for all of Physicians
In charge of staff hiring, education and compliance education
In charge of medical software computer conversion and implementation
Managed the 18 million dollar A/R, the financial reports, staff, claims and refund process
Visited the local hospitals we served to educate them on Payers policies and how important diagnosis
coding is in Radiology which in turn decreased our claim denials and improved the Hospitals' revenue.

1988-1998 Billing Manager, System Support, Trainer Iowa Health Physicians Cedar Rapids, IA
Started as Billing Manager for Pediatric Assoc. with 5 MDs then helped the organization grow into the Iowa Health System over 200 providers.
Managed billing, coding, claims denials, payer contracts, and system support
Completed 3 computer conversions, served as lead trainer and support for staff for each conversion
Implementation Team Lead that converted 60 clinics from old software programs over to IDX GPMS during the state wide implementation
Completed AAPC's Coding Certification to handle the new specialties and Revenue Management in 1998.
*Analysis of revenue reports and presentations to the Physician Board.
Increased revenue by improved claims management and coding for NICU and Cardiology and Internal Medicine


Education:
University of Northern Iowa
American Academy of Professional Coders
Kirkwoood Excel, Management Series, Accounting
Certified Medical Office Management (PMI)
Compliance (PMI) Toastmasters

Certifications
See above


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