Healthcare Analyst Resume

Title
Healthcare Analyst

Primary Skills
Comprehensive understanding of healthcare, medical billing, medical insurance, HIPAA, compliance issues, EDI

Location
US-TX-Irwin

Posted
Aug-13-07

Summary

Self-directed professional with a practical, results oriented approach. Eight years of management and three years consulting experience combined. Comprehensive understanding of healthcare, medical billing, medical insurance, HIPAA, compliance issues, EDI and information technology. Excellent written and oral communication skills. Highly effective organizational and prioritization skills. Able to relocate and travel. Experienced leader capable of coordinating or working on both large and small projects and work initiatives to ensure that goals and objectives are accomplished within established time frames and budget parameters.


Experience

2005-Present Cornerstone Medical Billing, Inc. Las Cruces, NM/Columbus, OH

President / Chief Information Officer / Certified Medical Coder (CMC)

Supervised billing and provided technical support for Electronic Healthcare Suite Intergy. Implemented firewall and VPN solutions. Coordinated upgrades and backups for client-server application. Monitored and trouble-shot hardware and software performance and EDI issues.

Coordinated with clearinghouses (WebMD and McKesson), insurance carriers, software vendors and regulatory agencies to ensure proper processing of more than $8,000,000 in medical claims annually.

Negotiated managed care contracts for higher reimbursement-achieving an average 20% increase from commercial carriers in 2006.

Created easily searchable and updateable large-scale custom document repository accessible via network, VPN or online connection-resulting in efficiency gains and cost savings.

Identified, collected and organized data from multiple sources to deliver monthly, quarterly, annual and ad hoc reports, highlighting areas for improvement in client financial performance.

Researched software vendors for client's new practice management suite; created detailed pricing model to assist in final selection; initiated RFP and negotiated contracts.

2003-2005 Santa Fe Natural Tobacco Co Santa Fe, NM
Developer Analyst

Designed and developed geographic information system application employing ASP.Net, VB.Net, XML, XSLT and .Net Web Services, allowing customers to locate stores carrying SFNTC products from the company website. Increased customer support satisfaction by 30% and call center response times by 50% within first month.

Monitored performance degradation during PeopleSoft implementation. Performed in-depth technical analyses to pinpoint cause of performance delays and application failures. Implemented changes to improve stability and performance, resulting in marked efficiency gains throughout the system.

Rewrote SQL and purged database of custom built CRM and B2B applications-increasing efficiency and preventing delays.

2002-2003 Independent Consultant Santa Fe, NM
Project Lead / Business Analyst / Developer

Led a fifteen-member team in the design, development and on-time implementation of an online HIPAA resource application for NaviNet Claims. NaviMedix began using the application nationwide to respond to HIPAA related support calls.

Pushed development of Bohannan Houston's web site to completion after it had stalled in-house for two years. Coordinated with department heads to gather requirements and with in-house graphic design and marketing staff to deliver comps and final product.

Transitioned Raven Talk-an environmental group with a strong print background but no knowledge of web design-to the web. Identified areas of weakness and authored individual training programs for graphic designer and typesetter in Adobe Photoshop Suite and GoLive, respectively.

Developed website and designed new online image for Sotheby's Intl. Realty Santa Fe, NM. Voted "Best Realtor's Website in New Mexico by the New Mexico Association of Realtors."

1997-2002 Casa Del Toro Bed & Breakfast Santa Fe, NM
Owner / Manager

Designed, implemented and maintained website and online marketing campaign

Negotiated vendor contracts and maintained monthly budgets-maintaining a positive cash flow both in season and off season.

Selected as Best Bed & Breakfast in Santa Fe by Money Magazine 2002.


Training & Education

Essential XSLT provided by Develop Mentor (12/2003).
PeopleCode, release 8.4, provided by PeopleSoft (08/2003).
Data Management Tools and Upgrade, release 8.4, provided by PeopleSoft (08/2003).
SQR, release 8.4, provided by PeopleSoft (08/2003).
People Tools I/II Accelerated, release 8.4, provided by PeopleSoft (07/2003).
Microsoft .Net boot camp provided by The Training Camp (03/2003).
Java workshop provided by Sun Microsystems (05/2001).
A.A., Business Administration and Computer Science, Palm Beach Community College, Lake Worth, FL (12/1994).


Keywords SQL, (MS Project, Word, Excel, Access) OLAP, MCDBA, MCSD.NET, MCAD, MCP # 2908586, CMC, EMR, EHR, EDI

Certifications
See above


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