Payor Contract System Implementation: o Set up contract & data models for contract negotiation.o Build, interpret & validate Medicare, Medicaid, Tricare & commercial contracts.o Set up software rules for expected reimbursement calculation.o Revenue Cycle data mining.Report Writing: o Epic Clarity Data Model– Hospital Billing (HB) Resolute and Professional Billing (PB) Resolute o Write reports for HB and PB Resolute pertaining to Revenue Cycle, Expected Reimbursement Contracts and Claims with WebI Universes and Star/Caboodle Schema, SQL, Crystal Reports. Business Process Improvement & Customized Training Specialties• Data migration• Testing/Documentation• Contract coding • Crystal Reports writing/conversions • SQL Queries & Data Modeling• Data Flow/Process Mapping• Data/Business/Systems Analysis

Epic HB Contracts o Medicare standard Epic setupo Complex commercial interpretation of written contractso Set up components, extensions, component groups, fee scheduleso Test contract results

Epic HB & PB Expected Reimbursement Contracts.o Set up components for Hospital Billing and Professional Billing Commercial, Tricare and Medicaid contracts. o Test contract calculations. o Hospital & Professional Billing Clarity Report Writing.

Epic Resolute Hospital Billing (HB)/ Expected Reimbursement Contractso Build rate summaries for 25 agreements representing 80 Epic contracts.o Plan, build & track components, extensions & fee schedules for HB contracts.o Test contract calculations.

Epic HB Expected Reimbursement Contracts & Contract Modelingo Create final reports from Contract Modeling Datao Interpret payor agreements into Epic build.

o Lead analyst and contract programmer for Hospital System’s conversion from Ascent 10 to NTT Optimum. o Analyze contracts, convert data to new system, test for accuracy. Document process. o Update & maintain governmental contracts for Worker’s Compensation, Tricare, and Medicare, as well as commercial contracts upon request.

o Monitor Ascent® interfaces.o Maintained governmental contracts for Worker’s Compensation, Tricare, and Medicareo Tested governmental contracts to assure accurate calculationso Updated and maintained complex commercial contracts upon request.o Converted and wrote new SQL, 5r and Crystal reports for Managed Care

o Monitor Ascent® interfaces.o Maintained governmental contracts for Worker’s Compensation, Tricare, and Medicareo Tested governmental contracts to assure accurate calculationso Updated and maintained complex commercial contracts upon request.

o Assisted with payor contract management conversion: Ascent® to Concuity®.o Standardized insurance codes & reimbursement rates.o Set up software rules for reimbursement methodologies.

Provided object-oriented analysis/design, coding and testing of company’s proprietary hospital management software application. Defined, wrote and managed requirements for a major section of this groundbreaking application.