Brian Spiker Email & Phone Number

Fairfield, California, United States

- Oversees preparation of monthly state Department of Health Care Services (DHCS) revenue reporting; ensures accuracy of rates, special accruals, and membership and reconciliation of payment. - Oversees monthly health care cost reporting process; ensuring accuracy of underlying claims expense and reporting of Incurred but Not Reported (IBNR) estimates. - Perform reconciliations, budget variance and trend analyses as needed. Reconcile global sub-capitation provider’s Consolidated Supplemental file records to the DHCS 820 File to ensure pass-through payment accuracy. - Lead financial analysis team efforts to provide support for year-end financial and external regulatory audits or surveys. Provide support for the annual DHCS Rate Development Template (RDT) process. - - Assist with medical loss ratio data collection and reconciliation. Participates significantly in the development of the annual health care cost budget; reviews monthly budget preparation; monitors actual to budget on a monthly basis and researches significant variations. - Participates in the review, procurement, planning, implementation, and upgrading (testing and validation) of PHC claims system. - Create data sets, extract, synthesize and validate data; perform qualitative and quantitative analyses.

San Francisco, Ca

• Responsible for building a financial reporting team to support the CFO for all activities associated with the financial management, budgeting, business analysis, and financial planning of the medical foundation• Managed the medical foundation’s monthly close process which included pulling monthly physician charges from multiple complex data sets in order to book monthly revenue • Calculated the physician service agreement in accordance with the contractual arrangements• Re-energized the monthly recurring reporting process by streamlining the existing reports and eliminating duplicative or unused reports

San Francisco

• Collects, analyzes and synthesizes complex data sets for adhoc and monthly reporting using Microsoft SQL Server. Reports are created and presented to all levels of the organization to assist in complex payment models for healthcare provider networks. • Lead analyst for preparing the annual Rate Development Template for the Department of Health Care Services. This process includes coordinating efforts between multiple departments, delegating tasks, reviewing deliverables and presenting and delivering final product to executives and regulatory agencies. • As the co-chair of the Data Stewards committee I am responsible for defining and implementing reporting policies, assisting in the creation of the business data dictionary and engage in ongoing identification of data quality anomalies and the contribution to implement corrective measures. • Worked as the Sr. Business Lead with many cross-functional teams including, the implementation of Affordable Care Act Section 1202, the ICD-9 to ICD-10 conversion and assisted with the creation of an Analytical Data Warehouse. Projects included becoming the subject matter expert and gathering criteria, writing Business Requirement documents, user acceptance testing and quality checking the final product. • Member of the implementation team tasked with integrating MicroStrategy Business Intelligence tool. Wrote and created the documentation for FFS PMPM CKPI metrics which included In Patient, Out Patient and Emergency Department attributes. Provided ongoing training and technical assistance for business users.

Santa Rosa, Ca

• Established and implemented a weekly, monthly, quarterly and annual reporting process to assist managers and directors in maintaining divisional financial viability by writing SQL Server queries to pull, analyze and manipulate financial data. • Created a bi-weekly physician payroll process for three different compensation models using MS Access reducing the payroll by 2 business days and reducing payroll errors by 5-10%. • Calculated monthly physician productivity using revenue cycle financial data, pulled from SQL Server, to support the executive team in physician recruitment, physician contract negotiations and overall organizational decisions. • Maintained, monitored and edited the local database in MS SQL Server housing 5 years of revenue cycle data. Also maintained the reference tables used to assist in monthly physician service agreements and productivity calculations. • Reviewed monthly close and reporting by evaluating SQL queries to troubleshoot, optimize, and tune SQL processes• Lead analyst in the transition from IDX data warehouse platform to an EPIC platform by writing and validating SQL scripts, updating reference tables and establishing bridge tables to ensure a seamless transition.

Analyze data from the IDX Billing and Accounts Receivable, and SCHED data warehouse applications used in patient billing. Responsible for preparing ad hoc and reoccurring reports per the direction of the clients on a daily, weekly, monthly and quarterly basis. Prepared financial, patient data, visit count, operational and summary reports. Data analysis done with MS access, SQL Query Analyzer and MS Excel.