* Supports multiple Central Billing Office (CBO) applications.* Accountable for the file transfers to multiple contracted vendors using FTP procedures both manually and automated.* Monitor and maintain automated scripted tasks. Report and repair failures as the occur. * Address and resolved Service Now tickets to assure SLA are meant.* Created and distributed reports and spreadsheets. * Assists users in determining functional requirements by analyzing current workflow and, to ensure processes are automated.* Tracks and reports the status of assigned implementation tasks* Alerts management of any issues or barriers that cannot be resolved by the team* Analyzes and manages resolution of system incidents with complex problems based on priority to minimize the impact on business operations.

* Input all requirements of specific payer contracts into Meditech and modify dictionaries as needed* Worked with Patient Financial Services, Patient Registration, and other departments to ensure staff is educated on how information needs to be entered in Meditech* Responsible that all contractual language is correctly interpreted and loaded into Meditech in a timely fashion* Identified and resolves problems as identified by Patient Financial Services. Maintains A/R so it is kept below industry average.* Monitored reimbursement and identifies problem areas. Implements action plans to correct problem. * Facilitated improvement processes with patient accounts and collections* Evaluated major contracts semi-annually and all contracts as deemed necessary* Loaded expected reimbursement rates into the information and/or contract management system.* Compared payment to expected reimbursement and identifies under-or overpayment issues* Monitored collections by the Patient Financial Services staff for problem areas and opportunities for improvement* Ensured coding system optimizes revenue for organization compliance* Reported regulatory to Corporate Affairs Administrator and Finance Department* Arranged training for managers around fiscal productivity and product management

* MEDecisions Case Management system. Single point of contact for any problem or issue. * Responsible for communicating any required changes to the business. * Planed and implemented any required upgrade as needed* Maintains the E-Talk Vice Recording System to assure calls are captured for appeals and Quality Assurance purposes* Responsible for the Cactus System for the implementation and scheduling patches upgrade to the Cactus application as required* Troubleshoot for users of Med-Decisions, E-Talk and completing projects for our Medical Directors, nurses, Claims managers and Member Service Departments* Required to work on all system configurations meeting strict and aggressive timelines during regular hours and off hours on call 24-7* Oversaw multiple system configurations, facilitates meetings to deliver 100% accuracy while maintaining deadlines* Completed upgrade projects: Conducts yearly upgrades of MEDecision Autocoder application with new CPT codes for use by our Utilization Management Department* MEDecesion Win Reports upgrade from various versions for the MEDecision Reporting application that included the implementation of a new report service as well as database server for the UM Actuarial department.* Implemented and upgraded McKesson’s Cerme web- based application to interface with MEDecsion’s applications for the Case Management department; Cache Database upgrades with an implementation of new WinUCS serve. * Made necessary upgrades to meet new system requirements and prevent comparability issues.

* Operated and monitored mainframe computers and associated peripheral equipment required to do batch processing on a wide variety of applications in a real-time, online environment via disk or tape* Provided ongoing technical support to internal personnel and users on supported softwarePrepared daily backups, check runs, and produced member I.D. Cards using “Data Card Embosser” and ran and matched explanation of Benefits* Advised end-users on what is technically possible and identified barriers to determine how to achieve desired report and screen formats* Solved production problems as they arouse for online systems* Clarified training and scheduling needs to acquaint end- users with new system enhancement* Knowledge with DOS.Lotus 1-2-3, Windows 95, Microsoft Mail* Knowledge with DEC VAX/MS, IDX and MACESS* Peripherals-IBM Laser Printers 4245 & 4800, Printer Server 32/Plus, Zerox Printer, Microfiche, Automatic Tape Library, Controllers 3745, 3746, Communication Controllers, Modems, 2914,3814,3840, Tape Drives TZ887, TSZ07, TK760 and Optical Scanners