Analytical and solution focused professional, leveraging previous management background and customer service experience, pivoting to HEALTH INFORMATION ADMINISTRATION with a drive to improve patient care and health administration in complex organizational environments. ➤ Credentialed RHIA – providing healthcare administrators with data queries, analysis and financial reporting for informed decision making, and recommendations for creative solutions to improve administrative processes.➤ Patient-Centered Administrator – pinpointing areas to help patients with Medicare and Medicaid and private insurance claims and medical reimbursements through analysis of medical records. ➤ Cross-functional Leader – understand relevant business processes, goals and strategy in order to provide analysis and interpretation to team members, cross-functional departments and executives.➤ Proficient Project Manager – personable and highly organized with meticulous attention to project deadlines, deliverables, ensuring all project stakeholders are informed and involved. ➤ Strong Communicator – articulate and tactful in communicating sensitive issues to management, adept in preparing presentations, reports and speaking to executives, peers, patients and service providers.TECHNICAL SKILLSMcKesson Star; AS400 database; One Content EMR; Google Analytics; Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook); MS Project Office✉ ✍ Welcome connections for professional networking.
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Loan AnalystValley View Home Loans Apr 2019 - Jun 2022Returned to lending industry while completing education and certifications to prepare to pivot career to Health Information Management. ► Consistently maintained excellent customer service with repeat customers & high application to call ratio of 1:3. ► Implemented more streamlined processes under management’s direction and reduced turnaround time on avg from 40 to 27 days and increased branch revenues by higher volume of loan closings per month. -
Data Validation SpecialistP3 Health Partners Oct 2018 - Apr 2019Las Vegas, Nevada, United StatesWorked with IT department to create, monitor and report Quarterly Part C ODAG files. Analyzed systems data and collaborated with IT department to correct data gap issues. Assisted with policy and SOP development via data monitoring. Conducted monthly Part C Organization Determinations, Appeals, and Grievances (ODAG) audit and performed health plans live audits. Determined CPT & HCPCS codes necessary for health plans prior authorizations.► Corrected erroneous or missing CPT or ICD 10 diagnosis codes to remain compliant with health plan and Centers for Medicare Services (CMS). ► Recommended programming changes to IT dept that resulted in cleaner data and more expeditious reporting -
Senior Management AnalystUniversity Medical Center Of Southern Nevada (Umc) May 2016 - Jun 2018Las Vegas, Nevada, United StatesConducted analysis of healthcare administrative, budgetary and private payer insurance related processes to pinpoint payment and reimbursement issues, quality of care issues and progress on key performance indicators. Assessed quality, utilization review and case management reports and prepared reports and presentations for management. Conducted audits of major payer accounts for over and under-payment of accounts. Submitted and conducted follow-up on out-of-state Medicaid provider enrollment applications. Created retrospective adjustment reports and recommended course for cure resulting in process changes. Conducted analysis of Medical Records for covered diagnosis to challenge denied claims. Reviewed claims with edits and applied necessary modifiers or coding changes in EHR.► Conducted audits of major payer accounts and identified payment errors resulting in hospital savings of $2.5M.► Conducted mass adjustments of bad and uncollectable debt resulting in reduction of Acct Rec by 3%. ► Recognized by the chief medical officer for process improvement in provider medical record documentation processes that led to a reduction in number of claim denials due to improper coding.► Commended by incoming CFO for superior effort in compiling financial report from each dept, piecing together archived data, filling in gaps of missing data and creating a cohesive story of the hospital’s historical finances. -
Branch ManagerFranklin American Mortgage Company Mar 2015 - May 2016Henderson, Nevada, United StatesEstablished Nevada office location in Southern Nevada for 12th largest direct lender in the United States. Supervised a team of 8 overseeing operations, hired and trained staff, handled customer relations, and met KPIs.► Found location for branch working with local commercial brokers, negotiated favorable lease terms and oversaw IT network setup; established first SW location in Henderson NV under budget and before due date.► Demonstrated leadership qualities to upper management, achieving $1M over initial projected revenues. -
Sr. Loan OfficerWj Bradley Financial May 2014 - Feb 2015Henderson, Nevada, United StatesReviewed customer financial information to determine eligibility, analyzed and interpreted regulations for compliance and worked with customers to find the best products suited to their needs. Supervised and trained junior associates.
John Gregory, Rhia Education Details
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Health Information Management -
Business Administration
Frequently Asked Questions about John Gregory, Rhia
What is John Gregory, Rhia's role at the current company?
John Gregory, Rhia's current role is Credentialed Registered Health Information Administrator ✷ Saving Costs through Data Analytics.
What schools did John Gregory, Rhia attend?
John Gregory, Rhia attended University Of Illinois At Chicago, Villanova University, Kaplan University.
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