Melissa Hix Email & Phone Number

Mason, Ohio, United States

Mason, Ohio

Provide project management and business systems analysis expertise for IT projects and initiatives. Manage both onshore and offshore development teams.

Direction of reimbursement methodologies, claims adjudication processes (within Facets), and payment mechanisms for timely and accurate claims payment.

Provided business relationship management, solutions design and development, production research and resolution, and system and process discovery for claims processing, claims configuration, provider data integrity, credentialing, and provider appeals.

Conducted elicitations with clinicians to capture business requirements for enterprise clinical toolbox (web-based tools). Analyze administrative health care and disability data, methodologies, and business logic; make recommendations based on analysis findings. Develop and maintain business requirements documents and investigate report and data issues.

Beavercreek, OH

Healthcare Information Technology Consultant responsible for research and requirements analysis for clients Electronic Health Records (EHR) application. Conduct elicitations with healthcare providers and clinicians to understand and capture workflow, processes, and capabilitites.

Founding manager of newly formed Business Partner Services (BPS) team, Business Relationship Management concept. Created BPS methods, processes, Service Level Agreements (SLA’s), and workflow tools to capture new project requests and prioritize strategic initiatives. Consult and collaborate with executive management, all business units (Finance, HR.

Responsible for strategic direction of web development and EDI teams. Implemented all EDI transactions and created EDI standards in support of claims payments and member eligibility. Responsible for development and implementation of all websites and web transactions.

Responsible for the implementation of all sales variable compensation plans within the sales compensation application. Gathered requirements, develop functional specifications and test plans for all sales plans. Provide technical support for sales compensation system, which includes user maintenance, installation of software, troubleshooting system.

IT consultant providing project management and business systems analysis expertise to clients in arena of consumer products, telecommunications, and software developement.

IT consultant providing business process analysis, systems analysis, process modeling, process improvement and quality assurance in DoD arena.

Evaluated software development standards and procedures to ensure adequacy and completeness. Examined products, processes, and procedures throughout the software development life cycle to ensure compliance with contractual requirements and interpreted standards.. Interfaced with the Independent Verification and Validation (IV&V) on audits and reviews as.