Roger Macias Email & Phone Number

Irvine, California

Orange County, California Area

Responsible for the management of day to day operations that include, Virtual Card, Electronic Check, and EFT healthcare claim payment product utilizing the HIPAA Compliant, ACA Section 1104 EFT & ERA Operating Rules Compliant NACHA CCD+ with X12 835 ERA (Electronic Remittance Advice), integrated with the largest ACH network and national healthcare clearinghouse.Oversee client and vendor specific implementations and other projects that include the scope, schedule, cost, resource allocations, and ongoing communication to upper management and key stake holders.Management of onshore and offshore client services and provider relations operations. Implemented and Manage SSAE 16 SOC 1 compliance and ongoing controls audit. Manage business priorities with Information Technology to include functional requirements, QA, and User Testing through deploymentOperational efficiency business projects that reduce cost and increase bottom line revenue

Title: Senior IS/IT Project Manager / PMO Responsibilities: Project manager for all aspects and phases of Capital and Operational IS/IT project implementations. Served as the liaison between various operational and product owners, members of the sales team and technical experts. Supported development managers with various project management activities/tasks with an emphasis in areas where my contribution would improve the effectiveness and efficiency of the mangers. As part of the IT management team, I assisted in managing the IT organization by bringing its operational aspects under tighter control and providing clear visibility / transparency for ongoing improvements. Responsible for coordinating financial aspects of IT operations such as monthly, quarterly and yearly budgeting, vendor invoices, internal and contractor headcounts by using spreadsheets / internal tools. Worked in partnership with internal financial and regulatory compliance teams to coordinate monthly, quarterly and yearly reports, document and process reviews. Additionally, I program managed the CMS regulatory compliance projects for 5010 and ICD-10.

Title: Client Implementation Manager (Project Management)Responsibilities: Managed the client implementation department with direct reporting to upper management. Primary sales engineer for account management and sales executives and point of contact for providing pre-sales technical assistance and product education. I was responsible for leading and managing projects through successful completion, including coordination of the activities of project contributors in order to achieve the desired goals in a timely and cost effective manner. I was also responsible for training new project managers on EDI processes, procedures and interpretation. Additionally, I was tasked with project managing and interpreting customer business requirements in an effort to anticipate and exceed their future needs for Commercial Healthcare, Workers Compensation and Automotive Health. This process included the implementation of Repricing Systems such as Batch EDI 837, Real Time EDI, WebMD (now Emdeon), Outbound EDI from scanning, Rate Load, Claim Export file and ongoing Data verification (Demographics, Rates, Eligibility 834 files). As well as responsible for quality assurance and verification of raw data files to comply with HIPAA requirements or approved proprietary formats. I served as a liaison between members of the sales team and other technical experts.

Business Administration With An Emphasis In Management

Business Administration With An Emphasis In Management