Sasha Goodwin, Mfa, Rhia, Cpc-A Email & Phone Number

Auburn, Me, Us

Pittsburgh, Pennsylvania, Us

Analyzing Medicaid and Medicare directives to translate policy into automated claim processing solutions. Configuration of benefits and pricing. Troubleshooting claim issues. Gathering requirements for HealthEdge member benefits configuration. HealthEdge Health Rules Payor configuration. Burgess and Altruista/Guiding Care configuration.

Evergreen, Co, Us

Contract-to-hire at Highmark Health. HRP configuration. Legacy system maintenance. Resolving complex business issues to achieve agreement across departments.

Bellevue, Washington, Us

Veeva Vault RIM implementation. Business analysis of current and future states. Leading system functionality and optimization discussions with vendor. Development of testing scripts and testing.

Oakland, California, Us

Ensured adherence to corporate policies and data quality within the compliance, privacy and ethics information systems. Reviewed monthly reporting and performed annual compliance program reports. Investigated billing alignment with regulatory guidelines to ensure compliance with CMS and OIG work plans.Key Achievements:✔ Conducted 36+ data quality checks; performs ongoing system testing. ✔ Successfully standardized data compliance of 150 data definitions. ✔ Delivered 40+ reports to track compliance and decision support for executives. ✔ Demonstrated strong teamwork skills by coordinating training for 300+ employees to create and revise policies through Lucidoc application.✔ Acquired Professional Coder Certification (CPC-A) in Spring 2018.

Seattle, Wa, Us

Served as the project lead to redesign workflow and train clinicians to detect and mitigate identity and subsequent documentation errors in a high-volume hospital database of confidential records. Resolved patient identity errors and ensured accurate information for regulatory audits. Key Achievements:✔ Streamlined operations by investigating and resolving 250+ identity errors witin electronic health records. ✔ Facilitated and implemented 38+ enterprise-wide processes and workflows in the Emergency Department and clinic. ✔ Identified operational errors in Epic from the Anesthesia and Radiology Data Systems; implemented workflows and resolved issues across 4 systems. ✔ Successfully trained 100+ ambulatory nurses to detect and resolve incorrect patient record selection.

Provided strategic direction and resolution of complex business problems with automated systems. Provided technical expertise by identifying, evaluating, and developing systems and procedures in planning for and testing system changes. Trained providers and their staff to submit Medicaid claims to Molina.Key Achievements:✔ Led training and outreach program for 500 providers for the Molina Idaho Medicaid QNXT 4.6 claim processing system implementation. ✔ Created system solutions for 33+ complex healthcare organizations across Idaho, USA. ✔ Provided key knowledge to Medicaid providers and vendors to facilitate claim submission and use of web-based portal systems.

Seattle, Washington, Us

Managed and coordinated design, development, implementation and enhancement of critical applications across diverse platforms. Partnered with the Escalation Team to identify, evaluate and analyze workflows to create effective solutions. Other tasks included analyzing business requirements, creating documentation, and leading implementation of QNXT system for claim processing issues within agreed timelines. Key Achievements:✔ Implemented IT system controls to configure claims processing software and developed 400+ test cases for government and commercial products for WA and OR. ✔ Proactively contributed to 75+ contracts, benefits, and group configuration projects.✔ Successfully maintained client relationships by developing new procedures and training curriculum for 50 claim analysts.

Certificate, Health Informatics

Master'S Degree, Creative Writing

Ba

Cpc, Medical Coding

Bachelor Of Arts - Ba, Creative Writing