Thomas Taylor Email & Phone Number

Raleigh, North Carolina

•Responsible for servicing North Carolina's health care providers and Trading Partners as part of the multi-program NC Medicaid Management Information System (NCTracks).•Guide Trading Partners through the onboarding and testing process for all 5010 ASC X12 HIPAA transactions (837, 270/271, 276/277, 835, 834. 820). •Ensure compliance for Trading Partners with ASC X12 Implementation and Companion Guide requirements by utilizing Edifecs’ Ramp Management (RM) portal.•Worked with CSRA Development on initiatives such as CAQH Phase I and II, ICD-10 CM implementation.•Developed EDI business processes in successful implementation of Medicaid Management Information System (MMIS), NCTracks. •Resolution of transaction errors, problem resolution, management, and connectivity issues.

-Managed the work and activity of Provider Service Consultant staff to include all operational and claim issues affecting health care providers.-Directed staff to track provider issues for root cause analysis, esclation, and closure. -Monitored staff performance including performance reviews. -Facilitated the preparation and analysis of reports.-Organized and managed key stakeholder business meetings.

-Manage the work and activity of EDI Field Consultant staff including, hiring, personnel activity, assignment, coaching, feedback management, performance and compensation review-Planned and executed training, educational seminars.-Managed statewide and out of state provider relationships.-Recruited, negotiated, and contracted with healthcare providers and EDI Trading Partners. -Promoted use of EDI marketplace solutions to healthcare providers.-Worked with strategic business partner, RealMed, in marketing their services and solutions to health care providers.-Educated providers on HIPAA X12 4010, 5010 transaction.

-Managed territory by serving as principal contact for healthcare providers, vendors, claims clearinghouses for all EDI issues. -Designed instructional curriculum and training materials for healthcare providers.-Responsible for marketing EDI solutions (HIPAA X12 transactions and Blue e web portal) to healthcare povders, vendors, and claims clearinghouses.-Worked with BCBSNC's Legacy and PowerMHS systems.-Conducted claims mining and audits in order to increase electronic usage rates > 90 percent for region.

Masters Of Business Administration, Business

Ba, Psychology

Education record

Education record