Integration Manager

• Jun 2022 - Present

Senior Product Support Engineer, Integration Services

• Apr 2020 - Jun 2022

Product Support Specialist

• Aug 2019 - Mar 2020

•Product expert for internal SQL-based pricing tool •Collaborated with Product Managers and Developers to solve application issues and develop product capabilities •Managed JIRA queue to track and resolve complex product issues for internal teams •Read and debugged SQL code to identify errors, bugs or inconsistencies. •Developed and recommended code changes to improve application performance and accuracy •Lead internal product trainings about application infrastructure and… Show more •Product expert for internal SQL-based pricing tool •Collaborated with Product Managers and Developers to solve application issues and develop product capabilities •Managed JIRA queue to track and resolve complex product issues for internal teams •Read and debugged SQL code to identify errors, bugs or inconsistencies. •Developed and recommended code changes to improve application performance and accuracy •Lead internal product trainings about application infrastructure and best practices

Senior Consultant

• May 2018 - Aug 2019

•Managed and trained project teams of Associates and Analysts to perform payment reviews in order to identify reimbursement inconsistencies •Analyzed contract language and fee schedules to audit hospital account volume to ensure reimbursement accuracy •Manipulated data using Microsoft Access to find trends and opportunities for revenue cycle improvement •Conducted research in client systems including Epic, Cerner, Concuity and McKesson to identify underpaid claims •Reviewed claims… Show more •Managed and trained project teams of Associates and Analysts to perform payment reviews in order to identify reimbursement inconsistencies •Analyzed contract language and fee schedules to audit hospital account volume to ensure reimbursement accuracy •Manipulated data using Microsoft Access to find trends and opportunities for revenue cycle improvement •Conducted research in client systems including Epic, Cerner, Concuity and McKesson to identify underpaid claims •Reviewed claims for billing and coding accuracy according to ICD-10 and CMS guidelines and makes appropriate billing/coding changes in nThrive Claims Management system •Prepared and presented findings and recommendations to client contacts (i.e. CFO, VP of Revenue Cycle, Director of Patient Financial Services) •Knowledgeable in ICD-10, CPT, HCPCS, DRG claim data •Lead recruiting efforts for out of state universities and colleges including resume review and phone screens

Consultant

• Aug 2016 - May 2018

Intern

• Jan 2016 - May 2016

Policy Analyst Intern

• Jun 2015 - Aug 2015

•Conducted research and produced a demographics report on the changing landscape of Independence’s market •Performed data analysis to project how Independence’s market will change in the next 15 to 20 years. •Presented data-driven findings and recommendations to Senior Executive Management. •Conducted research and produced a demographics report on the changing landscape of Independence’s market •Performed data analysis to project how Independence’s market will change in the next 15 to 20 years. •Presented data-driven findings and recommendations to Senior Executive Management.

Business Analyst Intern

• Jun 2014 - Aug 2014

Finance and Billing Department •Reconciled member rates and billing processes, confirmed accurate billing adjustments, reconciled billing discrepancies. •Calculated member rates and adjusted against Federally Facilitated Marketplace (FFM). AmeriHealth NJ Summary of Benefits and Coverage Audit •Reviewed summary of benefits and coverage updates for over thirty coverage plans, concluding in presentation of findings and recommendations to the AmeriHealth New Jersey Product… Show more Finance and Billing Department •Reconciled member rates and billing processes, confirmed accurate billing adjustments, reconciled billing discrepancies. •Calculated member rates and adjusted against Federally Facilitated Marketplace (FFM). AmeriHealth NJ Summary of Benefits and Coverage Audit •Reviewed summary of benefits and coverage updates for over thirty coverage plans, concluding in presentation of findings and recommendations to the AmeriHealth New Jersey Product Manager. •Presented bi-weekly project updates to senior leadership for Health Care Reform Forum via PowerPoint presentations. Independence Blue Cross Internship Program Project •Developed solutions for the Innovation Department on how to communicate their work across the company effectively. •Presented findings and recommendations to senior leadership. Show less Finance and Billing Department •Reconciled member rates and billing processes, confirmed accurate billing adjustments, reconciled billing discrepancies. •Calculated member rates and adjusted against Federally Facilitated Marketplace (FFM). AmeriHealth NJ Summary of Benefits and Coverage Audit •Reviewed summary of benefits and coverage updates for over thirty coverage plans, concluding in presentation of findings and recommendations to the AmeriHealth New Jersey Product… Show more Finance and Billing Department •Reconciled member rates and billing processes, confirmed accurate billing adjustments, reconciled billing discrepancies. •Calculated member rates and adjusted against Federally Facilitated Marketplace (FFM). AmeriHealth NJ Summary of Benefits and Coverage Audit •Reviewed summary of benefits and coverage updates for over thirty coverage plans, concluding in presentation of findings and recommendations to the AmeriHealth New Jersey Product Manager. •Presented bi-weekly project updates to senior leadership for Health Care Reform Forum via PowerPoint presentations. Independence Blue Cross Internship Program Project •Developed solutions for the Innovation Department on how to communicate their work across the company effectively. •Presented findings and recommendations to senior leadership. Show less