Experience

Jopari Solutions, Inc.

• United States
• Information Technology & Services
• 1 - 100 Employee

• Manager -Provider Technologies

  • Sep 2017 - Present

• Senior Business Analyst

  • Oct 2016 - Sep 2017

• Business Analyst

  • Apr 2012 - Oct 2016

  Work with a variety of submitters including Healthcare Providers, Pharmacies, Clearinghouses, Vendors, Practice Management Systems, and other eBill Companies to create a reliable route to send and receive EDI healthcare transactions in compliant ANSI X12 format.Create and implement payment processing capabilities for workers compensation payers including bill processing, issuing check/EFT payments, and transmitting ERA 835 files back to the submitting entity.Manage projects from concept through implementation and followup.Create Business Requirement Documents to ensure client and employer expectations are outlined and followed.Maintain strong working relationship with clients through regular meetings and follow throughPerform end to end testing, evaluate and communicate results.Coordinate project timelines between Development, Quality Control and Support.Conduct product training



Rycan

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• EDI Analyst

  • Aug 2011 - Feb 2012

  Manage all EDI (Electronic Data Interchange) functions for internal customers who include hospitals, clinics, and individual providers. Provide an electronic connection between providers and payers in order to simplify their business processes, and provide increase revenues and decreased costs associated with the revenue cycle. Track claim and EOB counts to ensure an ROI for our customer’s as well as improve the business’ bottom line.Responsibilities Create and maintain EDI file transfer download/upload jobs using FTP/SFTP and PGP encryption. Ensure timely processing of all files processed through the clearinghouse. Process and trouble-shoot failed claim submission, response, and remittance files. Enhance and expand payer availability by setting up new payer connections. Gathering and maintaining trading partner agreements with multiple vendors, clearinghouses and payers. Communicate payer downtimes to appropriate staff and/or customers. Create and implement a process and procedure to handle all EDI (Electronic Data Interchange) transaction enrollments.  Create and maintain database of EDI enrollment forms using Adobe Professional.  Maintain proficient knowledge of ANSI X12 transactions including but not limited to 835, 837, 270/271, and 276/277 in both 4010 and 5010 versions. Provide product documentation using Component One’s Doc-to-Help. AccomplishmentsEstablished a business partnership with a major clearinghouse to enable Rycan to submit and receive electronic transactions with Workers Compensation payers.Obtained direct connections with 2 payers within one month that immediately reduced expenses by $7,000 a year and increase Rycan’s bottom dollar. This cost savings grows exponentially as Rycan’s claim volumes increase.Successfully transitioned to 5010 compliance for healthcare transactions before the deadline of January 1, 2012

• Account Manager

  • Jul 2007 - Aug 2011

  Implement, manage, and maintain customer accounts and provide solutions to hospitals and clinics regarding their revenue cycle. Ensure client satisfaction and prompt response times. Responsibilities Manage and maintained up to 55 hospital/clinic accounts using Microsoft CRM.  Handle telephone and email support.  Conduct online software training with customers.  Provide product documentation using Component One’s Doc-to-Help.  Conduct software testing and troubleshooting using Microsoft LiveMeeting. Maintain proficient knowledge of ANSI X12 835 transactions. Maintain working knowledge of all Reimbursement Reporter modules including but not limited to: Remittance Management, Denials Management, Claim Scrubbing/Submission, Patient Charge Estimate, Eligibility, Coordination of Benefits, EDI Services, and Contract Management. Act as payer liaison and interact with insurance companies on a variety of topics ranging from missing remittance files to gaining a direct FTP/SFTP connection to their server.AccomplishmentsIncreased client participation in the non-participating payer program and recovered over $60,000 within 1 ½ years. This process now generates additional revenue monthly.



Schwan's Company

• United States
• Food and Beverage Manufacturing
• 700 & Above Employee

• Inbound Customer Service Supervisor

  • Apr 2001 - Jul 2007

  Successfully managed over 50 contact center agents in two locations in Southwest Minnesota. Responsible for over 5 million dollars in sales annually, while exceeding client expectations. Accountable for, but not limited to, department efficiencies, staffing, P&L, and overall customer service. The center received World Class Status for 2004, 2005, and 2006 from SQM (Service Quality Measurement Group, Inc.).Responsibilities Developed, coached and monitored 40-75 inbound/outbound sales service specialists to ensure client expectations are met. Proof-read and gave final approval on scripts for external clients. Maintained staffing needs within 10% of projected volumes. Completed and processed HR forms. Monitored production levels and service level agreements for their assigned functional area.  Work with employees on individual development plans (IDP); performance improvement plans (PIP); and accurately document disciplinary action with all employees.  Recommend disciplinary action up to and including termination if necessary; participates in coaching, mentoring, monitoring, and employee huddles in coordination with the Motivational Coaches.  Participated in Continuous Improvement Teams and presented information learned in seminars and other projects to staff in a formal setting.Accomplishments Saved over $100,000 in agent salaries through increased efficiencies. Saved over $6,000 in agent turnover. Supervisor of the quarter for 3rd quarter 2005 Increased production efficiencies that returned $125,000 in the first year and $200,000 the following year Developed a new strategy for tracking call center agent attendance and accountability standards across all supervisors and agents. Successfully participated in the center “Evening of Excellence” celebration committee for 2006, chairing multiple teams and work-groups.



Schott Corporation

• Receptionist

  • Jan 1999 - Jan 2001

  Answered incoming telephone calls both internally and externally. Provided light customer service and documented attendance. Performed limited payroll inputs, tracking of manufacturing audit rejects and shipping lot acceptance.AccomplishmentsIntroduced new telephone procedures which reduced transfer time by twenty percent.Completed an inventory for the warehouse, recommending process modifications to identify lost product. Answered incoming telephone calls both internally and externally. Provided light customer service and documented attendance. Performed limited payroll inputs, tracking of manufacturing audit rejects and shipping lot acceptance.AccomplishmentsIntroduced new telephone procedures which reduced transfer time by twenty percent.Completed an inventory for the warehouse, recommending process modifications to identify lost product.