Experience

Miraca Life Sciences

• United States
• Biotechnology
• 100 - 200 Employee

• Senior Systems Analyst

  • Jul 2013 - Present

  The job of the Systems Analyst – Reimbursement POD is crucial to efficient and effective Revenue Cycle operations. This role is responsible for providing billing systems solutions for a geographic region of third-party payers in coordination with Managed Care, Reimbursement, and Revenue Cycle Management. Job Responsibilities • Responsible for analyzing reimbursement data to advise business processes through the use of several database management tools such as SQL Server, Microsoft… Show more The job of the Systems Analyst – Reimbursement POD is crucial to efficient and effective Revenue Cycle operations. This role is responsible for providing billing systems solutions for a geographic region of third-party payers in coordination with Managed Care, Reimbursement, and Revenue Cycle Management. Job Responsibilities • Responsible for analyzing reimbursement data to advise business processes through the use of several database management tools such as SQL Server, Microsoft Access, PowerPivot etc • Responsible for third-party payer setup including EDI, ERA, and EFT • Ability to analyze 837/835, 270/271, HL7 files • Assists determining system root/cause for claim denials, rejects, and other systematic issues • Analyzes and revises existing system logic to accommodate billing arrangements • Contacts third-party payers regarding technical questions or claim errors • Coordinates special or test claim processes • Creates technical documents to support process and system flow changes • Performs weekly mass claims processes and quarterly audits • Coordinates with Systems & Data team for additional billing system administration and configuration • Utilize help desk software to manage and track incoming system change requests • Maintain full technical knowledge of all revenue cycle systems • Maintain a working knowledge of the business and advise business owners of potential system impacts

• Managed Care Specialist

  • Jan 2012 - Present

  • Research and resolve billing concerns and issues communicated by Sales, Client Services and Managed Care departments. • Leverage current systems (e.g., Sales Logix and the Caris data warehouse) to track, measure and trend billing issues, and then develop and execute corrective action. • Lead weekly managed care/billing meeting concerning tactical plans to either improve payor cash collection or the implementation of specific client requests. • Analyze data to ensure billing processes… Show more • Research and resolve billing concerns and issues communicated by Sales, Client Services and Managed Care departments. • Leverage current systems (e.g., Sales Logix and the Caris data warehouse) to track, measure and trend billing issues, and then develop and execute corrective action. • Lead weekly managed care/billing meeting concerning tactical plans to either improve payor cash collection or the implementation of specific client requests. • Analyze data to ensure billing processes are consistently followed, and take corrective action when deficiencies are noted. • Collaborate with Billing, Managed Care and Systems Support to implement corrective action plans. • Train Billing staff on provider or client-specific requirements, relating to either the system setup or a billing process. • Support sales training and client and patient phone call requirements, as needed • Accurately set up insurance codes in the Quadax billing system. • Complete special analytic/research projects, as needed.

• Billing Supervisor

  • Jul 2009 - Jan 2012

  This supervisor provides support for System and Sales Management. Helps maintain billing and related applications used by Caris billing and financial departments. Support liaison for Billing Dept with the Sales Directors, ASM teams and clients. Provides information regarding clients and their needs. This includes developing special billing processes to accommodate needs of our clients. Develop training programs, tools needed by the Sales Team for better understanding of the billing… Show more This supervisor provides support for System and Sales Management. Helps maintain billing and related applications used by Caris billing and financial departments. Support liaison for Billing Dept with the Sales Directors, ASM teams and clients. Provides information regarding clients and their needs. This includes developing special billing processes to accommodate needs of our clients. Develop training programs, tools needed by the Sales Team for better understanding of the billing process, insurance issues and the impact insurances can have on billing. Be available for clients when needed for meetings, phone calls, etc.



Miraca Life Sciences

• United States
• Biotechnology
• 100 - 200 Employee

• Client Services Specialist

  • 2007 - 2009

  • Utilize strong clinical knowledge to maintain and further develop client relationships to include medical leaders, medical institutions and medical associations • Act as a technical advisor on services for clients and internal staff members • Respond to client inquiries regarding clinical data, referral tests, analysis and diagnosis • Provide field support to sales team to ensure quick resolution of clinical issues • Build strong customer relationships through client focus… Show more • Utilize strong clinical knowledge to maintain and further develop client relationships to include medical leaders, medical institutions and medical associations • Act as a technical advisor on services for clients and internal staff members • Respond to client inquiries regarding clinical data, referral tests, analysis and diagnosis • Provide field support to sales team to ensure quick resolution of clinical issues • Build strong customer relationships through client focus, professional demeanor, reliability and responsiveness; provide service levels that meet customer needs and achieve department goals • Assist clients in completion of requisitions; complete missing information to process specimens • Execute handling of tissue and other related activities including lab operations support • Process client orders and facilitate shipping Show less • Utilize strong clinical knowledge to maintain and further develop client relationships to include medical leaders, medical institutions and medical associations • Act as a technical advisor on services for clients and internal staff members • Respond to client inquiries regarding clinical data, referral tests, analysis and diagnosis • Provide field support to sales team to ensure quick resolution of clinical issues • Build strong customer relationships through client focus… Show more • Utilize strong clinical knowledge to maintain and further develop client relationships to include medical leaders, medical institutions and medical associations • Act as a technical advisor on services for clients and internal staff members • Respond to client inquiries regarding clinical data, referral tests, analysis and diagnosis • Provide field support to sales team to ensure quick resolution of clinical issues • Build strong customer relationships through client focus, professional demeanor, reliability and responsiveness; provide service levels that meet customer needs and achieve department goals • Assist clients in completion of requisitions; complete missing information to process specimens • Execute handling of tissue and other related activities including lab operations support • Process client orders and facilitate shipping Show less



HarborOne Bank

• United States
• Banking
• 200 - 300 Employee

• Operations Support Staff

  • 2005 - 2007

  • Handle client calls and process transactions • Verify all branch and department documentation • Balance all stand-alone ATM machines, handle subpoenas and State/IRS levies • Answer multiple telephones; handle clerical duties to ensure smooth office operations Prioritize and expedite high-volume work load within strict deadlines • Handle client calls and process transactions • Verify all branch and department documentation • Balance all stand-alone ATM machines, handle subpoenas and State/IRS levies • Answer multiple telephones; handle clerical duties to ensure smooth office operations Prioritize and expedite high-volume work load within strict deadlines



Rave Stores

• Retail Manager

  • 1999 - 2004

  • Supervised, managed and trained a 10-person staff • Responsible for floor moves and maintaining clean atmosphere • Organized materials for staff meetings and events • Supervised, managed and trained a 10-person staff • Responsible for floor moves and maintaining clean atmosphere • Organized materials for staff meetings and events