Terri Smith
Epic Revenue Cycle Analyst- Technical Lead at OCHIN, Inc.- Claim this Profile
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Bio
Credentials
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Epic Charge Router
EpicOct, 2016- Nov, 2024 -
Epic Resolute Hospital Billing Claims Administrator
-May, 2010- Nov, 2024 -
Epic Resolute Hospital Billing Administrator
-Feb, 2010- Nov, 2024
Experience
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OCHIN, Inc.
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United States
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Hospitals and Health Care
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300 - 400 Employee
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Epic Revenue Cycle Analyst- Technical Lead
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Nov 2015 - Present
Supports Epic Resolute PB and PB Claims for several FQHC members. Supports Epic Resolute PB and PB Claims for several FQHC members.
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Johns Hopkins Hospital
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United States
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Hospitals and Health Care
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700 & Above Employee
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Senior Consultant
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May 2015 - Oct 2015
*Analysis identifying several key claims items- NPI’s, taxonomy codes, addresses, etc… Building for implementation *Mitigated ‘at risk’ Epic Progress Report status in 45 days through extensive build gap analysis and build items, resulting in a new ‘no risk’ Progress Report status *Claims scenario testing with 100% signoff from business owners *Clean Payments Workshop for Undistributed payments resulting in 50% reduction in Undistributed WQ’s *Build gap analysis and completion of build items for Bayview Medical Center and Johns Hopkins Hospital go lives *Claims Scenario testing of 60 scenarios with 100% signoff from appropriate business owners by specified due date *Parallel Revenue Cycle testing, working with business owners to gather legacy data, preparing PRCT workbooks including ADT/Reg items, Coding, and Charging *3M CGS configuration and testing; loading monthly LCD and quarterly CCI update files *Coordinated 3M CGS software upgrades with Interconnect and Epic TS *Integrated Testing script review *ICD-10 straddle claims build and testing *Configured HB Claim Definition Files for proper claims processing *Created and maintained Claim form override CERs to send claims to UB paper, 1500 electronic, 1500 paper as called for by each facility, location, department or NPI as needed *Customized Electronic and Paper UB and 1500 Claim form (FDF and ABF) using profile variables and CEV overrides *Utilized Charge Modification Extensions and Claim Complete extensions for specialty billing and claims scenarios *Automated UB Claim codes for PT/OT/ST *Support using Remedy and JIRA ticketing systems Show less
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Novant Health
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United States
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Hospitals and Health Care
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700 & Above Employee
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Senior Consultant
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Jan 2014 - Apr 2015
• Build and implementation of Claims processing, including: * 8 hospitals; 4 Ambulatory Surgery Centers; Provider Based billing; Split claim billing for CRNA, EKG providers *Reduced specific account and Claim edit WQ contents by 99% (over 700 HARs down to a handful) through analysis and identifying gaps in workflows, rules and master files *Implemented CPT billing to Medicaid specialty payor on Inpatient Behavioral Health accommodation code UB lines *Optimized build and workflows by collaborating with appropriate teams to identify gaps, eliminate redundancy *Completed Application Testing and Integrated Testing *Remittance Testing *Integral in completion of Closed Chart Testing: collaborating with business leaders to identify claims scenarios, building test patients, dropping charges, and coding, to replicate legacy claims for Business Office review and signoff *Mentored full-time employees for transfer of knowledge *Created and maintained Claim form override CERs to send claims to UB paper, 1500 electronic, 1500 paper as called for by each facility, location, department or NPI as needed *Customized Electronic and Paper UB and 1500 Claim form (FDF and ABF) using profile variables and CEV overrides *Utilized Claim Categories, Charge Modification Extensions and Claim Complete extensions for specialty billing and claims scenarios *Created and maintained Hospital Account Class overrides for specialty splits including Medicare vaccinations on inpatients *Created Jobs, Runs, and Batches as pertains to Claims processing and Remittance processing *Customized Claims reconciliation loaders to recognize SSI file formats *Created and maintained Claim edits (LPP and CER) and workqueues *Refined Account workqueues for DNB’s and claims reconciliations *Created DNB edit for HIPPS/RUGS claim codes workflow Show less
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UC San Diego Health
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United States
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Hospitals and Health Care
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700 & Above Employee
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Senior Consultant
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Jun 2013 - Jan 2014
Build and implementation of Claims processing, including: *Designed Medicare Part A Exhaust and Medicare Self Audit workflows and build *Created Payer-specific build and edits, specifically Medi-Cal of California *Consecutive Accounts workflow and build *Achieved 95% Testing acceptance rate with clearinghouse Passport *Documented builds for transfer of knowledge *Customized HB Claim Definition Files for proper claims processing *Created Jobs, Runs, and Batches for claims processing *Built Claims reconciliation loaders and customized for Passport files *Created Claim edits (LPP and CER) and workqueues *Built Electronic and Paper Claim forms *Created System Automatic Actions for IME processing and debit/credit write offs *Account workqueues for Medicare workflows *Built DNB edits as required by workflow or billing requirements *Analyzed Epic model automated UB Claim Codes and worked with project leaders to customize Show less
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Hackensack Meridian Health
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United States
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Hospitals and Health Care
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700 & Above Employee
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Senior Consultant
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Jan 2012 - May 2013
Build and implementation of all Claims processing, including: *Achieved 90% average Production acceptance rate with clearinghouse ePremis in just 2 weeks after go-live *Integral in completion of Parallel Claims testing: collaborating with business leaders to identify claims scenarios, building test patients, dropping charges, and coding, to replicate legacy claims for Business Office review and signoff *Bridged the gap between standard claims and NJ State Reporting by analyzing requirements, documenting differences, and working closely with build owners *Integral team member in design of case management review process *RMO setup and testing *Implemented Financial counselor workflow utilizing Acct Activities and Account *Created System Automatic Actions for Late Charge Processing based on specific criteria of when charges should be written off or when a late replacement claim should be sent *Completed Application Testing *Designed Claims steps of Integrated Test scripts based on scenarios *Built and maintained Payors and Plans, customized for HB only use or PB only use *Automated UB Claim codes for MSPQ, Therapies, and IP to OP Show less
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Sanford Health
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Hospitals and Health Care
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700 & Above Employee
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IT Billing Application Support Specialist
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Nov 2009 - Nov 2011
• Supported Epic Claims–related issues from an IT perspective • Used Chronicles to create programming points and extensions for claims • Maintained and updated CDFs • Built Claims batch jobs • Manipulated Profile Variables and Aii Overrides in 4010 forms • Tested and implemented Epic Release Notes and Special Updates in consultation with business partners and Epic • Supported upgrades to versions ‘09 and ’10 • Provided post-implementation support of Special Updates and Interim Updates • Import in EAP and FSC in Chronicles • Performed claims build for implementation of provider-based billing • Taught new hire HB training courses (1 day) Show less
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Education
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Augustana College (SD)
Bachelor's Degree
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