Education
MBA-International Business
Florida Atlantic University
(2009)
Graduate Business Communications Certification
Florida Atlantic University
(2008)
Certificado Avanzado de Negocios en Español
University of Wisconsin
In progress
BS Health Administration
University of Central Florida
(2001)
Business Background
5 years hospital consulting
Project Manager-2 years/ongoing
- Responsible for developing claims review and pursuit strategy for new projects/facilities
- Developed SOPs for work coordination with offshore team
- Managed and streamlined revenue assurance projects to improve revenue flow for nationwide, multi-facility hospital systems. Facilities ranged between 200 and 750 beds
- Worked with senior management to identify and resolve data irregularities in 835 and 837 patient files
- Coordinated with clients to identify and resolve data and contract issues and coordinate operations with client desired results
- Performed solution testing for newly acquired facilities to determine potential monetary success of projects
- Interpreted and modeled hospital/payor contracts in SQL database
- Responsible for establishing, recommending and maintaining the most efficient remote system access possible across multiple hospital platforms (AS/400, Meditech, Healthquest, Invision) and VPNs (Citrix, Cisco, custom web portals)
- Designed, developed and managed knowledge sharing database for multi-facility, multi-system market
- Developed training program and materials for both domestic and foreign employees. Trained analysts face to face and remotely via phone and internet
- Provided technical support, maintained and upgraded all network components, software and hardware for local office and remote users
Contract Manager-2 years
- Conducted meetings with insurance companies to resolve contract interpretation and claim underpayment issues
- Responsible for front line learning of hospital patient accounting systems and subsequent training of analysts. Trained and managed work flow for India based analysts
Claims analyst-2 years
- Analyzed underpaid inpatient, outpatient and same day surgery claims.
- Identified underpayment trends due to billing and coding errors, contract interpretation issues and insurance processing mistakes.
2 years human resource consulting
Recourse Communications
Sourcing Traffic Manager
- Edited and provided feed back on HTML advertising campaigns
- Trained and instructed recruiters on use of resume database.
- Managed bulk email campaigns and responses. Determined site relevancy, keywords and position skill sets needed to locate candidates on a national level
- Tested and provided feedback on development of new, online applicant tracking tool
- Delegated resume sourcing duties to a team of ten. Reviewed and processed work submissions and client orders.
- Managed client resume database through resume evaluation.
- Heavily involved in the development and testing of applicant tracking software sold to clients nationwide.
Accomplishments
- Successfully managed SQL based claims tracking system that handled claim flow through contract based filters for trend analysis, revenue flow improvement and data/registration irregularity cleanup, leading to an increase of cash inflows for the client hospital and improved patient management practices.
- Responsible for the identification and pursuit of $1.2M dollars in one year.
- Designed and developed database used to track contract and claim underpayment issues, resulting in increased trend recognition and simplified review process. Reports used in business development process and knowledge sharing structure across remote office locations.
- Developed training material for analysts based in India, Missouri and Florida on use of SQL based claims review and reporting and use of multiple hospital patient accounting and imaging systems.
Consistently demonstrated innovation and problem solving skills, resulting in new methods of issue tracking
Consistently demonstrated innovation and problem solving skills, resulting in new methods of issue tracking
Consistently demonstrated innovation and problem solving skills, resulting in new methods of issue tracking
Skills
Project management
SQL reporting and queries
Contract modeling
MS Sharepoint
Superior communication skills
Excellent presentation skills
Practical understanding of US healthcare systems
Rapid language acquisition
Database development (Access)
Language Skills
Spanish-Advanced (business fluency estimated in a year)
Mandarin-Basic conversation
Interests and Affiliations
Florida China Association
Mensa International
Phi Sigma Pi-honor society
International Travel, Culinary Arts, Latin Dance, Piano, Guitar