ELECTRONIC HEALTH RECORD OPTIMIZATION SPECIALIST Skill Highlights Analyst skills Managed care contract analysis, payment analysis appeal, quality data analysis Above average computer skills Microsoft Office Suite, Adobe (full version), Athena Clarity, Crystal Reports, Internet email proficiency Professional Experience Electronic Health Record Optimization Specialist Company Name － City State Assist primary care practices providers improve quality scores expertise practice workflow, electronic health record systems, quality measures. Assists practices implementing using systems (quality reporting, EHR modules) improve patient care outcomes provide clinical data required satisfy contract requirements. Provides support population management pod practice level tracking monitoring individual process outcome measures eligible managed care Medicare patients chronic diseases diabetes, cardiovascular disease, depression. Understands clearly communicate, verbally writing, clinical quality measure components global payment contracts EHR Use Requirements. Understands federal state EHR incentive programs, mandates legal requirements, develops implements programs educate providers staff achieving federal state incentives required, compliance legal obligations. Meaningful Use, ICD10, HIPAA, Privacy) Assists EHR Team creating plans new implementations, interfaces upgrades Understands provider's contractual obligations BIDCO develops implements training communication plans support needs. Quality Improvement Coordinator October 2013 August 2014 Company Name － City State Worked support primary care physicians office staff achieve quality incentives part global payment managed care contracts. Support PCP practices implementing quality improvement initiatives. Provide support managing patient registries reports training practice POD level eligible managed care Medicare patients chronic diseases. Work individually PCP practices help manage required testing quality measure goals promote optimal health clinical outcomes. Train PCP practices Athena Clarity quality software application access registries outcomes individually. Healthcare Financial Analyst Payer Audit Charge Capture Analyst July 2011 October 2013 Company Name － City State Run analysis denial data identify billing coding trends. Develop comprehensive reports designed reduce repeated billing coding errors. Manage database applications reporting government audit tracking. Manage audit process government commercial payers assure submissions accurate timely. Revise coding charge submission errors identified internal external audits making necessary changes within Medicare FISS Medicaid MMIS applications well internal systems. Analyzes information department's pre-bill, coding rejection denial edit databases unresolved third party claims determine root causes edit issues potential resolution originating departments and/or PFS clinical coding staff. Responsible daily validation, collection follow-up payments received government third party payers relation internal contract information. Modeling reimbursement methodologies contracts third party managed care payers financial model RMS system. Post adjustments reversals adjustments online access billing receivable system. Clinical Research Assistant II February 2011 July 2011 Company Name － City State Performed detailed internal audits utilizing protocol schema assure required data completed per protocol hospital policies regulatory patient binders. Verify eligibility study procedures adhere protocol requirements file deviations/violations necessary. Completed adverse event med watch forms required protocol adverse events reports criteria met. Extracted data protocol patients online medical records, outpatient charts, private physician office records, Independent Review Board (IRB) office order assure chart completeness. Assured proper informed consent obtained documented. Program Fund Developer March 2007 January 2008 Company Name － City State Research, write, budget development grants submitted private foundations corporations. Networking resulted significant sustained relationships community committed donors. Worked closely contract manager ensure consistent communication reporting funders. Produced variety quarterly, mid-year end-of-year reports. Worked closely development team, bookkeeper, residential services advocate, statistical coordinator executive director ensure provision high-quality services adherence contractual obligations. Provided leadership coordination promote organizational visibility support local, state national levels. Vice President/Co-Owner August 2007 Current Company Name － City State Established S Corporation ground up. Successfully negotiated contracts companies including reviewing revising contractual terms conditions. Developed budgets, established rates mapped area scheduling. Supervised staff 30 daily activities quality customer care. Worked company President receive 100% customer satisfaction survey Accounting payable receivable. Helped company increase profits 32% year. Education Training CITI TRAINING, Certification, 2011 100% accuracy HIPAA AND HUMAN SUBJECTS COURSE, Certification 1 2011 PENNSYLVANIA STATE UNIVERSITY 100% accuracy Bachelors Science 1 2002 GPA: Dean's List GPA: 3.8 Dean's List GPA: 3.8 Skills Accounting, Adobe, ADR, Analyst, Auditing, billing, budget development, budgets, charts, contracts, CPT, Crystal Reports, customer satisfaction, customer care, data analysis, database applications, databases, edit, email, financial, forms, government, grants, ICD-9, leadership, legal, director, managing, access, Microsoft Office Suite, office, Modeling, Networking, organizing, organizational, policies, Coding, Project management, quality, Quality Improvement, reporting, Research, RMS, scheduling, upgrades, validation, workflow