Pamela Davis has over 20 years of experience in healthcare operations and revenue cycle management. She seeks a manager or leadership role where she can utilize her experience to improve business operations, streamline services, and reduce costs while eliminating unnecessary processes. Her background includes implementing revenue cycle projects, evaluating processes, developing relationships across departments, and testing electronic remittance processes. She most recently served as the Manager of Revenue Cycle Remittance/Collections and Credit Resolution, overseeing operations across three locations.
Lyle M. Crippen has over 20 years of experience in healthcare administration and linking healthcare clinicians with information technology. He has held several leadership roles, including Chief Operating Officer at Elite Medical Billing Solutions where he managed operations and oversaw 23 physician practices generating over $10 million annually. Crippen also has experience implementing medical practice management software as an Administrator at ProtoMed Medical Management Corporation. He is skilled in areas such as business operations, project management, regulatory compliance, and health information technology systems.
Building Effective Denial Management DashboardsCitiusTech
油
In this whitepaper, we try to create dashboards from the lens of Coding and Compliance Managers the real users who rely upon these dashboards regularly to help financially sustain a facility.
Celesia C. Moore has over 15 years of experience in healthcare administration and operations. She has held roles such as Senior Configuration Specialist, Senior Provider Operations Specialist, and Care Coordinator at WellCare Inc. supporting provider networks in Florida, Louisiana, and Texas. Moore is currently seeking a Bachelor's degree in International Business and has experience with systems such as SQL, Microsoft Office, and healthcare IT applications.
Calvin Beecher is an experienced Implementation Manager with over 20 years of experience in account management, project management, and client services. He has a background in healthcare administration and nursing. Currently he is a Senior Consultant at CVS Caremark where he manages implementations and operations for external Accountable Care Organizations. Previously he held various roles with increasing responsibility at CVS Caremark, United Healthcare, and the US Army.
Chaka Bell is an analytical and results-driven consultant with over 10 years of experience in claims systems and clinical applications implementations, with a focus on compliance and clinical reporting. She has experience as a project manager, business analyst, and operations manager supporting various health insurance clients. Her expertise includes configuration of claims, membership, provider, and medical management systems, as well as NCQA HEDIS and AHCA Florida Medicaid reporting.
Senior QUI Data & Operations Analyst descriptionmichael chaffee
油
This position is responsible for developing complex metric and scorecard reports that monitor key outcomes and operational processes for a quality and utilization improvement department. The position works with leadership to design quantitative studies and analyze data to support decision-making. Duties also include maintaining databases and applications, developing policies and procedures, and providing end user support. Requirements include a degree in a relevant field plus 5 years of experience extracting data from complex databases and developing reports using tools like Crystal Reports.
The convergence of health plans and healthcare providers has led to the growing importance for provider-led health plans (Payviders). This eBook highlights the data and technology capabilities necessary for Payvider organizations to optimize performance and drive operational efficiencies.
This document summarizes the experience and qualifications of Bonnie M. Mezzano as an experienced health care claims manager with over 35 years of experience. She currently serves as the Director of Claims for North American Medical Management of Illinois/Manager of Claims for Optum Collaborative Care, where she oversees claims processing, ensures regulatory compliance, manages staff, and improves workflows. Mezzano has extensive experience in all aspects of the claims process and a track record of success in leading teams and implementing systems to improve efficiency.
Tracie Renae Lightfoot has over 15 years of experience in account management and sales roles within the healthcare supply chain industry. She has a proven track record of building strong customer relationships, growing revenues, and providing value-added services. Her experience includes roles at Vizient/VHA/Novation, PDX, and McKesson Pharmaceuticals where she managed customer accounts, implemented programs, analyzed data, and ensured pricing accuracy. She is currently pursuing her Associate's Degree at Tarrant County College.
Avoid PRM failures by avoiding ensuring it's not simply a repository for documenting simple tasks. PRM failures occur when the IT solutions only serves to document activities instead of serving to streamline the physician experience.
Member Engagement Using Sentiment Analysis for Health PlansCitiusTech
油
Sentiment analysis (or opinion mining) is a natural language processing technique used to determine whether data is positive, negative or neutral. Sentiment analysis for health plans deals with member opinions to improve healthcare services and patient experience.
Major Hospital Embraces Role Based Access ControlHanno Ekdahl
油
A large mid-western hospital group had grown by acquisition and integration of new facilities. The resulting complex structure of hospitals, medical schools, and clinics has created a difficult environment for managing identities and access to critical clinical systems. Requesting and fulfilling access requests for critical roles is time-consuming manual work. Role Based Access Control (RBAC) offered a framework to improve user access management efficiency and effectiveness.
RPA (Robotic Process Automation) promises to automate various complex tasks for healthcare organizations payers and providers to improve member experience, lower costs and relieve employees from rising pressure of work. But when it comes to actual applications of RPA, most companies are having a difficult time. This brief eBook outlines the benefits, challenges, tools and key healthcare use cases of RPA that can help healthcare organizations boost their productivity.
Qy Ross is a senior project manager with over 15 years of experience in healthcare revenue cycle management, project management, and data conversions. He has a track record of successfully leading large-scale implementation projects for electronic health record systems like Cerner, Meditech, and Epic. Ross oversees teams, manages schedules and risks, creates reports for executives, and acts as a liaison between business and IT. He has improved revenue, reduced accounts receivable, and optimized business office processes for multiple hospitals and healthcare organizations.
The document provides an executive profile and resume for Linda Ellis, who has over 20 years of experience managing revenue cycle, patient financial services, and financial analysis in healthcare. She is skilled in areas like revenue cycle management, reimbursement optimization, claims processing, Medicare/Medicaid systems, and policy development. Her accomplishments include restructuring departments to improve reimbursement rates and implementing new billing processes. She has held director roles overseeing billing, claims, and reimbursement departments and has experience managing the revenue operations of both physician groups and billing companies.
Greg Fortgang has over 16 years of experience in revenue cycle management and financial analysis at Wellstar Health System. He currently serves as Manager of Contract Management, where he is responsible for ensuring accurate contractual reimbursements and producing detailed payor performance reports. Fortgang received his MBA from Kennesaw State University with a concentration in finance and a 3.92 GPA. He has a proven track record of identifying problems, recovering underpayments, improving processes, and exceeding financial goals throughout his career.
AR management is key to healthcare billing companys profitability and sustainability. To set themselves to eliminate
revenue leakage, billing companies must begin an active assessment of where they stand with current service provider
experience and what future improvements are needed.
Monica Wright has over 20 years of experience in insurance billing, collections, customer service, and administration. She currently works as a Billing Trainer for Emory Healthcare, where her responsibilities include training staff, processing insurance claims, working with patients on billing and payments, and managing billing operations. Previously, she held roles in medical billing and worked as a Referral Coordinator at Emory Healthcare. She aims to provide superior customer service and uses various software programs to perform her duties.
Nathan Erwin has over 15 years of experience in billing, revenue cycle management, and financial analysis roles in the healthcare industry. He currently serves as Assistant Director of Billing Services at Medfusion Laboratories, where he oversees the billing department and identifies opportunities to improve revenue capture and cash flow. Previously he held manager and supervisor roles at several laboratories and healthcare companies, focusing on billing processes, financial reporting, and reducing revenue loss. He has extensive experience with financial systems and a background in systems analysis.
This document is a resume for Arrisha C. Lax. It summarizes her education, including an Associate's Degree in Hospital Health Services Management from Heritage College and current pursuit of a Bachelor's Degree from the University of Phoenix. It also outlines her work experience in roles such as MDM Specialist, Customer Service Lead, and Data Coordinator. Her resume highlights skills in areas like problem solving, attention to detail, customer service, and various software like MS Office, SAP, and Salesforce. Contact information and a list of technical and soft skills are also provided.
This document summarizes an individual's qualifications for a healthcare IT position. They have 20+ years of experience in [1] implementing and supporting clinical and financial systems, [2] analyzing surgical and financial data to improve operations and reduce costs, and [3] training staff on new healthcare technologies. They also have advanced degrees in business administration and health services administration along with membership in several professional healthcare organizations.
This white paper will discuss prioritizing actuarial innovation, insurance business oriented architecture, evaluating your actuarial environment, enterprise actuarial data architecture, potential solutions, and critical success factors.
Presented by William Freitag, Managing Partner and CEO, Agile Technologies
MedHimalayas provides knowledge process outsourcing (KPO) solutions such as data management, medical writing, drug safety monitoring, and pharmacovigilance. Their services support pharmaceutical, biotech, and medical device companies of all sizes. MedHimalayas has skilled professionals, validated databases, and flexible solutions to meet client needs and regulations.
Pamela Wilhelm seeks a position utilizing her skills in process analysis, project management, system documentation, and as a subject matter expert. She has over 15 years of experience in the pharmaceutical industry, most recently as Manager and SME for Aggregate Spend at Boehringer Ingelheim Pharmaceuticals, where she led transparency reporting efforts and ensured accurate and timely data. Prior to that, she managed clinical operations systems and processes at Boehringer Ingelheim and various IT roles at other companies.
Jay Wash has over 15 years of experience in data analytics, project management, and customer service. He currently works as a Data Consultant providing support to hospitals on quality reporting and regulatory submissions. Previously he has held roles managing billing operations and resolving unpaid medical accounts. He has a proven track record of using data analytics to improve processes, enhance customer experiences, and ensure data integrity.
Vianne Jackson has over 15 years of experience in administrative support and revenue cycle specialist roles. She has a background in customer service, data entry, document control, and human resources administrative assistance. Her experience includes maintaining patient accounts and resolving healthcare billing issues, uploading and downloading documents, and providing HR support by preparing new hire paperwork and payroll data entry. She has skills in HIPAA compliance, accounts receivable systems, electronic medical records systems, document management systems, and Microsoft Office.
This document provides guidance on 5 questions to ask prospective clinical data management service providers. The questions address providers' standard operating processes, quality assurance audits, discrepancy management processes, training support for data managers, and conditions that trigger change orders. Asking these questions helps ensure the provider is qualified, uses validated processes, and is transparent about issues like change orders that could increase costs.
Insurance new business process diagramabhinayverma
油
This slide gives a high level overview of the New Business Acquisition process for Insurance companies. Exact process may vary based on firm, line of business etc. but at a high level, this process overview should suffice.
- Nohemy Reynolds has over 15 years of experience in healthcare systems analysis, project management, and desktop support. She has a proven track record of supervising teams and supporting a wide range of clinical and administrative applications.
- Reynolds has strong technical skills and understanding of healthcare systems and processes. She is experienced in training users, troubleshooting issues, and ensuring compliance.
- Her background includes roles with increasing responsibility at major hospitals in Chicago, Alaska, and Illinois where she oversaw operations, trained staff, and improved processes.
Faye Cummins has over 14 years of experience in revenue management, third party billing, and Nextgen EPM specialization. She has worked as a manager of third party billing at SpecialtyCare since 2012 where she oversees billing, intake, and collections. Prior to this, she was a Nextgen EPM specialist at Saint Thomas Physician Services from 2009-2011 and a sales tax accountant at Terex Utilities from 2005-2009. She holds an MBA and a bachelor's degree in management from the University of Phoenix.
Tracie Renae Lightfoot has over 15 years of experience in account management and sales roles within the healthcare supply chain industry. She has a proven track record of building strong customer relationships, growing revenues, and providing value-added services. Her experience includes roles at Vizient/VHA/Novation, PDX, and McKesson Pharmaceuticals where she managed customer accounts, implemented programs, analyzed data, and ensured pricing accuracy. She is currently pursuing her Associate's Degree at Tarrant County College.
Avoid PRM failures by avoiding ensuring it's not simply a repository for documenting simple tasks. PRM failures occur when the IT solutions only serves to document activities instead of serving to streamline the physician experience.
Member Engagement Using Sentiment Analysis for Health PlansCitiusTech
油
Sentiment analysis (or opinion mining) is a natural language processing technique used to determine whether data is positive, negative or neutral. Sentiment analysis for health plans deals with member opinions to improve healthcare services and patient experience.
Major Hospital Embraces Role Based Access ControlHanno Ekdahl
油
A large mid-western hospital group had grown by acquisition and integration of new facilities. The resulting complex structure of hospitals, medical schools, and clinics has created a difficult environment for managing identities and access to critical clinical systems. Requesting and fulfilling access requests for critical roles is time-consuming manual work. Role Based Access Control (RBAC) offered a framework to improve user access management efficiency and effectiveness.
RPA (Robotic Process Automation) promises to automate various complex tasks for healthcare organizations payers and providers to improve member experience, lower costs and relieve employees from rising pressure of work. But when it comes to actual applications of RPA, most companies are having a difficult time. This brief eBook outlines the benefits, challenges, tools and key healthcare use cases of RPA that can help healthcare organizations boost their productivity.
Qy Ross is a senior project manager with over 15 years of experience in healthcare revenue cycle management, project management, and data conversions. He has a track record of successfully leading large-scale implementation projects for electronic health record systems like Cerner, Meditech, and Epic. Ross oversees teams, manages schedules and risks, creates reports for executives, and acts as a liaison between business and IT. He has improved revenue, reduced accounts receivable, and optimized business office processes for multiple hospitals and healthcare organizations.
The document provides an executive profile and resume for Linda Ellis, who has over 20 years of experience managing revenue cycle, patient financial services, and financial analysis in healthcare. She is skilled in areas like revenue cycle management, reimbursement optimization, claims processing, Medicare/Medicaid systems, and policy development. Her accomplishments include restructuring departments to improve reimbursement rates and implementing new billing processes. She has held director roles overseeing billing, claims, and reimbursement departments and has experience managing the revenue operations of both physician groups and billing companies.
Greg Fortgang has over 16 years of experience in revenue cycle management and financial analysis at Wellstar Health System. He currently serves as Manager of Contract Management, where he is responsible for ensuring accurate contractual reimbursements and producing detailed payor performance reports. Fortgang received his MBA from Kennesaw State University with a concentration in finance and a 3.92 GPA. He has a proven track record of identifying problems, recovering underpayments, improving processes, and exceeding financial goals throughout his career.
AR management is key to healthcare billing companys profitability and sustainability. To set themselves to eliminate
revenue leakage, billing companies must begin an active assessment of where they stand with current service provider
experience and what future improvements are needed.
Monica Wright has over 20 years of experience in insurance billing, collections, customer service, and administration. She currently works as a Billing Trainer for Emory Healthcare, where her responsibilities include training staff, processing insurance claims, working with patients on billing and payments, and managing billing operations. Previously, she held roles in medical billing and worked as a Referral Coordinator at Emory Healthcare. She aims to provide superior customer service and uses various software programs to perform her duties.
Nathan Erwin has over 15 years of experience in billing, revenue cycle management, and financial analysis roles in the healthcare industry. He currently serves as Assistant Director of Billing Services at Medfusion Laboratories, where he oversees the billing department and identifies opportunities to improve revenue capture and cash flow. Previously he held manager and supervisor roles at several laboratories and healthcare companies, focusing on billing processes, financial reporting, and reducing revenue loss. He has extensive experience with financial systems and a background in systems analysis.
This document is a resume for Arrisha C. Lax. It summarizes her education, including an Associate's Degree in Hospital Health Services Management from Heritage College and current pursuit of a Bachelor's Degree from the University of Phoenix. It also outlines her work experience in roles such as MDM Specialist, Customer Service Lead, and Data Coordinator. Her resume highlights skills in areas like problem solving, attention to detail, customer service, and various software like MS Office, SAP, and Salesforce. Contact information and a list of technical and soft skills are also provided.
This document summarizes an individual's qualifications for a healthcare IT position. They have 20+ years of experience in [1] implementing and supporting clinical and financial systems, [2] analyzing surgical and financial data to improve operations and reduce costs, and [3] training staff on new healthcare technologies. They also have advanced degrees in business administration and health services administration along with membership in several professional healthcare organizations.
This white paper will discuss prioritizing actuarial innovation, insurance business oriented architecture, evaluating your actuarial environment, enterprise actuarial data architecture, potential solutions, and critical success factors.
Presented by William Freitag, Managing Partner and CEO, Agile Technologies
MedHimalayas provides knowledge process outsourcing (KPO) solutions such as data management, medical writing, drug safety monitoring, and pharmacovigilance. Their services support pharmaceutical, biotech, and medical device companies of all sizes. MedHimalayas has skilled professionals, validated databases, and flexible solutions to meet client needs and regulations.
Pamela Wilhelm seeks a position utilizing her skills in process analysis, project management, system documentation, and as a subject matter expert. She has over 15 years of experience in the pharmaceutical industry, most recently as Manager and SME for Aggregate Spend at Boehringer Ingelheim Pharmaceuticals, where she led transparency reporting efforts and ensured accurate and timely data. Prior to that, she managed clinical operations systems and processes at Boehringer Ingelheim and various IT roles at other companies.
Jay Wash has over 15 years of experience in data analytics, project management, and customer service. He currently works as a Data Consultant providing support to hospitals on quality reporting and regulatory submissions. Previously he has held roles managing billing operations and resolving unpaid medical accounts. He has a proven track record of using data analytics to improve processes, enhance customer experiences, and ensure data integrity.
Vianne Jackson has over 15 years of experience in administrative support and revenue cycle specialist roles. She has a background in customer service, data entry, document control, and human resources administrative assistance. Her experience includes maintaining patient accounts and resolving healthcare billing issues, uploading and downloading documents, and providing HR support by preparing new hire paperwork and payroll data entry. She has skills in HIPAA compliance, accounts receivable systems, electronic medical records systems, document management systems, and Microsoft Office.
This document provides guidance on 5 questions to ask prospective clinical data management service providers. The questions address providers' standard operating processes, quality assurance audits, discrepancy management processes, training support for data managers, and conditions that trigger change orders. Asking these questions helps ensure the provider is qualified, uses validated processes, and is transparent about issues like change orders that could increase costs.
Insurance new business process diagramabhinayverma
油
This slide gives a high level overview of the New Business Acquisition process for Insurance companies. Exact process may vary based on firm, line of business etc. but at a high level, this process overview should suffice.
- Nohemy Reynolds has over 15 years of experience in healthcare systems analysis, project management, and desktop support. She has a proven track record of supervising teams and supporting a wide range of clinical and administrative applications.
- Reynolds has strong technical skills and understanding of healthcare systems and processes. She is experienced in training users, troubleshooting issues, and ensuring compliance.
- Her background includes roles with increasing responsibility at major hospitals in Chicago, Alaska, and Illinois where she oversaw operations, trained staff, and improved processes.
Faye Cummins has over 14 years of experience in revenue management, third party billing, and Nextgen EPM specialization. She has worked as a manager of third party billing at SpecialtyCare since 2012 where she oversees billing, intake, and collections. Prior to this, she was a Nextgen EPM specialist at Saint Thomas Physician Services from 2009-2011 and a sales tax accountant at Terex Utilities from 2005-2009. She holds an MBA and a bachelor's degree in management from the University of Phoenix.
James McGann has over 30 years of experience in information systems and project management, specializing in document imaging and electronic document management systems. He is currently the Application Development Manager at Millers Mutual Insurance, where he has successfully led large-scale implementation projects over the past 14 years, including new core systems, a document management system, an agency rating and quoting system, and employee/agency portals. Previously, he worked as an independent consultant, managing the implementation of document management systems across multiple offices for the State Workers Insurance Fund.
This document is a resume for Diane A. Carr which summarizes her experience in health information management roles over several years. It highlights her expertise in areas such as electronic health records, computerized health information systems, coding, clinical documentation improvement, and revenue cycle management. The resume lists her work history in various interim management positions where she improved coding quality and productivity, reduced denied or unpaid claims, and oversaw transitions to new computer systems.
This document is a resume for Kathy Yearout, an accounting and bookkeeping professional with over 25 years of experience. She has extensive experience in accounts payable/receivable, payroll processing, budget monitoring, taxes, account reconciliation, and human resources management. Her resume lists her employment history working for various construction, manufacturing, and property management companies, where she has held roles including full charge bookkeeper, office manager, and vice president of business affairs. She has proficiency with Microsoft Office, QuickBooks, Peachtree, and ADP payroll software.
Abstract A key element of any software is to protect the software from various attacks and in case if any theft has occurred then the developer must be able to prove their ownership. Software Watermarking is one of the technique which helps in proving the authentication of the developer. A lot of research was done in Software watermarking but all this work is discussing on various embedding techniques of a software watermark into a program and the software watermark which was used for embedding is a serial number or a unique identification of the developer. In this paper a new methodology to obtain the software watermark, which is known as Version Based Software Watermark, is given. The remaining part of the paper discusses on the importance of the Version Based Software Watermark, properties of VBSW and evaluation results of the VBSW. Keywords: Software Watermark, VBSW Version Based Software Watermark, LOC, version number
Pamela Ellis has over 15 years of experience in healthcare revenue cycle management, patient access, and EMR implementation. She has held various leadership roles managing revenue cycle departments and teams, improving processes, increasing collections, and ensuring regulatory compliance. Her experience spans a variety of healthcare settings including hospice, laboratories, hospitals, and academic physician groups.
Pamela Ellis has over 20 years of experience in healthcare revenue cycle management, patient access, and EMR/EPM implementation. She has held various leadership roles at healthcare organizations and consulting firms, managing teams and improving revenue cycle processes through initiatives like denial recovery, training development, and system implementations. Her background includes experience with revenue cycle assessments, interim management, and strategic planning.
Randal Blanc is a revenue cycle management professional with over 10 years of experience in healthcare billing and collections. He has held various manager roles overseeing revenue integrity, patient financial services, and IT/compliance. His experience includes working with large hospital systems and third-party billing vendors. He aims to enhance hospital revenue through initiatives like reducing late charges, capturing missed charges, and improving billing processes and compliance.
Laurie Carpenter Randall has over 15 years of experience in accounting, finance, auditing, and reimbursement analysis. She currently works as a Reimbursement Analyst II at Our Lady of the Lake Regional Medical Center, where she prepares Medicare and Medicaid cost reports for multiple hospitals. She previously worked as Controller and Operations Manager for a dental practice, Reimbursement Coordinator at Our Lady of the Lake Hospital, and Supervising Senior Auditor at KPMG.
Chris Mitchell Customer Experience Leader_Business Analyst 10.29Chris Mitchell
油
Chris Mitchell is a customer experience leader with over 15 years of experience in customer service, operations, and business analysis roles. He has a proven track record of using data-driven methods to improve processes, reduce costs, enhance the customer experience, and increase organizational performance. Mitchell holds a Bachelor's degree in Business Administration from Regis University and has worked for companies such as Intuit and Ouray Sportswear in various customer-focused positions.
The candidate has over 18 years of experience in revenue cycle services and management. She currently works as a Revenue Cycle Service Analyst and is seeking new opportunities. Her experience includes managing patient service contact centers and denial management teams. She has strong skills in provider relations, training, compliance, and project management.
The document discusses a solution from Washington Consulting and EMC for improving healthcare providers' revenue cycle management. The solution aims to streamline billing processes, reduce errors and denials, and improve cash flow. It leverages EMC's Documentum xCP platform to automate workflows and integrate content across systems. Key benefits include expediting content development, decreasing administrative costs, and empowering managers to allocate resources more efficiently. The solution provides a comprehensive approach to managing accounts receivable from start to finish.
Julie Krasnoff has over 20 years of experience in physician and healthcare billing, accounts management, and medical administration. She currently works as a Processing Manager, where she oversees billing and claims processing for 36 medical practices. Previously, she held positions as an Edit Manager and Assistant Supervisor, where she managed teams and coordinated billing operations. She has extensive expertise in billing systems, coding, accounts receivable, and ensuring compliance.
Victoria Day has over 20 years of experience in healthcare, with expertise in revenue cycle management and IT systems implementation. She has extensive leadership experience overseeing revenue cycle operations for ambulatory surgery centers and implementing Healthland Centriq software. Her background includes roles in business analysis, revenue cycle process improvement, and medical billing. She currently works as a senior consultant helping clients implement Healthland Centriq revenue cycle modules.
Gregory Scott Martin has over 15 years of experience leading continuous improvement initiatives using lean principles. He is skilled in quality control, process analysis, regulatory compliance, and training. Martin holds a Six Sigma Green Belt certification and has successfully implemented various process improvement projects to increase efficiency and reduce costs and defects. His experience spans multiple industries, including aerospace, banking, and lending.
Dawn Cassity has over 20 years of experience in customer service and operations leadership roles. She has a track record of strategic planning, business development, budget management, and people leadership. Her experience includes setting up new customer service departments, managing call centers, and driving process improvements. She currently works as a Training & Quality Assurance Manager at Goodwill, where she develops policies and procedures and ensures compliance with accreditation standards.
Lindsey Whitney is seeking a position in business administration with expertise in marketing, operations management, and project management. She has over 15 years of experience in the insurance industry, most recently as a QA Test Lead. In previous roles, she led teams, improved processes, increased sales and revenues, and developed automation strategies. She holds an MBA and a bachelor's degree in management and marketing.
This document contains the resume of Cynthia Martinez, who has extensive experience overseeing revenue cycle operations and implementing electronic medical record systems like Epic for various healthcare organizations. She is skilled in project management, process improvement, and financial analysis. Key experiences include directing revenue cycle functions for large multi-specialty practices and hospitals, and leading the implementation of Epic and other systems to optimize billing and collections.
This document contains the resume of Cynthia Martinez, who has extensive experience in healthcare revenue cycle operations and project management, including overseeing the implementation of electronic medical records and billing systems. She is skilled in process improvement, team leadership, and ensuring projects are delivered on time and under budget.
David Bagley has over 20 years of experience in operations management, strategy, risk management, and process improvement. He has a proven track record of developing business control models, facilitating regulatory requirements, and managing large-scale projects. Bagley is an expert in leading initiatives that drive operational efficiency and mitigate risks.
David Bagley has over 20 years of experience in operations management, strategy, risk management, and business development. He has a proven track record of developing business control models, facilitating regulatory requirements, and managing initiatives. Currently he is a senior project manager focusing on functional change management, software implementation, and ERP strategic initiatives for Providence Partners.
Jennifer Crossthwaite has over 15 years of experience in project management, systems implementation, operations management, and financial analysis. She has expertise in Microsoft applications, SAP, Oracle, and other systems. Her experience includes roles managing grants and new system implementation projects at Live Violence Free, improving processes and implementing quality assurance programs at the Nevada Public Employees' Benefits Program, streamlining audits and training staff in new software at the Nevada Department of Taxation, managing contracts and shipments in SAP at Microsoft Licensing, and adjudicating return claims and improving logistics processes at Xerox. She holds an MBA and BS in Business Management.
Pamela Montagnese Wilhelm has over 15 years of experience in project management, clinical trial management, and customer support roles. She has a proven track record of successfully leading teams, implementing new systems, and ensuring processes are carried out accurately and efficiently. Her background includes roles implementing clinical trial systems, providing user support, and developing tools to automate workflows.
Carol Roddy is a seasoned accounting and insurance professional with over 30 years of experience. She has extensive expertise in accounting systems, financial reporting, and process improvement initiatives. Roddy has successfully led multiple large-scale system implementation projects and served as the subject matter expert for billing, receivables, and payment systems. She is skilled in problem-solving, communication, and adapting to change.
Danika Tynes has over 17 years of experience in program management, analytics, and management consulting. She specializes in driving large projects, introducing change initiatives, and collaborating with stakeholders. Her background includes strategy development, program delivery, process improvement, change management, and technology integration. Currently she is a Research Professor at Georgia Tech Research Institute, where she provides program support as the Systems Integrator for Georgia's Medicaid Management Information System transformation initiative.
1. Pamela A Davis
8707 River Park Rd Cell: (904) 568-1316
St. Augustine, Florida 32092 mrj8554@gmail.com
Objective
Seeking a manager or leadership position utilizing 20 years of healthcare experience focusing on improving
business operations, streamlining services using innovation to facilitate cost savings while eliminating processes
that do not add value.
Revenue Cycle Operations & Systems Accomplishments
Leading and orchestrating the Centers of Excellence initiatives for Oracle Document Capture, Virtual
Merchant, and Retail Lockbox Mayo Clinic Florida, as well as collaborating and working with other Mayo
Clinic sites during their implementation with their Centers of Excellences initiatives.
Implemented and led several Revenue Cycle projects at Mayo Clinic Health Systems of Waycross, Inc.
within an 18-month timeframe. Projects implemented include Lockbox, Virtual Merchant (credit card
processing), Centralized balancing and Cerner remittance posting.
Ongoing and continuously evaluation of processes in remit in both Mayo Clinic Florida and MCHS
Waycross in an effort to reduce costs while creating efficiencies using Mayo Clinic Florida resources, Lean
principles and automation in enterprise correspondence and remittance functions across all three Mayo
Clinic sites.
Developing relationships with accounting, systems services, Information Technology, and Revenue Cycle
departments with Mayo Group Practices and Mayo Clinic Health Systems.
Tested and implemented several 835 (electronic remittances) payers between 2006-2011, while multi-
tasking system testing and operational support for Mayo Clinic Florida.
Managed and implemented the transition Waycross Health Systems Remittances functions and Credit
Balances to Mayo Clinic Arizona and Mayo Clinic Rochester within 2 months. Continuous improvements
are ongoing including: Institutional Balancing, Suspense Account Posting and balancing, creating
procedures and ongoing training on two patient account systems: Meditech and Cerner Practice
Management.
Employment History
2016-2015 Manager, Revenue Cycle Remit/Collections & Credit Resolution
Managing operations in 3 locations at an Enterprise level.
Projecting and strategizing using industry standards data, patient accounting system
data (cash collection, bad debit, controllable/non-controllable adjustments, and
reimbursement reporting) and days revenue outstanding (DRO).
Utilized lean process concepts while collaborating and partnering with Billing and
Accounts Receivable, Patient Accounts Services, Systems, IT, and non-revenue cycle
areas to improve processes and the patient experience.
Engaging as an Epic system Subject Matter Expert (SME) for our new future state
patient accounting system for the enterprise 2014-2018. Preparing for future state
2. structure using stabilization methods, patient accounting system cleanup initiatives, and
development of workflows.
2015-2014 Senior Operational Analyst, Mayo Clinic Florida
Supervising Enterprise Correspondence team in Florida. Analyzing processes and
seeking continuous improvements opportunities for the teams we support in the
revenue cycle (Credit Review, Billing and Accounts Receivable, Patient Accounts
Services, and non-revenue cycle areas). Educate and assist in aligning document
imaging requirements on Oracle IPM and its replacement by working with the systems
and revenue cycle teams while leading Oracle Oversight Committee.
Supporting and training other operational analysts across all three Mayo Sites in remit
and Waycross on various Mayo Clinic practices regarding interfaces, applications,
testing, and overall remittance and correspondence functions.
Projects actively involved in: Hyland Onbase project, Waycross Process Improvements
align remittance practices with Mayo Clinic, Institutional Balancing testing with
Rochester Systems on new payers, and leading the Healthquest form function testing
team across all Mayo Clinic sites.
2014-2011 Operational Analyst III, Mayo Clinic Florida
Evaluates current processes while collaborating with business partners in accounting,
billing and follow, compliance, systems services, and Information Technology
throughout the Mayo Group Practice.
Project Implementation using project applications, education, and Mayo Clinic
certification programs to improve processes.
Analyzes and interprets remittances and correspondence data to share with colleagues
reduce waste and create value added processes that are cost effective and meaningful.
Creates workflows and reporting to better understand cash management processes in
order to identify gaps in process and incorporate process improvements and efficiencies
in areas of banking, remit operations, correspondence, and patient accounting system
functionality.
Composes new procedures for project and annually evaluates current procedures for
updates.
2011-2006 Systems Analyst II-Revenue Cycle, Mayo Clinic Florida
Plans, manages, tests, and facilitates installation of medium sized software programs
or other technical projects to support systems, processes, or project teams across the
Enterprise Revenue Cycle.
Leads team for electronic remittance implementation on a continuous, ongoing project.
Provides support for internal customers regarding system and processes and report
creation throughout the Revenue Cycle.
Works with external customers to accomplish system-related tasks for projects.
2006-2004 Patient Financial Representative II, Mayo Clinic Florida
Collects, reviews, discusses, and documents demographic, insurance, and financial
information with patients and payers.
Responsible for management and collection of Mayo Clinic Account Receivables
through the use of automated systems and revenue cycle processes.
3. Responds to and resolves a variety of account, billing and payment issue from patients
and customers.
Interprets, applies and communicates policies regarding medical and financial aspects
of patient care to assure reimbursement for organization.
2004-2002 Charge and Cash Posting Supervisor, Franciscan Skemp, Lacrosse, Wisconsin
Managed departmental functions, budget, and overall departmental processes.
Participation on multiple process improvement and upgrade teams.
Implementation of ongoing (HIPAA 835) electronic posting opportunities to increase
posting efficiencies and decrease departmental cost.
Preparation and training for upgrades, departmental processes, and organizational
changes.
Familiarity with open item, line item, and AS400 accounting hospital system.
2002-1999 Program Coordinator/Director, REM Council Bluffs, Inc. Council Bluffs, IA
Managing a cost effective and efficient program for people with disabilities.
Budgeting and maintaining overhead expenses in areas of human resource, vendor
contracts, and facility maintenance.
Partnering with case managers, families, and staff to build a cohesive relationship
with the client with the goal of consumer independence.
Complying with state and federal regulations to maintain a residential care facility.
Creating and implementing programs for clients to increase daily living skills and
promote dignity and independence.
1999-1998 Claims Auditor, Blue Cross Blue Shield of Nebraska
Accountability for adjusting claims while following policy protocol.
Obtaining and maintaining a high-level of accuracy and speed of claims processing.
Processing inquiries using decentralized resources such as utilization management
and member services within the company to process claims
1997-1996 Beneficiary Representative, Tricare Health Care Alliance
Using excellence in customer service to obtain new policyholders and maintain current
policyholders.
Trouble-shooting billing inquiries.
Educating beneficiaries in all aspects of their health care plans
1991-1993 Motor Transport Operator, United States Army
Education, Certifications & Memberships
o PMP Pursuing Project Management Certification-In Progress (2015)
o Masters of Healthcare Administration (2010)
o Mayo Quality Academies: Fellows Bronze (2012) & Silver Certified (2013)
o Bachelors of Science: Business (2001)
o Certified Nursing Assistant (2003)
o HIMSS Membership since 2012