PROFESSIONAL PROFILE

Meticulous professional with 10 years of Administrative, Technical and Clinical experience in the Healthcare sector. Known for the ability to grasp business needs translate them into clear and concise specifications as well as extract and manipulate data from RDMS is order to make critical decisions to improve the outlook of the organization. In pursuit of an Analytical, Administrative or Management oriented career position, supporting the mission and operational needs of the organization.

SKILLS AND ACCOMPLISHMENTS

• Possess strong computer and office administration skills with a vast knowledge of Windows and Microsoft Office Suite Word, Excel, PowerPoint, Access, and Visio .
• Ability to write SQL queries in order to retrieve pertinent information from DBMS.
• Extracted data from existing data stores, developing and executing departmental reports for performance and response purposes by using oracle SQL, SAS, SQL SERVER 2012.
• Ability to conduct data mapping, and create ER diagrams using data modeling tools.
• Acquired extensive experience in Data Analysis, design and modeling of applications in the Data Warehouse.
• Proven ability to move data across and within platforms by using ETL tools, such as SQL server IMPORT/EXPORT UTILITY, SSIS, and INFORMATICA.
• Strong visual modeling and business process modeling skills using RUP and experienced in developing use case models, Data Flow Diagrams, Activity Diagrams, and State Chart Diagrams.
• Experienced in gathering and assessing customer requirements using Rational UML.
• Knowledge of healthcare information systems, experience with Practice Management software and fully trained on HIPAA Guidelines.
• Knowledge of ICD 9/ CPT codes.
• Developed the competency to plan, design, and implement EMR solutions for Healthcare entities.
• Test EMR applications to find errors and ensure applications meet specifications.
• Work closely with EMR vendors to gather information about application needs, as well as input and output requirements.
• Developed Analytic and Research writing skills by conducting surveys, and analyzing results.
• Successful hands-on experience using HIT software such as, CERNER Power Chart, ZIRMED, PAYDC, HS WORX, WebPT, NaviNet, CollaborateMD, and ATHENA HEALTH.
• In-depth understanding of HITECH and ONC Initiative to encourage widespread HIT adoption.
• Comprehension of principles and processes related to the provision of customer and personal services including assessing customer needs, exceeding quality standards for services, and evaluation of customer satisfaction.
• Utilize project management skills by analyzing the strengths, weaknesses and opportunities of an organization and suggest appropriate courses of action required to effectively and efficiently address myriad challenges facing the organization.
• Self-motivated individual with strong communication skills, great attention to details and the ability to work under pressure.
• Exceptional organizational and time management skills and the ability to work independently as well as in a team setting.
• Excellent team player with demonstrated experience of working diplomatically and collaboratively with all levels of staff to ensure successful implementation of assignments.
• Effectively motivate and foster morale across a diverse group of patients utilizing excellent interpersonal skills.

PROFESSIONAL EXPERIENCE

Clinical Application Analyst

Confidential

This is a Pain Management and Physical Therapy Clinic, which needed help with implementing an Electronic Medical Records EMR System. The clinic was seeking the ability to conform to a paperless office by streamlining all their clinical data, and medical claims data to the newly implemented system. This would allow for better transparency, increased productivity, and improved workflow among the clinical and non-clinical staff. Some benefits of this newly implemented system was to improve on the quality of care giving to patients provide a patient centric environment through the use of a full integrated EMR system ensure patient demographics are entered into the system and adequately tracked and track all clinical supplies used to treat patients. This project was very helpful in providing patients with the most beneficial care through the use of evidence based clinical decision making. I was also involved in the Data modeling process for various tables to be included in the database, utilizing Microsoft VISIO as a platform for modeling data for easier understanding for stakeholders.

Responsibilities:

• Conduct JAD sessions to elicit requirements from medical personnel while ensuring feasibility with technical leads.
• Ability to gather business requirements for the design of the systems database.
• Design and developed Use Cases, Activity Diagrams, and Sequence Diagrams while using UML.
• Ability to identify Data Entities, Attributes, Relationships, Constraints, Primary keys, Foreign keys as well as organize data in a normalized fashion using normalization techniques within the database.
• Produced product requirement documents including use case diagrams and scenarios that provide detailed explanation of what is to be delivered with level of priority.
• Review test cases to ensure accurate and complete testing of user requirements.
• Conducted requirement workshops and interviews to gather business and systems requirements from approvers, team leaders, and other stakeholders.
• Assist with the successful roll out of new EMR systems.
• Worked as a liaison between business users, testers and application development team.
• Design and implement patient flow sheets.
• Ensure systems compliance with meaningful use guidelines.
• Routine Clinical Documentation on Electronic Medical Record Software.
• Generate and analyze data on the trends and utilization of clinical resources and prepare reports as needed.

Reimbursement Data Analyst, Confidential

The pain management and physical therapy clinic, needed help optimizing their claims processing unit. This project entailed tracking and analyzing all medical claims as well as maintaining all clinical data and ensuring that the clinic is reimbursed in a timely manner. In addition we used data to identify clinical trends in order to identify effective treatment protocol we also utilized the data to improve on marketing, with the end goal of cutting down on wasteful expenditures. Analysis of patient utilization of treatment was also performed in order to eliminate any unwarranted treatment protocol. While at this organization, I have been able to help with the extraction and migration of data from their legacy system into a new system which was implemented as a result of an upgrade. In addition we also had to extract data from the practice management systems, and EMR system into the data warehouse using an ETL tool.

Responsibilities:

• Routine Communication with insurance companies to ensure timely payments of medical claims.
• Performed ad-hoc reporting analysis as well as manipulate complex clinical data on MS SQL SERVER.
• Wrote SQL statements to retrieve data from disparate tables utilizing JOINS on SQL Server.
• Validation of claims data from all resources for accuracy utilizing structured queries.
• Generated and analyzed data on the trends and utilization of clinical resources as well as prepare reports.
• Perform random sampling of claims data to ensure compliance with billing rules and regulations.
• Ensure patient charges and insurance payments are accurately entered into EMR System, and cross referenced with Healthcare Clearinghouse.
• Initiate insurance verification prior to treatments.
• Perform chart review to determine integrity of medical records and medical billing.
• Collection and dissemination of patient health information and ensure the completeness of patient medical records.
• Effectively utilize data analytic tool to analyze and monitor patient health status to identify successful treatment protocol.
• Regularly convey complex information regarding patient treatment, insurance regulations/coverage, etc.
• Routinely collect and discuss sensitive patient information via face-to-face and phone interactions.
• Successfully manage accuracy and relevancy of information contained in patient records.
• Manage inventory and purchases of medical and office supplies.
• Provide comprehensive training and mentoring to new personnel.

Rehab Technician, Confidential

• Attended several clinical in-service meetings and regularly engaged in on-the-job training.
• Utilized attention to detail and time management skills to accurately enter monthly billing figures into a database system.
• Regularly participated in quality circle teams and effectively solved issues related to quality and productivity.
• Assist patients in performing rehabilitative exercises and regularly convey technical and non-technical information.

Sales Representative, Confidential

• Utilized superior interpersonal and technical skills to generate sales and regularly exceed sales expectations quotas.
• Successfully managed competing priorities, shifting workloads and changing deadlines.
• Effectively identified customer needs and used persuasion skills to lure customers into purchasing equipments to meet/exceed their needs.
• Routinely explained complex and technical information regarding the use, operation, and care of merchandise.