ANGELA E. STEVENSON

404-***-****

acq0i9@r.postjobfree.com

PROFESSIONAL SUMMARY

17+ years’ experience in Managed Care, Revenue Cycle & Claims Processing

Strong experience with Epic Tapestry Core, UM & Referral, Plan Link, Business Segmentation, Benefits Engine HP & AP Claims

Strong leadership aptitude

Strong knowledge in EPIC Data Courier

Project Management

ICD-10 Implementation & Conversion

Professional & Hospital billing

Epic Certification - EPIC/ Benefits Engine Basics, AP claims & Health plan

Proficient & Knowledgeable in Tapestry AP Claims, Provider Contracting & Eligibility

EDUCATION/CERTIFICATION

Beulah Heights Univ. - B.S. in Leadership & Administration – Exp. Graduation Date: 8/ 2016

CPAR- Certified Patient Accounts Representative- 2006

EPIC – Certified Benefits Engine HP & Benefits Engine AP Claims

PROFESSIONAL EXPERIENCE

PEACE HEALTH – (CHERY CONSULTING) SPRINGFIELD, OREGON – 3/2014 – 5/2015

CONFIGURATION ANALYST

Responsibilities:

Loaded new contracts, authorization and benefit configuration.

Modified the provider contract, authorization rules and benefit plan configuration as required.

Configured contracts, benefits and rules and general edits to support claims processing.

Examined benefit explanation of coverage to determine best approach for loading benefits offered, including co-pays, out-of-pocket maximums and state/regulatory benefits.

Created Copays using Visit Type benefit group, specified visit type benefit grouping in the Visit type master file record, updated and corrected visit type components.

Testing of AP Claims, Performed configuration activities in one or more of the following areas: institutional and provider contracts, benefits, authorizations, and/or general configuration, such as system edit rules, fee schedule updates.

GROUP HEALTH - (WORKBEAST CONSULTING) MADISON, WISCONSIN – 7/2013 – 12/2013

EPIC TAPESTRY/ BENEFITS ENGINE – CONFIGURATION ANALYST

Responsibilities:

Created new benefit buckets, adjudication tables and formulas to be built in order for benefits and claims to adjudicate accurately.

Familiar with CPT codes, diagnosis codes, payment methods including fee schedules, RBRVS, DRGs that support AP Claim payments.

Tested build through claims after benefit/master files build, to make sure claims adjudicated correctly.

Worked and Collaborated with other EPIC application modules to support Tapestry, Tapestry Referrals and Benefit Engines such as ADT/Prelude, Cadence, Professional and Hospital billing, My Chart.

Referrals Build: Building Rules, EAP, Preference List, Services Sites, Classes, Types, and Reasons, Department or location.

Built Benefit packages and plans for HCR /Marketplace, Outlined Client business needs into Epic solutions, Tested claims to ensure proper processing, Documented and updated workflows, Built, updated & managed Master file records, CRM build, Provided analytical and processes support to the internal business partner related to Tapestry & BE.

SUTTER HEALTH - (BAHAMA CONSULTING) SACRAMENTO, CA - 12/2012 – 6/2013

EPIC TAPESTRY – TEAM LEAD / IMPLEMENTATION OF ICD-10

Responsibilities:

Tapestry Build Experience w/ ICD-10 Conversion

Tapestry Lead for ICD-10 Conversion, Involved in procurement of requirements for ICD 10 diagnostic codes implementation, ICD 10 organizational strategic planning to accommodate the Epic implementation timeline, organization's other software/upgrade dependencies and the regulatory date requirements.

Provided analytical support to help identify systemic risks and opportunities resulting from the ICD-10 mapping and rule definition efforts. (Gap Analysis) Researching and troubleshooting issues to understand software build steps needed for production environment of business application.

Defined ICD-9 to ICD-10 mapping process using GEMs, Converted ICD-9 codes to ICD-10 in Tapestry Systems, provided build, test & validation support, Created & Revised workflows and test scripts used for testing activities, provided training to end users.

Created Presentations for Management teams illustrating results of analysis. Identified & Documented test issues during testing.

KAISER PERMANENTE ATLANTA, GA - 3/2007 – 11/2012

EPIC TAPESTRY/BENEFITS ENGINE - CONFIGURATION ANALYST 8/2009 – 12/2012

Responsibilities:

Full life cycle - Implementation, designed, validated, build and test of EPIC Tapestry/ BE applications which includes: Design, Build, and Test & Go-Live).

Provided build, testing, and support for CRMs, Business Segmentation, capitation, eligibility, resolute, referrals, AP claims.

Hands on experience of managed care areas of the healthcare business including, AP Claims, Business Segmentation, Benefits Engine, Referrals.

Understanding of Case Management, experienced in creating contacts in Tapestry Admin.

Created new Payors & Benefit Plans/ Packages in the system.

Developed test plans, test scripts and workflows via Visio.

Built and modified benefit packages, imported, updated and managed master files: EPG, DPG, CPG, CMG, PPG, SER, REF, CMK, Created reviewed & authorized provider referrals; Set up provider records.

Advised business partners on operational changes and system revisions.

OPERATIONS SUPERVISOR 3/2007 – 8/2009

Responsibilities:

Managed 15 - 20 Appointment Scheduling Call Center agents.

Managed service level to 80%, and above.

Responsible for conducting Quality assessments & performance reviews.

Developed training and coaching materials.

Created and maintained department job descriptions.

Implemented procedural and departmental changes. Interviewed, recruited and hired FTE and Temp employees.

Operated as the lead point of contact for any and all matters specific to Appointment scheduling.

Facilitated management and team meetings.

PEROT SYSTEMS LANCASTER, PA – 2/2006 – 2/2007

REVENUE CYCLE PROJECT MANAGER

Responsibilities:

Managed the day-to-day operations of A/R dept. of Auto Claims & Workers Comp division at a major Hospital

Ensured collection of accounts through extensive follow-up.

Prepared and filed HB &PB electronic claims.

Provided timely analysis of revenue cycle to enhance claims processing and cash flows.

Defined areas of weakness within department workflows & devised action plans.

Created a handbook for the collections department.

Lead the department in collecting over $35 million in revenue from High Dollar claims.

Developed strategic business relationships with other department Managers/Directors.

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