Manager System
Resume:
Lisa Adams
Villa Rica GA ***80
Home Phone 770-***-****
E-mail ********@*********.***
http://www.linkedin.com/in/adamslisa
Objective: Improve service, increase productivity, profitability and secure
myself continued advancement and compensation through team and individual
contributions.
Qualification Summary: 14 highly skilled years. Knowledgeable in Cerner
Powerworks, Monarch, Crystal, Payerpath (AllScripts), Cyberquery (Advanced
Reporting tool), NextGen Practice Management, Gateway EDI solution, and
some knowledge of NextGen EMR.
Significant Experience
1996 - Current Wellstar Health System Marietta GA
Wellstar Health System
1996 Data Entry Clerk -Payment Posting
1997 Data Entry Supervisor/Interim Manager - Supervise & train 20
employees, posting & balancing the A/R billing system.
1998- 2008 Special Projects Manager - Liaison between the Business Office
and I/T
2008- current Manager of Billing Operations and Systems
. Key contact, owner and core member of the Practice Management system and
the Claims Manager system
. Instrumental in establishing the interface & transition between our
existing system and a new internal billing accounting system.
. Maintain entire General Ledger of Wellstar's billing system for 70
practices within the Physician's Group ensuring that the A/R is rolling
up appropriately and that all providers are compensated appropriately.
. Instrumental in the upload and updates of new payer contracts into the
billing system, track reimbursement and/or underpayments made by payers.
Trained/formed a Fee Schedule team to continue this process.
. Responsible for pricing and fee schedule analysis yearly to ensure no
monies are left on the table. Also, created CPT code specialty
spreadsheets for all payers by practice, provider, & business office to
view at a global level as opposed to looking at it per contract...great
analysis tool! Responsible for all physicians' group pricing methodology
for all specialties (based on RVUs).
. Instrumental in implementing, documenting, testing & training of our
current claims/EDI solution for 70 practices/1100 employees in less than
a year. Assists practices with issues or failed claims. Directly educate
vendor with system customizations needed via payer requirements and/or
practice. Customizations personally reviewed, tested & released to the
practices with documentation to support these changes.
. Instrumental in reducing the number of submitted paper claims, currently
we are at 95% electronic claims submission for both primary and secondary
claims with a 98% clean claim rate.
. Instrumental in reducing the volume of paper EOBs and the manual process
of posting remits by implementing electronic remits for 90% of our payer
mix as well as expediting payment via EFTs.
. Maintain the majority of the application master billing system tables.
Design, customize & provide reports for all areas of the Physician's
Group from administration to the end users. Instrumental with
interfacing & contacting billing systems providers & collection agencies,
reduce the number of statements delivered.
. Responsible in testing, documenting and training all practice management
system upgrades (usually twice a year)
. Facilitates a User Group meeting for all users every two months in
regards to both our claims and billing system.
. Continuously streamlines processes that benefit all users as we want "to
work smarter not harder"
. Oversees a Help Desk (5 System Analysts) that support both the billing
system and claims system for the entire Medical Group that encompasses
over 70 practices
. Work very closely with Coding/Compliance department to ensure that all
practices are standardized in our processes and code/document
appropriately meeting CMS guidelines.
. Currently, in the process of building/testing a new Practice Management
system (NextGen) and Claims EDI solution (Gateway) to be rolled out to
all 70+ practices with a completion date of 10/1/11 while also bringing
on all newly acquired practices as we move forward.
. Responsible for "go live" implementation for the billing/claims software
for all 70+ practices (team of 6 that includes myself) as well as
continuing to support the current practice management software.
1992 -1996 Tampa General/St. Joseph's Hospital Tampa FL
Data entry, payment & charge posting
Education 1983- Florida Junior College (Jacksonville Fl) Associate in Arts
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