DIANA BEASLEY-WEIGEL

**** ******* ****

Louisville, Kentucky 40220

502-***-**** (C)

SUMMARY OF EXPERIENCE

A proven professional with a broad background in health care finance, clinical data analysis, clinical research and information management. Recognized for expertise in data integration, clinical coding and claims processing. Experienced in data warehousing, decision support, expert systems, executive support, EMR, financial applications and clinical information.

What I do Best…: Ability to review large amount of data and define patterns and issues quickly. Ability to determine the issues from the noise of clinical claims data and resolve the problem.

PROFESSIONAL EXPERIENCE

Aetna,Inc 2013-May 2017

Sr. Clinical Consultant

-Integration of clinical data into a data warehouse.

-Audit and Model data into the Milliman Actuary Application and determine the differences in the Milliman model vs Aetna current Actuary Model.

-Conform Coventry and Aetna authorization data

-Define rules for counting of Observation hrs.

-Review DRG data for Coventry

Humana, Inc. 1987-2013

Louisville, Kentucky

Sr. Clinical Consultant

-Responsible for integrating both Hospital/clinic/physician and independent Laboratories laboratory results data into an enterprise warehouse – via HL7/CCD/CDA and Loinc documentation and mapping.

-Responsible for defining CPT codes, HCPS codes, SNOMED, ICD9, ICD10 and LOINC for clinical decision support system within a laboratory database.

-Developed rules and logic to implement and clean claims into an integrated analytic database.

-Supported Multiple clinical information database (predictive model, Obesity, End of Life, clinical research areas) – resulted in United States Patent #8,543,428, 5,453,125

-Defined and programmed data transformation criteria and integration of claims information from multiple acquisition platforms. This data transformation was used corporate wide in all clinical and financial reporting areas. (PCA Florida, PCA Texas, Choice Care, Badger, Metavance, OSF, MetCare,Cariten, MDCARES, Aracdia, and other acquisitions).

-Acted as lead developer in a financial system used corporate wide for major strategic decisions.

-Clinical review of rules for Predictive Model and other clinical research as defined especially with work related to the University of Miami Medical School, Brookings Institute, Harvard Pilgrim, etc.

-Analyzed data to provide information for Medical Underwriting and Actuary Department, Finance and Clinical Systems

Self-Employed

Information Analyst

-Developed financial, clinical and operational reports for multiple Columbia HCA market sites, Tenet Healthcare, Community HealthCare System.

-Designed strategic financial systems to audit bad debt and claims oversight for Community Health, a for-profit hospital corporation.

National Health Laboratories, Inc.

Louisville, Kentucky

Director of Accounts Receivable

-Managed the operational flow of a regional laboratory accounts receivable department. (AR $10.2 mil/month / 55 + staff).

University of Louisville Medical School

Louisville, Kentucky

Clinical Research Associate

-Performed clinical research, data analysis, computer modeling and associated research.

-Attended daily clinical rounds (trauma, surgical, morality and morbidity, etc.).

-Participated in various medical school computer planning and educational committees.

-Assisted in surgery and patient care

Hospital Clinical Experience

South Florida and Louisville, Kentucky

Clinical Laboratory Technologist

Medical Technologist

Surgical Assistant

Jefferson Community College (part time instructor)

Microbiology

Clinical coding

TECHNICAL

IBM Mainframe Series 3OXX, TSO, MVS/ESA, JCL, DFSORT, QUICKJOB, EZTRIEVE,

DB2, SQL/DS, ORCALE SQL, QJ, PLQ/SQL,SAS,COGNOS

Relational and Hierarchical databases, PL1, Pascal, FOCUS, Lisp

Microsoft Office Products

CLINICAL DOCUMENTATION/CODING

HL7/CCD/CDA/EMR/LOINC/SNOMED/CPT/HCPS/ICD9/ICD10

EDUCATION

M.S. Applied Math & Computer Science, University of Louisville, Speed Scientific School,

Louisville, KY

Graduate Studies University of Louisville Business School

B.S. Bellarmine College, Louisville, Kentucky. Major: Biology/Chemistry

MT/A.S.C.P. American Society of Clinical Pathologist Medical Technology

Professional Medical Coding Certificate (AAPC-CPC- working on CPH)

Courses in ICD-10, HL7,SNOMED,LOINC

PUBLICATIONS/PATENT

Computerized System and Method for Estimating Levels of Obesity in an Insured Population

United States Patent, Sept 24,2013, Pat Number 8,543,428.

Computerized Categorization of Payer Claims; multiple levels

United States Patent, June 06,2010, Pat Number 7,343,142.

Sprat JS, Greenberg RA, Buchino JJ. Witten M, Beasley D: The use of computers in the management of registries for familial adenomatous polyposis. In Familial Adenomatous Polyposis, Ed,., Alan R. Liss, NY, Nov 1990.

Beasley-Weigel DJ: Implementation and development of a regional cancer center management information system, Master of Science Thesis, Speed Engineering School, University of Louisville, 1988.

Shield CB, Beasley DJ, Ratcliff D, Fry D: The influence of acidosis on canine brain mitochondria. Surgical Forum, 31:483-485, 1980.

Shield CB, Beasley DJ, Miles, JP. Albright L : Early management of head trauma, JYMA, January 1980.

Flint L, Beasley DJ, Richardson D, Polk HC: Topical providone-iodine reduces mortality in bacterial peritonitis. Journal of Surgical Research 76, March, 1979.

Voyles CR, Beasley DJ, Wieman JA, Flint L: Wound bacterial clearance following trauma and shock. Surgical Forum 8: 235-242, 1978.

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