Medical Billing Engineer

Resume of Priti R. Jhaveri

Email: *******@*****.***

Resume of Priti R. Jhaveri

Email: *******@*****.***

Work Experience Summary:

I have over 24 years of work experience in the computer industry. During this tenure, I had the privilege to work in different industries such as Medical Billing company, telecommunications (Lucent Technologies), leading developer of relational database software (Informix Corp), software development and hardware distributor (Hinditron Informatics Ltd.), Computers manufacturer (Essen Computers).

During my working years, my roles involved that of a Team Lead, Technical support, Database Analyst, Database Administrator, Customer Support and Application Software Tester.

I have been working in the field of medical billing for the past 12 years, the role I have played in this field are that of supporting Medical Billing software, talking to clients for technical problems for Billing software, resolving internet and computer-printer issues, coordinate with clearing house or Insurance companies including Medicare, Medicaid for Enrollment, claims transmission-rejections and denials. As a lead Database Administrator, INFORMIX being the primary database., Data Modeling, Customer Support and Front-end Application support, Development using Informix tools such as 4GL, ESQL/C and ISQL.

Educational Qualifications:

• Bachelor of Science (Industrial Electronics)

o Watumull Institute University of Bombay India

• Bachelor of Science (Mathematics, Computer Science)

o Bhavan’s College, University of Bombay India

Certifications:

• Oracle Certified Professional (Oracle 8i)

• Informix Certified Professional

Technical Skills:

Hardware: PC Range, Dell-Poweredge -Windows Server, NCR, DELL Unix Server, Novell

Operating Systems: Unix, Ultrix, Windows 98/2000/XP/7/10, MS-DOS

Relational Databases: INFORMIX On-Line ver 5.xx

INFORMIIX Dynamic Server ver. 7.xx

Oracle 8i

Databases: DBASE

EXPERIENCE Total of 25 Years Professional Experience.

Medical Billing Software Office: Provides Medical Billing Software and inhouse Billing

March 2003 - Current) Medical Billing Software and Hardware Support Specialist

Hardware: PCs and Windows Server, Networking and System Configuration. Printer/Scanner Setup and Support.

Software: Windows Server, Windows-10/7/XP/2000, Microsoft Office WORD/Excel, Office 365, IDrive Backup Setup.

Scope of Work & Responsibilities:

I acquired a broad skill set which has enabled me to perform the tasks that are required of me. We provide required Hardware and Software for providers office and support their systems, including our in-house developed Medical Billing system. We prepare machines off-site, Install-Configure Windows, Setup Networking, create users, assign permissions, install and configure anti-virus software. Install Printers and share printer and other resources on the network. Create System Image and System Recovery Disk, Setup Windows Backup. Once system is taken at the client side, I support using remote support. I Support clients for their day to day operations, any issues related to our software, Windows Updates or any hardware or machine related issues including network-connectivity or antivirus related problems. I setup and support Medical claims transmission system too.

We also try to recover data and rebuild the system if possible. We use LogMeIn, Team Viewer and NetOp Remote Control Software for support calls. We support about 75 clients.

I was responsible for setting up and configuring about 80 clients to 4010 and 5010 format changes and recently ICD10 changes were implemented.

I am responsible for the clients’(doctor’s) enrollment process to transmit claims and receive reports from Clearing House like (EMDEON and MDONLINE), Direct Medicare and Medicaid and BlueCross BlueShield.

Recently helped all the clients to move on to Novitasphere System. While working with EDI department with Medicare, Highmark BCBS, Availity and Ability, I have acquired extensive knowledge about the claims file Loop-Segment format. Using this expertise, I help clients for the transmission problems, including first and second level level (999 and 277) rejections. Explain reason for rejections to the clients and help them to transmit corrected claims, secondary claims. I also coordinate with Insurance companies and clients for any specific rejections/EOB denials, like enrollment issues or payer specific changes and Paper (HCFA-1500) claims rejections.

I have worked with WEBMD, EMDEON and MDONLINE clearing house, HighMark-eDelivery systems, IL-Availity Clearing House, Palmetto GBA eServices. Coordinated for creating providers accounts for transmission, setup and configured Medical claims transmission process for providers. Fill out required enrollment forms and explain Transmission and receiving reports process, analyze claims rejections and explain the reason for rejections to the providers-doctors’ offices.

I was also involved in the testing of different Medical Billing Software like Office Ally, KAREO, MPM-Pro. Check all aspects from users’ side. Create Practice, Enter Providers data, check Group and Individual Practice configurations. Enter valid data and check transmission for Commercial and Government Insurances.

Setup and check Remote Desktop Connection for clients to connect from their home or other office locations. Setup iDrive backup for office machines. I am also familiar with Procomm Plus, ROBOFORM and QuickBooks and Office 365.

I am also responsible for preparing aging reports for unpaid claims and distribute to the team of 10 for different providers. Work on secondary Insurance claims and transmit those claims with correct line posting and reason codes.

TSR Consulting Services- USA. Consultant to Lucent Technologies, USA May 1996 – December 2000 Consultant to AT&T, USA

Database Administrator and Client Support.

Projects: TCMS (Treasury Cash Management System)

Hardware: NCR Systems

Software: Unix, Informix Dynamic Server, 4GL, ESQL/C, I-SQL, PL/SQL

Scope of Work & Responsibilities:

Technical Area: TCMS (Treasury Cash Management System) Database Administrator

• Analyzing the requirements and working on the logical design and implementing the physical design.

• Designing, documenting, implementing and training the users for Disaster Recovery Procedures for client and Server Systems.

• Coordinating with the System Administrators for installing Informix Products. The Informix products included Dynamic Server 7.2, ESQL/C, Informix-4GL. I was responsible for designing of the setup procedures for installation and fine tuning of the Informix software on development, test and production machines during Y2K period.

• Tuning the kernel parameters, file system layout and database disk layouts.

• Creating the database schemas, extent sizing, archiving and logging strategies.

• Designing and writing shell scripts for

- Reorganization of database tables for better performance.

- Paging and Alerting the support personnel for database problems.

- Maintenance of users and their access to the database.

• Maintaining the security and access control to the database by the users.

• Installing and troubleshooting client side TCMS and I-Net software in a client-server environment. It also included preparing and providing the documentation and support to more than 65 users.

• Maintenance of multiple instances on the same system for developer’s testing and users testing during cloning period. Cloning was performed during the separation of Lucent Technologies from AT&T.

• Interacting and coordinating with the users and developers for any application changes and new requirements.

• Performing any database related changes for triggers and stored procedures.

• -Providing maintenance and support for Wire Input Polling System(WIPS). This system included polling bank data and checking feeder file processing.

Informix Inc. India Office

May 1995 – March 1996) Technical Support Engineer.

Hardware: DEC 5100, HP-9000, PC-486

Software: HP-UX, DEC, SCO, Informix Products

Scope of Work & Responsibilities

• Provided both Pre-Sales and Post-Sales technical support for a broad range of Informix customers.

• Responsibilities included Installation, Configuration, Benchmarking and Parameter Tuning. Also prepared setups for Training courses.

• Setting up and performing Informix product demonstrations to prospective clients.

• Extensive troubleshooting and problem-solving relating to installation and performance issues as well as application problems. Answering Technical Queries.

• Benchmarking (based on a complex set of requirements simulating the customers environment on the customers platform)

• Answering technical queries about Informix products from various Informix customers (Siemens, Reliance, Larsen & Toubro, Asian Paints)

• Setting up and participating in INFORMIX road shows and exhibitions

The post sales job involved

• Informix Product Installation (including Informix On-Line, 4GL, I-SQL, I-NET, I-STAR etc.)

• Conduct training on all Informix Products

• Fine tuning Informix and UNIX, based on the knowledge of Informix and UNIX internals

• Client application review and recommendations for performance and tuning. The review involved understanding customer’s database design and client applications. The recommendations were based on the specific technical knowledge of Informix and that of the application.

Hinditron Informatics Ltd., India

November 93 – April 95 Sr. Software Engineer – Informix Support

December 1992 – November 1993 Sr. Software Engineer – System Support

Hardware: DEC 5100, HP-9000, PC-486

Software: HP-UX, DELL Ultrix, SCO, Informix Products, Windows 3.3

Scope of Work & Responsibilities

-Responsible for INFORMIX Installation, Configuration, Benchmarking, Parameter Tuning.

-Solved installation, performance related and other application problems.

-Performed product Demonstrations and Training.

-Responsible for UNIX and PATHWORKS support.

-Create Users, assign permissions, help for password resets.

-New software installation, setup work station with network connectivity for development team.

-Configured modem, printer, terminal server and email services.

-Performed maintenance and training for HITEK-07 graphics emulator and HT340 emulator.

Essen Computers Ltd. India

August 1989 – November 1992) Hardware Customer Support Engineer

Hardware: Pc-XP, Pc-AT

Software: DOS, Windows, Novell, Unix

Scope of Work & Responsibilities:

-Responsible for maintaining PC/XT/AT -PC range of products.

-Repaired and tested of power supply, monitors and printers up to component levels.

-Installed and maintained Voice Message Exchange Machines.

-Installation, Configuration and maintenance of UNIX and NOVELL networks.

Courses Attended:

2001 - SQL STAR INTERNATIONAL LIMITED – Bombay India

• Oracle 8i Database Administration – I and II

• Oracle 8i Network Administration

• Oracle 8i Performance and Tuning

• Oracle 8i Backup and recovery

1998

• SAP50 R/3 Basis Technology (4.0) 2 days

1995 - INFORMIX Inc., Asia/Pacific, Singapore

• Informix Online Dynamic Server System Administration -I

• Informix Online Dynamic Server System Administration -II

• Informix Online Dynamic Server System Performance Tuning

• Informix Online 5.0 Internal Architecture and Advanced Administration

• Informix Online 5.0 System Administration -I

1994

• Developing Applications Using Informix-4GL

• Developing Applications Using Informix-ESQL/C

• Informix SE Administration

• Informix Online 5.0 System Administration

• Incorporating Stored Procedures and Triggers into Informix Databases.

• Managing and Optimizing Informix Databases.

• Configuring Informix-NET and Informix-STAR

TRAININGS CONDUCTED:

Siemen’s India Ltd.

• Developing Applications Using Informix-4GL

• Informix Online 5.0 System Administration

• Managing and Optimizing Informix Databases

Larsen & Toubro Ltd

• Developing Applications Using Informix-4GL

• Informix-SE Administration

Reliance Industries Ltd., Nestle India Ltd. & Amijay Elastic Processors Pvt. Ltd.

• Informix Online Dynamic Server Administration-I

Goodlass Nerolac Paints Ltd.

• Developing Applications Using Informix-4GL

• Introduction to Database and Server Administration

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