Project Manager Training
Resume:
CORA V. TURNER
Lawrenceville, GA **044
****.******@*******.***
www.linkedin.com/in/coraturner/
SUMMARY OF QUALIFICATIONS
A professional with over 10 years of experience in the healthcare
industry. Professional background includes both client-facing roles
and several years of supervisory experience. Proven success
implementing clients' need into software application development and
training variety of end-users (direct staff, providers, clients, and
management).
Proficient in the following competencies:
. Exposed to using ICD 9/ICD 10 coding standards in Medicare and
Medicaid domains of the healthcare systems and industry for
inpatients, outpatients, Reimbursement methodology.
. Experienced in creating End- User Test Plans. Thorough hands on
experience with designing test cases covering all test conditions
and eliminating redundancy and duplications.
. Partner with subject matter experts to gather and develop detailed
business requirements for system implementations and service
requests.
. Prepared the Business Workflow Diagrams using MS-Visio.
. Medical Claims experience in Process Analysis and Implementation
in 835/837/834/270/271/277/997(X12 Standards) processes of Medical
Claims Industry from the Provider/Payer side.
. Proficient in gathering business and technical requirements from
both formal and informal sessions through interviews, WebEx,
questionnaire, video conferencing, and conference calls.
. Conducting training sessions and designing training materials.
EDUCATION
Bachelors of Business Administration, concentration in Finance
Augusta, GA
Georgia Regents University (formerly Augusta State University) May
2005
CERTIFICATIONS
Certified Patient Account Representative (CPAR) Complete 2009
Financial Management Association
WORK EXPERIENCE
PrimeCare Technologies Duluth, GA
Business Analyst Nov 2012-Mar 2014
The project required development, trouble shooting and enhancements of
PrimeVIEW Dashboard application. PrimeVIEW gives the employees the ability
to see in-depth variety of key performance indicators (KPIs) within the web-
based application. This includes a date-range filter for extracting
accurate data within a particular service date, along with the ability to
filter by Region, Facility Name, States, Medical Type and/or Group.
Responsibilities:
. Conducted Joint Application Development (JAD) sessions to collect
requirements from business owners, SMEs (Subject Matter Experts) and
marketing team and prepared business requirement that provided
appropriate scope of work for technical team to develop prototype
and overall system.
. Worked with the project manager for planning and organizing the
project activities, and in communicating with other business
managers and stakeholders of the project.
. Maintain thorough and concise documentation for tracking of all
software configuration change request forms for quality audit
purposes.
. Assisted with the developing test scenarios / test cases for testing
the functional requirement.
. Worked closely with QA and Developers to clarify/understand
functionality and resolve issues.
. Retrieved client's data files and mapping using SQL statements.
. Participated in Database Design session.
RHA Behavioral Health Services Atlanta, GA
Accounts Receivable Supervisor (Government Payer)
June 2006- Nov 2012
RHA Health Services, Inc. is a $220M multi-specialty healthcare system
providing 'patient-centered' Behavioral Health, Intellectual Development
Disabilities (IDD), and assisted living/long term care services in
Tennessee, North Carolina, and Georgia. RHA consist of 2 sub-acute 16 bed
facilities, 15 outpatient clinics, two pharmacies and over 600 clinical
staff.
I provided overall supervision of the Accounts Receivable Team to ensure
that claims are processed accurately and timely. Analyzed the credentialing
and re-credentialing process for physician and non-physician practitioners
staff in satellite facilities in North Carolina and Georgia. Achieved a 33%
reduction in accounts receivables within 3 months from $1,116,550.63 to
$378,244.44.
Responsibilities:
. Worked on analysis of ICD9 to ICD 10 conversion for the new qualifiers
used in the 837 claims for the diagnosis and procedure/HCPCS codes.
. Held regular meetings with the software developers to assure that the
critical software projects were discussed and issues were resolved
beforehand.
. Gathered requirements for North Caroline managed care incoming 834
enrollment file / data to the Eclipse ERP system.
. Assists with data collection and cleanup for the Medicare Credit
Balance report.
. Developed, implemented and maintained record-keeping systems,
forms, application, and procedures related to billing, processing,
cash receipts and other accounts receivable activities.
. Under general direction, gathered, defined and documented highly
complex business requirements for NPI crosswalk.
. Performed manual testing by building 837 claims, converting them into
EDI file, uploading them into mainframe region and doing error
resolution & testing for 5010 requirements & NPI crosswalk.
. Answer questions and inquiries about system functionality and provide
user support, including training, help and instructions with end-users
in North Carolina.
. Developed a Microsoft Access database, including but not limited to
medical licenses, board certification, DEA/CDS Certificates,
provider/NPI number and renewal period expiration dates.
HCA Health Care
Norcross, GA
Refunds Department Supervisor
May 2005 - June 2006
Nashville-based HCA (Hospital Corporation of America) was one of the
nation's first hospital companies. One of the nation's leading provider of
healthcare services, a company comprised of locally managed facilities that
includes about 165 hospitals and 115 freestanding surgery centers in 20
states and England.
I provided overall supervision of the Refunds Department Team to ensure
that the refunds are processed accurately and timely. Arranged training
modules for new process development and implementation. Utilized systems
for refunds and credit balances. Scrutinized percentages of claims
processed to ensure correct coding for claims. Determined contractual
adjustments to resolve outstanding issues.
Responsibilities:
. Managed 25 - 30 hourly employees in a call center environment while
monitoring and evaluating production reports/metrics on a daily basis
through the call center systems.
. Functioned as lead on several projects and provided written and oral
feedback and recommendations to management and providers, which
increased workflow productivity.
. Collaborated with key providers ranging in size from $100,000+ to
several million dollars; brought on to turn around issues with claims
process, acting as point of contact; result was significant increase
in customer satisfaction.
. Organized/planned employee schedules on a weekly basis to through
workforce management.
. Provided leadership and direction to employees in order to effectively
achieve goals and objectives through coaching, continuous learning,
collaborative relationship building, motivating, evaluating and role
modeling.
CAREER HIGHLIGHTS
01/13/2012 - RHA Behavioral Health Services
Developed a Microsoft Access database, including but not limited to medical
licenses, board certification, DEA/CDS Certificates, provider/NPI number
and renewal period expiration dates.
12/17/2010 - RHA Behavioral Health Services
Created a temporary billing form template, in PDF format, that is used to
bill our clients to Medicaid. Received an award of excellence for
increasing the collection rate percentage from 70% to 96.5%. Received a
departmental award for increasing the collection rate percentage by 50%
during the 2010 fiscal year.
04/05/2006 - HCA Health Care
Designed and implemented an Excel Patient Credit Balance Worksheet audit
program to test the efficiency of all aspects of accounting refunds
controls. This Excel spreadsheet allowed for more efficient determinations
of commercial and patient overpayments based on insurance contracts.
SKILLS
. Computer Languages: Microsoft SQL Server 2012
. Adobe: Acrobat (Professional), FrameMaker, Photoshop, LiveCycle
Designer, Reader
. Microsoft Office: Access, Project, Excel (with Power Pivot & Power
Query), SharePoint, Outlook, PowerPoint, Word, Visio, OneNote,
Publisher
. Operating Systems: Windows, iOS, Android
. E-learning: Camtasia
. Other: TurboMeeting, Cisco WebEx Meeting Center, Citrix GotoMeeting,
Audacity, SnagIt, FileZilla, Active Directory, social media and
mobile technology
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