Manager Management

Emily M. James

**** ****** *****, ******, ** ****9 ***********@*****.*** 512-***-**** M

Director of Billing / PFS Director / Product Manager / Chief Revenue Officer / EDI Medical Practice Office Administrator / Sr. Business Analyst / RCM Summary of Skills:

Strategic direction, product planning, roadmap creation, execution and adoption of solutions throughout the product development lifecycle

R&D Medical Software Development

Documentation of Requirements, User Stories, Use Cases

Extensive Revenue Cycle Management experience

CAH PFS Management; Inpatient, Outpatient, Ancillary, Emergency Room, Registration, Billing and Collections

FQHC/CHC/RHC experience; billing and collections, revenue cycle management, detailed reconciliation of quarterly WRAP funds, grant reporting, clinic management, finance

Direct supervision of 10-25+ employees

Research, Implementation/Project Manager and Training for multiple Practice Management and Electronic Medical Records systems

CPT4 and ICD-9 coding of surgical procedures, hospital and office evaluation and management

HMO, PPO, Medicaid, Medicare and commercial insurance contracts, claims, appeals and reimbursement knowledge, payment and charge posting

Trainer and Super-User/Expert Proficiency for NextGen EPM/EHR (NCP EPM), AthenaHealth PMS, Digichart EMR and Mysis Medic/Tiger PMS

Proficient in developing policy, procedures and processes for existing and new departments

Extensive experience with electronic healthcare claims and real time eligibility transactions, ERA

Project Management experience

Site and Provider Credentialing

Work History:

NextGen Healthcare Information Systems, QSI, Austin, Texas Product Manager - PFS, EDI, Scheduling July 2014 – January 2016 Senior Business Analyst – PFS, EDI, EMPI, Ambulatory, In-Patient December 2012 – July 2014

Developing and executing product plans and roadmaps for various products with clear understanding of the market direction, regulatory requirements, technology trends, competition, portfolio management and other variables impacting product strategy

Work closely with internal stakeholders (e.g. Development, Sales, Marketing, and Client Support)

Represent the organization as a Subject Matter Expert, including industry presentations, government and commercial initiatives, client collaboration, prospect events, sales support and other external situations

Collaborate and work with UX/UI team to plan product features with usability in mind

Create, manage and maintain business requirements

Ensure execution against envisioned product parameters for monitoring product performance, and activity to ensure all aspects of product delivery

Prioritizing and managing requirements

Demonstrate features to internal and external stakeholders and solicit feedback to sanction the design

Develop diverse exhaustive use-case scenarios to test the design of the system.

Communicate the design and intention of the requirements to the developers.

Cross-integrate requirements into other application areas when appropriate

Software Product Development/Management

Emily M. James

8102 Cahill Drive, Austin, TX 78729 ***********@*****.*** 512-***-**** M Heart of the Rockies Regional Medical Center, Salida, Colorado May 2010 – November 2012 Patient Financial Services (PFS) Manager/Director

Direct Daily Management of 25+ employees

Daily Management of Critical Access Hospital IP, OP and ER Registration, Front Desk, Billing and Collections

Revenue Cycle Management

Development of improved Process and Procedures to maximize operational efficiencies allowing for a 50% increase in monthly encounters without adding addition staff or shift hours

Development of streamlines CICP reporting process, decreased prep time by 75%, improved compliance from 45% to 100%

Oversee physician billing/collections for Internal Medicine, Orthopedics and Sports Medicine, Urology, Oncology and Rural Health Clinic

Project Management

Complaint Intake Coordinator

Charge Master management and maintenance

Contract negotiations with Insurance Companies and Vendors

CPSI, CraneWare, SharePoint, ClaimRemedi, FirstData, Insight Reporting experience

Departmental budgeting and maintained budget compliance for two departments simultaneously

Selection, Implementation and Training of NextGen (EPM and EHR) in five specialty locations

Development of Training curriculum and materials for NextGen EPM Lone Star Circle of Care. – Georgetown, Texas June 2007 – May 2010 Practice Administrator/Director of Billing and Patient Revenue / Billing Systems Senior Manager

Direct Daily Management of 10-25+ employees

Implementation and Training of new software system NextGen (EPM and EHR) at three separate safety-net practices in the Williamson/Travis County Area

Development of Training curriculum and materials for NextGen EPM

Creation/Implementation/Management of In-House Billing and EDI Departments

Development of Process and Procedures for the OBGYN Clinic and Billing/EDI Departments

A/R, Collections, Billing, EDI

Grant Reporting

Development of accounting/finance reporting for three safety-net (CHC/FQHC) practices in the Williamson/Travis County Area

Liaison between the Account/Finance Department and Billing Department

Liaison between IT/Tech Support/Development and Billing/Finance/Account Department requirements/needs Travis OB/GYN Associates, P.A. – Austin, Texas June 2005 – April 2007 Practice Manager/Business Office Manager

Direct Daily Management of 25+ employees

RCM, Central Billing Office Management

Facility Management, HR Management

Training and Implementation of new software systems AthenaHealth PMS and DigiChart EMR

Development of Process and Procedures for the clinic and billing department

A/R, A/P, Collections, Billing

Contract Negotiations with Insurance Companies and Vendors

Marketing, Budgeting, Purchasing

Emily M. James

8102 Cahill Drive, Austin, TX 78729 ***********@*****.*** 512-***-**** M Cardiothoracic and Vascular Surgeons, P.A. - Austin, Texas Medical Surgical Coder/Accounts Receivable Representative Texas Cardiovascular Consultants, P.A. - Austin, Texas Office Manager

Allergy Testing Laboratory, Esoterix, Inc. - Austin, Texas Office Manager/Accounting Assistant

Education:

Texas A&M University, College Station, Texas

Bachelor Business Administration Degree

Management with Human Resource emphasis

Industry Affiliations/Certifications:

American Academy Professional Coders

NextGen NCP Certification

Medical Group Management Association

HFMA Certified Revenue Cycle Representative

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