Maria Hercilia Baer (Mari)

ad0x63@r.postjobfree.com

210-***-****- / 210-***-****

San Antonio 78221, TX

Summary:

Have obtained positions, in which, I can help clients in a professional and conscientious manner.

An effective team member, who is enthusiastic, personable, and very comfortable leading or collaborating in a professional appearance and manner.

A thorough understanding of the Composite Health Care System (CHCS) – MHS- GENESIS infrastructure and how the Medical Expense and Performance Reporting System (MEPRS) and Department of Défense Medical Human Resource Management (DMHRSI) GFIBs Regulation’s, PowerChart/RevCycle (Inpatient/Ambulatory, FirstNet, Pathnet, Pharmnet, Radnet, Dentrix, RevCycle, and MHS Genesis Patient Portal Regulation’s which impact workload reporting and billing systems processes, workload accounting and aggregation methods, reimbursement policies and budgeting methods.

8 Years of Data analysis, data mining skills including proficiency using Business Objects, MS SQL SERVER, TSQL, (or other Oracle database mining tools), MS EXCEL- Power Pivot, MS ACCESS, SSIS AND SSRS.Tableau,

Proficient with flowcharting tools such as VISIO; writing and presentation skills including expertise using MS POWERPOINT, MS WORD or equivalent.

Professional Experience:

Lackland Air Force Base (Planned Systems International (PSI) Mar 2021 – Nov 2022

Department of Defense- Military Expense Medical Expenses & Performance Reporting Health (MEPRS) and -Medical Human Resource System (DMHRSI)

DHA Business Data Analyst

Lackland Air Force Base (Air Force Medical Support Agency (AFMSA) Nov 2018 - Mar 2021

AFMRA MEPRS System Data Analyst and Quality Assurance Trainer

Provide guidance for uniform reporting requirements and comparable data submission to designated management levels within Air Force Medical Support Agency (AFMSA) and the Air Force Medical and Dental Treatment Facilities. Resource Managers.

, PowerChart/RevCycle (Inpatient/Ambulatory, FirstNet, Pathnet, Pharmnet, Radnet, Dentrix, RevCycle, and MHS Genesis Patient Portal Regulation’s which impact workload reporting and billing systems processes, workload accounting and aggregation methods, reimbursement policies and budgeting methods.

Assist in interpreting, implementing, and disseminating policy to base level by higher level directives.

Assist in the collection of data for development of MEPRS procedural material, program management policies, practices, and procedures.

Provide consultation, direction, and training on personnel, workload, and financial reconciliations to the MTF MEPRS Managers.

Develop metrics to measure the accuracy and variance of all MEPRS personnel, workload, and financial data reported by AF MTF MEPRS Managers.

Ensure the AF MTF MEPRS Manager feedback is received on all data variance identified on the MEPRS Early Warning and Control System (MEWACS).

Consolidate and report feedback on data variance identified on metrics, including variance identified on MEWACS to the AFMRA/MEPRS Program Director.

Manage and maintain new and existing databases to support MEPRS by writing queries and developing reports using Business Objects, Microsoft Access, and Structured Query Language (SQL).

Provide MEPRS and CHCS related training to new and existing MEPRS managers during Knowledge Sharing Sessions.

Monitor EASIV Source Files and Transmission Timeliness at least twice a week and notify MTF MEPRS Managers when they are behind schedule/overdue.

Assist in overall management and oversight of the AFMRA MEPRS Program.

Familiarity with provider templates, empaneling processes, referral management, ancillary and other provider to support ratios. Able to identify and formulate MTF flow models and develop the necessary metrics/statistics/flowcharts/etc. to support such analysis. Understand the processes related to the provision of ancillary services and be able to access, summarize, interpret, and present such data.

Familiarity with MTF Business Plans and their impact under the prospective payment/revised financing rules. Extensive knowledge of monitoring and identifying patient demand in the direct care system and the ability to monitor patient utilization on the network to identify areas for opportunity or recapture.

Able to prepare, organize, and program) to include editing, debugging, downloading, modification and maintenance) both routine and non-routine, ad hoc data queries from standard DoD databases that specifically include: CHCS, AHLTA, M2, MEPRS, EASIV, DMHRSi, RMS and CarePoint, GENESIS

Proficient with flowcharting tools such as VISIO; writing and presentation skills including expertise using MS POWERPOINT, MS WORD or equivalent.

Data mining skills including proficiency using Business Objects, MS SQL SERVER, TSQL, (or other Oracle database mining tools), MS EXCEL, & MS ACCESS.

Tele-BH/ BAMC Infused Solutions - San Antonio, TX Apr 2017 - Sep 2018

Program Scheduler and Data Analyst

Assist in overall management and provides direct support to all the Army Virtual Tele-Behavioural Health Military Treatment Facilities (MTF's) through the Warrior Resiliency Program Tele- BH Mental Status Evaluation Requirements. Subject matter expert related to policy, metrics, and training. Assist in interpreting, implementing, and disseminating policy to base level by higher level directives.

Interface with WRP Providers and healthcare extenders and provide case specific feedback as necessary to complete any Mental Status Evaluations with accurate information and forms. Management of SharePoint Sites and Providers Template schedules.

Responsible for coordinating subordinate employee recruitment, performance assessment, work assignments. Manage processes and procedures to ensure timely and quality completion of work according to client’s contractual obligations.

Responsible for the daily operational workflow, to include communication with external and internal customers, resolution of customer issues, and identify workflow concerns for specific cases and employees.

Direct the training of team members on workflow and contractual modifications expeditiously Analyze and report on a monthly and quarterly basis operational statistic. Provide Data entry and analysis, Draft formal memos. Validate project data and perform updates in various government systems including but not limited, CHCS, AHLTA, HAIMS & EHR, MEPRS file and table functionality.

Provide consultation, direction, and training on building hospital locations and Providers Template in the CHCS file and table structure.to support customer service and correct or complete data errors and/ or omissions.

Responsible for completion of Medical Quality Assurance Training Program. Provide quality assurance and guidance Data Quality to all government personnel, including performing technical support, consultation, direction, and training to all of Army Virtual Tele-Behavioural Health MTF.

Training support with the Army Regulations Instructions and medical system, develop sustainable means to correct and prevent discrepancies, improve timeliness and completeness, and correct erroneous data or complete otherwise incomplete data where possible. These requests for support may come electronically, telephonically (by telephone), in person or in Virtual Tele-Communications. Ensure information captured in our AHLTA, HAIMS, Command Directives Mental Status Evaluation, DD 3822, and Consent Forms is complete, accurate and timely and to continuously improve data accuracy, completeness, and timeliness to assure uniformity, reduce variance, and promote standardization of information in our medical information systems across all our MTF's.

Provide E-forms credentialing tasks in support of the processes managed by the senior credentialing specialists and in response to MTF's requests for WRP Tele-BH. Gather credentialing information, perform PSV of healthcare professionals' credentials, and conduct data bank queries. Reviews credentialing applications, conduct follow-up to obtain missing credentials/information, conduct verifications, create provider credentialing records within CCQAS and maintain the CCQAS record.

San Antonio Military Medical Lincoln Bldg. Jan 2012 - Apr 2017

Referral Specialist CAMO

The primary purpose of this position is to serve as a Military Medical Referral and Consult Clerk III in support of the Consult Referrals Appointment Management Office (CAMO). Coordinate patient scheduling activities for BAMC and WHMC medical facilities ensuring a smooth flow of daily services with Brooks' city Base and Randolph AFB medical facilities to follow.

Writes queries and stored procedures to generate data using Microsoft SQL. Concepts and processes of managed care (both within the military and civilian environment) under TRICARE Contracts, revised financing, consult/referrals and appointment management, primary and specialty care delivery systems, ancillary support services, staffing models and experience with modeling all aspects of healthcare delivery. Knowledge of policies and procedures related to the TRICARE program and the Health Services Support Contract (TRICARE Contracts, TRICARE Plus, TRICARE Prime, TRICARE for Life, Referrals and Authorizations, etc.)

Familiarity with provider templates, empaneling processes, referral management, ancillary and other provider to support ratios. Able to identify and formulate patient flow models and develop the necessary metrics/statistics/flowcharts/etc. to support such analysis. Understand the processes related to the provision of ancillary services and be able to access, summarize, interpret and present such data.

Understand Coding/billing processes sufficient to evaluate processes impacting revenue cycle management. Obtain a thorough understanding of the Composite Health Care System (CHCS) infrastructure and how the Medical Expense and Performance Reporting System (MEPRS) regulations, coding conventions and industry standard reimbursement regulations impact workload reporting and billing systems. Become familiar with DoD coding and billing processes, workload accounting and aggregation methods, reimbursement policies and budgeting methods.

Perform maintenance of medical records and review maintenance of medical records to ensure they are maintained in accordance with Air Force regulations/instructions and other established guidelines.

Perform a variety of administrative duties in support of the medical facility. Provide information in response to patient inquiries on medical providers, scheduled release date, and authorized treatment, instructions on test preparations, diets, and procedural requirements. Aggressively process thoroughly all Specialty Clinic authorizing or re- routing pending Referral within MTF to MTF or Civilian Network ensuring process in a timely manner. Use multiple office automation software with varied functions to produce a wide range of documents, formats.

Manage processes and procedures to ensure timely and quality completion of work according to client’s contractual obligations customers, resolution of customer issues, and identify workflow concerns for specific cases and employees.

Ensure the use of best practice workflows and operational excellence in activities are utilized and seeks methods of automating recurring processes.

SAIC /APPTIS Japan Jun 2008 - Jul 2011

Beneficiary Service Representative (BSR)

As the TRICARE Beneficiary Services Representative (BSR) I provide TRICARE Overseas Program (TOP) educational and technical assistance to eligible TRICARE program beneficiaries regarding specific TRICARE benefits and service.

Perform day-to-day enrolment, portability, and transfer of enrolment via WEB DOES/ DEERs /CHCS

Conduct detailed briefings to beneficiaries who are in-processing, out-processing, retiring, or deploying approximately 8000 personnel yearly. Primary Care Managers (PCM) to beneficiaries who are being enrolled and explain the responsibility of the PCMs they are being assigned.

Produce routine enrolment reports and run daily discrepancy PIT report within the Composite Health Care System (CHCS) resolving data inconsistencies between DEERS and CHCS database. Processing registration of TRICARE beneficiary within the Composite Health Care System (CHCS).

Maintain electronic system/paper files and data integrity. Researches and interprets benefits, policies and procedures to military staff, remote site Points of Contact (POCs), and beneficiaries using TRICARE Policy Manuals as well as other resources.

Provide customer support to the Military Treatment Facility (MTF) Commander and or the TRICARE Area Office staff as directed by the Regional Lead, Deputy Program Manager or Program Manager. Provide phone coverage and assistance for walk-in enrolment traffic within the TRICARE Service Center.

Participate in off-site briefings, such as enrolment briefings, fairs, or other functions if directed by the Regional Lead. Providing education and enrolment information to beneficiaries. Obtain required training and maintain system accounts as appropriate. Availability to the phones, walk in traffic, and faxed enrolment forms are top priorities. Must be able to determine the appropriate assistance levels and when call forwarding, or other referrals are needed to address the beneficiary's question.

Balboa Naval Hospital Navy Drug Lab Jun 2006 - Jul 2010

Urinalysis Coordinator Screener (BSR) SAIC /APPTIS

Designated in writing by the commanding officer. Maintain all urinalysis files −ensure observers and assistant UPCs are properly trained −maintain and update directives and instructions pertaining to urinalysis −ensure command compliance with Navy requirements.

Provide Chain of Custody - The UCS is required to maintain positive control of all urinalysis specimens

The chain of custody begins the moment a service-member takes possession of the urine sample bottle. Chain of custody ends for the UCS when he/she places the urinalysis samples in the mail or delivers them to the NDSL

. Direct Observation - Every sample must be given under direct observation by a member of the same gender as the person giving the sample.

As an observer must never lose sight of the bottle, never take observer must never lose sight of the bottle, never take observer must never lose sight of the bottle, never take observer must never lose sight of the bottle, never take possession session of the bottle, and must watch the urine leave the body and enter the bottle.

Quality Assurance on Specimen Custody and Specimen Document (DD 2624) - DD 2624 is the only specimen custody document authorized.

Skills:

Computer Skills Proficiency in Data General, CHCS,CERNER Outlook, MS Word, Excel, QuickBooks, CSA (Creative Solutions Accounting) Intuit, DOES, DEERS, ALTHA, HAIMS, PCMRA Database, SharePoint, SAIC Intranet. Microsoft Access and Structured Query Language (SQL). (10+ years)

Assessments:

White Belt

Personality: Customer Service Fit — Proficient (November 2019)

Assesses personality traits that result in high-quality customer service. Full results: https://share.indeedassessments.com/share_to_profile/687b52bef4dbb29b5025d27509372eed53dc074545cb7

Management & Leadership Skills: Impact & Influence — Familiar November 2019

Education:

Mounte Miguel High School 1995

Cuyamaca Community College AA General Studies

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