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C++ Payment Integrity

Location:
Loxahatchee Groves, FL
Posted:
March 07, 2024

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Resume:

JEFFREY ICE

***** ****** **** ***********, ** ***70 561- 307- 8799 ad36wv@r.postjobfree.com

Summary

Accomplished Chief Technology Officer offering over 35 years of infrastructure development including national and overseas team management. Current creator and owner of several technology-based patents including broadcasting on the internet and single use credit card transactions, as well as several other patent pending’s.

SKILLS AND EXPERTISE

Strategic Technology Planning

IT Governance

Global Contract Negotiations

Technology Team Development

Emerging Technologies

Project/Program Management

Development Methodologies

Proficient with Chip Level Programing with Multiple Processors

TECHNICAL TOOLBOX

Operating Systems: Windows (all), Linux (all), UNIX, OS/2

Databases: SQL Server / MySQL, DB2, Informix UDS, SYBASE, Cloudscape, Access, Paradox Development Tools: MS Visual Studio, NetBeans, QT, PowerBuilder, JBuilder, ESQL/ C, Jprobe, Jtest, CVS, Informix NewEra, InstallShield, Delphi, Paradox/ Paradox for Windows, CAD, Autodesk, Pivotal, Jira Multimedia: HoloLens, Java 3D, Java Media Framework, 3DS Max, Lightwave

Languages: Java, C, C++, SQL, XML, HTML, HTML5, Pascal, Assembly

EDUCATION

Broward Community College, Computer Science (1985)

INTERESTS

TKE, inventing, problem solving, carpentry, and old cars.

PROFESSIONAL EXPERIENCE

360 Health Systems Inc, Miami, FL (Payment Integrity for Payers and Hospitals)

Software & Algorithm Engineer (2016- March 2023)

Spearheaded the development of 360 Healthcare’s innovative payment integrity, fraud, waste, and abuse solution platform. This software empowers health plans and payers’ organizations to effectively analyze and recover lost revenue with total visibility into their payment integrity initiatives.

Highlights:

-Developed and maintained federal and state physician fee schedules, CMS Medicare, and Medicaid NCCI edits.

-Developed and maintained recovery algorithms and reference tables to identify claims over- payments for different clients and their LOB.

-Maintained vendor access and support for interfaces into the application.

-Utilized a dynamic blend of programming languages, such as C#, C++, and Object-Oriented Programming (OOPS), alongside PHP, to implement robust and scalable solutions.

-Designed and managed software development project plans.

-Worked closely with Sr BA in order to deliver projects on time and on budget.

FEB-DEC John Hopkins (JHHC) (Subcontracted through 360 Healthcare Systems)

-Developed and maintained recovery algorithms and reference tables for over-payments.

-Worked with vendors to understand defined file formats as well as response files. Set up vendor system access.

-Utilized a dynamic blend of programming languages, such as C#, C++, and Object-Oriented Programming (OOPS), alongside PHP, to implement robust and scalable solutions.

-Developed and maintained as well as ran monthly and quarterly reports to match billing by the vendor. This would validate those adjustments to claims that had been completed and matched the vendor line items.

-Created reports for payment recovery management as required.

AZZLY, Vero Beach, FL (Electronic Medical Records Technology)

CTO/CIO (2008-2015)

Led the development efforts for electronic medical records technology using a stack that included C#, C++, and Object-Oriented Programming (OOP) principles. Utilized Silverlight and QML-QT to create user-friendly and responsive interfaces, enhancing the overall user experience for healthcare professionals. Created and cultivated a new department/product with accountability for overseas and local development teams, product design from the ground up, and revolutionary healthcare patent pending technology.

Complete knowledge of the follow standards:

- X12 5010 all protocols (837,635,270,271,275,277,278,829,834) for healthcare. Integrated a complete clearinghouse with all protocols as well as auto posting of 835’s. Worked directly on 832 6020 for fee schedules.

-ICD-9, ICD10- CM, ICD10- PCS and crossing mapping.

-HL7 protocols all versions (CCD, CCR, CCDA, PQRS QRDA Cat 1 and 3)

-Clinical Research Integration

-Third party controls, interfaces and databases (Loinc, FDA, NPI, Zip +4, Telerik, Atalasoft, Snomed, Labsoft, NDC, nih, nist)

SkyConnect Aero, Washington, DC (Aviation Mapping Technology)

Development Contractor (2006-2009)

The Sky Connect tracking systems provides operators with real time knowledge of all airborne, shipborne or ground assets, improving peace of mind and enhancing safety, especially for those who operate in remote areas. Operators can view the location and track the status of an entire fleet under any circumstances. The system also delivers quality voice communications. More than 1,500 aircraft around the world are flying with sky connect equipment.

Highlights:

-Designed and built the mapping and communication software and hardware for tracking vehicles. Developed transmission of messages to and from dispatch as well as GIS data for tracking both electrical power lines and any other GIS data that a client required.

-Developed an internet-based system that allowed for any location to access the information real time. This was extremely important during Katrina when all communications were out and the only way to communicate was via satellite, IP communications etc.

-Use the Iridium network both for voice and data and used backup sites for redundancy.

Stock Diagnostics, Ft. Lauderdale, FL (Algorithmic Data Solutions for Financial Institutions)

CTO/CIO (2004-2006)

Spearheaded research and development of proprietary software designed to reveal the logical relationships between financial statement data and stock price performance this software examines, combines and displays financial statement data in unique ways, allowing breakthrough discoveries to be made. Software analyzes and monitors 1,801 data points for each of over 10,000 public companies, more than 240 industries and at least 12 sectors of the economy.

Highlights:

-Purchaser and administrator of all aspects of data center and company.

-Led the software development team and provided QA.

-Worked with (Cisco, watchguard (intrusive detection slash protection), EMC CX300, clustered servers (SQL 2000) VERITAS Software, F5 load balancer, C, C++, C#, VB, ASP, .NET, Java, JavaScript, SQL 2000, Windows 2003 Advanced Servers, XP, 2000, Exchange.

Merchant Online, Boca Raton, FL (Contracted Software Development/Consultation)

CTO/CIO (1998-2000)

Offered the first fully integrated private, secure, and anonymous payment solution for commerce on the Internet and in the real world.

Highlights:

-Integration of three acquired companies and formation of new product lines.

-In charge of all software development team, testing procedures, and QA.

Pipe Dream, Inc., Palm Beach, FL (Internet Broadcasting)

Co-Owner and CTO (1997-1999)

Created an innovative software solution for information broadcasting companies on the Internet.

Highlights:

-Invented patent for broadcasting on the Internet (this application is in a collegiate textbook used at FAU today) ISBN number 0-8493-1858 -0 Handbook of the Internet and Multimedia systems and application (chapter 37) and is featured on the cover of the book. It was also printed for capital IEEE magazine.

-In charge of software development and provided QA.

IBM, Boca Raton, FL (Internet Broadcasting)

Senior Systems Analyst (1996-1998)

Worked on the team that developed ViaVoice for Windows standard edition v10.0. ViaVoice for Windows standard edition had the voice recognition features needed for the small office / home office environment.

Highlights:

-In charge of converting voice type speech recognition from OS 2 to windows.

- developed all software for integration with Microsoft word 6.0 through 8.0. In charge for all components of integration with Windows through ViaVoice speech engine.

Streetwise Systems, Boca Raton, FL (Internet Broadcasting)

Senior Systems Analyst (1996-1998)

Backend solutions for financial institutions, which included functions such as loan calculators, general ledgers, reporting, invoicing and more.



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