Epic Resolute Health Care
Resume:
June Shotsberger
********@*****.***
WORK SUMMARY/EXPERTISE
Twelve Years’ Experience with Epic System /Resolute Professional Billing Admin/ PB Claims
A passion and ability to design and deliver creative solutions that solve client’s most challenging problems, demonstrated ability to thrive in fast-paced environments with minimal oversight; flexibility, resilience and adaptability are defining traits. A high level of critical thinking, including an ability to navigate ambiguous and dynamic circumstances. Performed multiple cradle-to-grave implementation experiences; broad health care and IT industry knowledge. Ability to interpret and interface between technical and functional counterparts across our solutions and our customers’ teams. Flexible learning mind-set, with ability to apply skills to new situations.
Epic Implementations
Epic Upgrades
Epic Optimizations
Clearing House Systems
Expert in Payer Claim Guidelines/Specifications
Twenty + Years Healthcare Revenue Cycle Management
Possesses the ability to build trusting relationships with multiple Client Executives at all levels and for numerous unique customers
Possesses analytical ability sufficient to work in a data-heavy environment and to identify trends in the data
effective communication, negotiation, influencing decision makers, business planning, strategy, problem solving, decision making and time management skills.
Leadership – guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services.
Tactical Execution – oversees the development, deployment and direction of complex programs and processes
Physician Billing /Physician Coding
Claims /Remittance /Follow-up
EHR, Claim Scrubber, Coding System Administration
CERTIFICATIONS
Epic Resolute Professional Billing SBO Administration 2013 –Current/NVT’s 2023
Epic Resolute Claims and Remittance 2015-Current /NVT’s 2023
Epic Resolute Hospital Billing 2019- Current /NVT’s 2023
PROFESSIONAL EXPERIENCE
Epic Resolute Professional Billing Analyst
Utoledo Hospital, Ohio
September 2023-Current
Resolute PB and PB Claims Support
Resolve issue for all facets of Professional Billing by use of Service Now ticket application
Provided high priority ticket support for Operational owners
Complete New and Maintenance Build within deadlines given
Develop build documentation/Test build
Work with all Epic teams on issues affecting billing
Epic Resolute Professional Billing Analyst
Rush Hospital, Chicago IL (Remote)
September 2019-September 2023
Resolute PB and PB Claims Support
Resolve issue for all facets of Professional Billing by use of Service Now ticket application
Provided high priority ticket support for Operational owners
Complete New and Maintenance Build within deadlines given
Develop build documentation/Test build
Work with all Epic teams on issues affecting billing
Upgrade Lead Routine Quarterly Upgrades
Claim Form/837 Payer Policy Updates
Projects: Auto write offs, Auto Attachments, PB Contracts
Maintain Master Files SER, EAP
Epic Professional Billing Claims Analyst
Cleveland Clinic, Cleveland, OH
June 2019 – August 2019
Responsibilities include build and implementation of Wisdom Dental Claims Module
PRE-GO-LIVE
Planning and design, fact finding meetings with operational owners
Understand Reporting Needs
Customize build to fit business needs
Work with Vendors, Claim Scrubber etc.
System Build:
Build Claim, Credit and Follow-up WQ’s/Profiles
Router Updates
Electronic Claim requirements, CDF, RMO, SA, Follow up rules, work queues, CDF, RMO
Responsible for working collaboratively with Epic TS, Billing Office and Third-Party Vendors in setting the system protocols / Use of claims scrubber and Optum Coding System
Testing:
Provided demonstrations and documentation of new build and new system functionality
Create test scripts for application testing and integrated testing
Validated and Rebuilt Epic module for successful implantation and cross application with ambulatory team and interface team
Data Courier to all environments
Go Live:
Support Command Center
Transfer Knowledge to core Resolute Team
Epic Hospital Sr. Billing Analyst SBO
Northshore Hospital, Chicago IL
Jan,2019 -May,2019
9600 Gross Point Road Skokie, IL 60201
Responsibilities:
Lead on Claims Upgrade Project
Review build requirements
Delegate Build
Prepare build documentation
Prepare test scripts /perform test
Responsible completion of all Upgrade build
Sr. Epic Professional Billing Administration/Claims/Remittance Analyst
2013- Dec,2018
Loyola University Hospital, Maywood, IL
Responsibilities:
PRE-GO-LIVE
Planning and design, lead fact finding meetings with operational owners.
Customization build to fit business needs
Interface with Vendors/ Claim Scrubber, Coding Systems, Statement Vendors
Understand Reporting needs
System Build:
Service Area, Facilities, Providers, EAP Codes, Modifiers, Fee Schedules, RMO, CDF
CDM
Fee Schedules
Router Build
Charge Review, Claim and Follow up rules, work queues and profiles
Testing/Training:
Create test scripts for all specialties
Create Training Material /Lead WebEx Training Sessions
Provided demonstrations and documentation of new build and new system functionality
Application testing, integrated testing
Validated build /update build to support workflow brought up during end user acceptance testing.
Lead inn application testing and integrated testing standards to ensure system functionality/work with interface team and ambulatory team
Document build/Data courier
Additional Build:
PBB Billing according to payer regulations
Lab/Research/Wisdom Dental Module
Extensive Anesthesia Billing build
Transplant Billing work queues
Extensive Contract builds
Estimates
GO-LIVE
Resolved go live build and workflow issues
Provide support to Operations team leads, physicians and end users
Supported the command center by answering calls and resolving Revenue Cycle Issues
Resolved issue for all facets of Professional Billing by use of Service Now
Provided support for high priority issues daily
POST GO-LIVE
Maintain system build
Work on Break Fix issues
Upgrade Installation 2015, 2017
Identify, build and implement enhancement for PB during upgrade and through special updates when new features come available
Lead System Optimization to meet Epic Stars program
Participated and lead uplift projects in all area’s scope/planning/build/installation/support
Professional Billing Revenue Cycle Operations Manager
Aggeus Healthcare, Chicago, IL
2012-2013
Responsibilities:
Epic Billing
Assisted with Install Epic System/Interfaced with Realmed Claims System
Build/Test
Train and Support Follow -up Team
Build monthly reports
Professional Billing Revenue Cycle Operations Manager
MidAmerica Cardiovascular Consultants (Sold Practice to Advocate Healthcare), Oak Lawn, IL
2010-2012
Responsibilities:
Managed Billing Team, Claims Team and Follow-up Team of 20 + FTE’s
Managed Registration/Scheduling/ Billing/Coding/Payment Posting /Follow Up by use of Nextgen System
Point of contact for Vendors Realmed claims vendor,3M Coding Vendor, Statement Vendor
Build and run monthly reports to review with practice managers
Physician Payer Enrollment
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