IT - Facets Configuration Analyst
Resume:
Jillian Minder
970-***-**** *************@*****.***
Relevant Experience:
Computer Skills: 54 wpm at 99% accuracy, proficient in Microsoft Office programs
United HealthGroup dba Rocky Mountain Health Plans (Contract Configuration Analyst)September 2015 – Current
Building and testing contract updates for Medicare, Medicaid, CHP+, Private Pay and other lines of business for both medical and facility claims.
Preparing fee schedule extract pulls and reconfiguring pulled data in Excel.
Running data inquiries in Access for data analysis.
Contract review for correct claims payment compared to the claims systems.
SQL knowledge – manipulating the system to pay properly per our contract.
Clinical Editing System coordinator.
Answering questions from other departments.
Rocky Mountain Health Plans (Hospital Claims Analyst) June 2013 - September 2015
Processing of claims for correct payment to provider’s offices for private pay, Medicare and Medicaid members.
Proficient with Facets, Macess, and Rocky.net computer programs.
Comparing allowed payment of claims to member benefit plans and provider contracts for correct claims payment.
Reprocessing and figuring for multi-million dollar claims, transplant claims and other various specialties.
Harden Hospice (Human Resource Assistant) April 2012 – June 2013
Payroll entry for 60+ employees along with paycheck distribution
Open enrollment distribution, new hire orientation and paperwork, background checks, maintaining employee and provider files for compliance.
Accounts Payable, ICD-9/CPT coding.
Organized company potlucks, employee appreciation gatherings and other moral boosting occasions.
Coordinated corporate training meeting for upper management and yearly training seminars for registered nurses including arranging air travel and hotel accommodations.
Scheduled and conducted first round interviews for new employees. Schedule second round interviews for upper management.
Monument Medical Consultants (Billing Manager/Scheduler) February 2010 – April 2012
CPT/ICD-9 coding, medical terminology, data entry.
Medical office billing for Medicare, Medicaid, commercial insurances as well as aging reports and claim corrections.
Highly skilled with ten key, multitasking and multiple phone lines.
Knowledge of HIPPA privacy regulations
Compiled and mailed out patient statements, billing and collections.
Accounts payable/receivable as well as explanation of benefits knowledge
Scheduled appointments for Mesa Pain Management, compiling and organizing patient files, obtaining preauthorization for procedures on patient’s behalf
Proficient in Medical Manager computer program
Education:
Colorado Mesa University, Grand Junction, CO
Bachelor of Mass Communications with Minor in Business GPA 3.75
High School Diploma Grand Junction High School; Grand Junction, Colorado.
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