Resume of Patrick Mono
SUMMARY
Epic professional bringing experience across Revenue Cycle, Clinical, and Reporting implementations to his work. He is certified in EpicCare Ambulatory, Resolute Hospital Billing (HB), HB Claims, Epic Remittance, and Benefits Engine. Well experienced in Tapestry, Reimbursement Contracts, Resolute Professional Billing (PB), PB Claims, Single Billing Office (SBO), Cadence/Prelude, Ambulatory, ClinDoc, Reporting with emphasis and experience in all Revenue Cycle applications, Charge Router, SER, Connect, and integration with Inpatient and EpicCare.
CERTIFICATIONS
Epic Resolute Hospital Billing
Epic Resolute Hospital Billing Claims
Epic Hospital Billing Remittance
Epic Benefits Engine
EpicCare Ambulatory
Tapestry Pending – Certification in May
Resolute Professional Billing – Certification in July
Reimbursement Contracts – Certification in July
EXPERIENCE
11/19 – 04/20 Sr. Billing/Claims/EpicCare Ambulatory Analyst
Infirmary Healthcare IT – Mobile, AL
Worked on navigator build and Configuration
Configured and built preference lists
Worked on building WorkFlow Engine (WE) Rules to re-design Navigators
Built and modified various EpicCare CER rules and Express Lane
Configured different Therapy Plans to suit clinicians needs e.g. display protocols of certain type, assign default orders, & assign Calendar views
340B – Configured the charge router to ensure charges price correctly
Revenue Guardian – revamped the Revenue Guardian to look for ECG/EKG Orders
Built and troubleshoot – Charge Router and System Action Queues
Optimized different Workqueue Types by updating existing rules
PCL strings for Claims – Work on adjusting paper claim forms to print correctly
Charge Champion Dashboard – Configured and added different components into the Dashboard
Built new DNBs and Account Activities to suit different Account Workflows
Maintained CDM built – Updated Fee Schedules, Procedures, Preference Lists, Cost Center assignment tables, category lists etc.
Work with external vendors and direct payers to perform routine build testing and troubleshoots e.g. clearinghouse 276/277 files, credit card rejections etc.
Cash Management – Set-up and maintain Payer ID mapping, set-up flexible cash loader etc.
Reimbursement Contracts – Configured and optimized the system to correctly perform reimbursement contracts based on updated payer requirements
Built new Consecutive Account triggers based on updated requirements
HB Statements – Updated SmartLinks within statement forms
CDF – Updated the CDFs with overrides such as addresses, occurrence codes, value codes etc.
UB/CMS Claim Forms – Built and updated various overrides within the claim forms for NPI, Tax IDs etc.
06/19 – 11/19 Sr. Billing/Claims Analyst & EpicCare Ambulatory
Montefiore Health IT – Yonkers, NY
Rotated within the revenue cycle to Help the EpicCare Ambulatory team with various optimization tickets
Worked on revamping Synopsis so clinicians can compare various patient data based on medications, vitals, procedures etc.
Built and modified various Flowsheets, Dynamic documentations, procedures etc.
Configured various SmartSets to improve on documentations making easier for clinicians workflows
Built and optimized the Revenue Guardian
Built and troubleshoot – Charge Router and System Action Queues
Revamped different Workqueue Types
Built several Claims overrides both at the Claims and CDF level
Maintained fee Schedules, Procedure and Payer-Plans
Built and optimized account activities and DNBs
Maintained and optimized unique Dashboards & Reports to users satisfaction
Coordinated troubleshoots for Direct Payer and ClearingHouse
Worked on reimbursement contracts with emphasis to build new contracts based on payer requests
Coordinated the transitioning of system from Legacy into Epic
Refined Discovery Session Questionnaires
Worked on WFWT – WorkFlow WalkThrough
Conducted Site Visits and gathered enough build information
Work on the build of SPARCS
Worked with EDI team to classify direct connects and Clearinghouse set-ups
Worked on ABF/FDF claim forms
Manage all the Remit Codes action set-up for various payors
Compare Payer-Payor Extracts in Legacy System and in EPIC
Configured the CDF to trigger various custom edits
Built System Definitions, Department Settings, EB Profiles, Account, various WQs, rules, and claim edits, as well as and a vast majority of essential Hospital and Professional Billing configurations.
Configured electronic and paper claim segments and CDF rules and overrides.
Configured Charge Router for PBB
CDM – Assists in data analysis between legacy and Epic. Prepared an export of all procedures from the legacy system into epic. Make use of the Charge Matrix to capture, review, & reconcile the legacy system into Epic system.
2/15 – 06/19 Sr. Billing/Claims/CDM Analyst
Hackensack Meridian Health – Hackensack, NJ
Go-Live support for EpicCare Ambulatory – Take calls pertaining to clinician workflow issues
Performed troubleshoots for Navigator build
Optimized different CER rules and Express Lane
Modified different SmartSets to better benefit clinicians workflows
Worked on building Dynamic Documentation set-ups and setting up WE rules to display specific navigators.
Coordinated the transitioning of system into Shared Payor-Plan
Built NON-PAR claims form records for unique providers
Assisted with the build of PINs for Professional Billing providers
Build Excel Macros for various internal use such as SharePoint Dashboards, Automation etc.
Manage all the Remit Codes action set-up for various payors
Configured the CDF to trigger various custom edits
Built System Definitions, Department Settings, EB Profiles, Account, various WQs, rules, and claim edits, as well as and a vast majority of essential Hospital and Professional Billing configurations.
Configured electronic and paper claim segments and CDF rules and overrides.
Configured Charge Router build to automate BB modifier addition if Certain codes are linked to Medication records
Resolve ICN errors triggered from ClearingHouse
Go-Live command center and elbow support for 50+ clinic and department rollouts.
4/13 – 2/15 Sr. HB Application Coordinator
New York University Medical Center - NY, NY
•Developed an enterprise-wide utility tool that automated the process of importing provider eligibility records including network, credentialing restrictions, par/non-par status, claims reconciliation, etc.
•Built System Definitions, Department Settings, EB Profiles, Account, various WQs, rules, and claim edits, as well as and a vast majority of essential Hospital and Professional Billing configurations.
•Released accumulated AR
•Reduced “60 days+”AR aging to less than 3%
•Built and modified Fee Schedules, Fee Schedule Groups, RVUs in Fee Schedules, Alternate Revenue Codes into EAPs, Alternate CPT Codes into EAPs, Associated Cost Centers into EAPs, Modifiers into EAPs
•Configured electronic and paper claim segments and CDF rules and overrides.
•Built Claim Edit and Charge Review rules and workqueues in support of numerous clinics and hospital departments.
•Set up SPLIT Error type Claim Edit Checks for various conditions e.g. Worker’s Comp 9700 Attachments errors, Taxonomy Codes, NPI/UPINS, SER restrictions, etc.
•Configured various batch jobs for numerous departments with creative mnemonics and properties in order to release the desired outputs.
•Developed new screens, scripts, programs, queries, reports, and/or other technical components according to specifications either developed through interaction with the customer or provided by project manager or team lead.
•Monitored and evaluated business needs and service requirements related to the charge description master (CDM)
•Assisted with system analysis related to charge master and charge capture functions, including the reconciliation of charges from all sources
•Go-Live command center and elbow support for 100+ clinic and department rollouts.
9/10 – 4/12 Sr. HB Analyst
Rochester General Hospital, Rochester, NY
•Managed functionality within both Resolute Professional Billing and Resolute Hospital Billing Applications
•Managed charge handling enhancements within the charge router including charge capture, and Dx/Px CPT handling
•Managed ticket resolution and change control within Remedy
•Validated various billing and security workflows and configurations
•Researched, organized, analyzed and synthesized data to support effective decision making while working within tight deadlines
•Configured MyChart access and training for billing office and patient access
•Maintained data quality
•Wrote reports for various departments in Crystal Report, and SYBASE SQL.
•Worked with Central Billing Office to acquire data requirements for reporting needs and following through with development and validation data.
•Coordinated billing activities with HIM, clinical integrity members and built third–party reimbursement contracts and reports.
•Supported internal and external reviews, assisted in business development, reimbursement, and charge capture processes
•Analyzed and developed technical guidance on healthcare finance issues and provided education to service areas as needed for accurate charge capture, billing and coding
•Provided analysis and review of charge capture processes and the charge description master (CDM)
•Researched and analyzed charges held up in Epic Charge Review, Charge Router, Account Workqueues and Error Pool edits
•Assisted in deployment to new practices including build, testing, training & support
08/06 – 5/08 Resolute PB/HB Analyst
Sisters of St. Francis
•Provided functional expertise to implement resolution processes and to optimized edits that defined the workqueues to drive accountability to the appropriate areas.
•Assisted in formulating and defining system scope and objectives for new departments and service areas.
•Analyzed and tested billing, as well as clinical workflows based on business operations
•Designed, configured, coded and tested security settings in ADT/Prelude, Cadence, Ambulatory, and Hospital and Professional Billing.
•Developed system security specifications and decision flows based on requirements.
•Worked closely with the Install team to modify Epic model content.
•Developed and documented internal procedures.
•Recommended new reports/existing report improvements that ensured leading practice revenue cycle performance monitoring
•Provide feedback to applicable Clinics and Departments regarding issues identified and facilitated discussions to further identify root cause(s) and potential resolution(s).
CREDENTIALS
B.S. University of Louisville, Louisville, KY
Engineering
M.S. University of Louisville, Louisville, KY
Engineering
RHIA
Professional Billing, Professional Billing Claims, Hospital Billing, CDM (Charge Description Master), Hospital Billing Claims, Single Billing Office, Tapestry, Reporting Workbench, Charge Router, Electronic Remittance, Ambulatory, Connect trained and experienced, SQL Server, Chronicles, Cadence/Prelude, Security, Epic implementation methodology, Clarity Reporting: ADT/Prelude/ASAP/HB/PB/ Radiant/Willow/Amb/Inp, Go-live planning/execution, Software testing, Multiple go-lives/Implementation Cycles, Mentoring of staff/consultants, Staff/end-user training, Management and movement of data, Issues, communication, and risk management, Interfaces/FTP/Servers and Hardware, Printing and Faxing