Kenneth J. Carr

*** **** ****** * ********, IL **104

w C: 708-***-****

adfbbt@r.postjobfree.com

OBJECTIVE: To secure a challenging position with a progressive organization that will utilize my skills to benefit and advance the company while acquiring additional skills and knowledge to increase company efficiency EXPERIENCE

Experian Health Care (Schaumburg, IL) 07/12-Present EDI Systems Analyst

· Act as primary technical contract for payer connectivity, system monitoring, triage and coordination of systems issues, file transmission, and routine automated processes

· Perform daily and other routine checklists including file transmission, report generation, connectivity checks, file manipulation, and job validation.

· Monitor 277CA, 999, 835 and 837 files

· Diagnose and resolve data provider issues as needed. Track open issues and report to customer support, development, and/or clients until resolution is obtained

• Working with the help desk staff to track and resolve issues using Sale Force

* Work with trading partners and vendor for missing and erred reports

* Monitor/create SFTP/FTP connections, file transfer connections

* Work with various providers for missing 835 remits and claim rejections.

* Assist various provider with internal SFTP connections

· Create and maintain documentation about data provider connectivity, scripts, schedules, and contact information

· Generate and distribute routine reports per provider requests

· Maintain processes, scripts, encryption keys, and other key information uses in file transmission processes. Work with development to modify and/or create new scripts and processes as needed

· Perform system maintenance tasks as necessary

MED3000 Central Billing Office (Tinley Park, IL) 05/08 – 07/12 Analyst/Trainer

· Meet with clients to discuss system perimeters and to customize enhancements as requested

· Assist in system designs with new clients specifications

· Track and follow up on trouble tickets and provide support for those not resolved with general help desk support

· Troubleshoot and resolve issues, recommending or making changes in system as needed

· Train Clients on system software during implementation using GE Practice Management

· Create Training Manuals for training

· Maintain different Modules for GE Practice Management

· Provide educational support for client throughout contractual period

· Participate in client implementation and go live procedures

· Provide technical support for management staff

· Maintain system functionality and perform frequent system tests for upgrades

· Create/run reports for management staff

· Analyze information needed to review and accurately settle clams according to client policy and insurance and state regulations.

· Monitor claims denials and work with AR Staff on denial trending.

· Monitored A/R Staff ‘s coding and billing procedures for outpatient/inpatient billing

· Work with various insurance companies on appeals and denial trending issues

· Train/re-train employees on system procedures as needed due to changes or enhancements using GE Practice Management system

· Create and re-write policies and procedures as needed for changes or enhancements

· Create and manage AR standards

Various Contract Positions 10/07 – 5/08

Contract Support at Swedish Covenant & Adventist Hospital Project Manager for Alexian Brothers Medical Center

· Coordinated the front end staff, mentoring their work assignments

· Kept tract of daily totals for registration corrections

· Created training manuals and verification processes

· Trained employees on procedures in Meditech

Springfield Services Corp (Tinley Park, IL) 05/07 - 07/07 Systems Trainer Analyst

· Implemented new system procedures for contract hospital/clinic staff

· Provided technical support for management and training staff

· Created training manuals

· Trained staff on all procedures involving billing, registration, and coding

· Provided system maintenance

Advocate Health Care (Des Plaines, IL) 06/97 - 05/07 Manager Front End Operations/PFC Front End Educator

· Managed all activities involving front desk and patient contact, patient registration, and front desk collections

· Oversaw and took necessary action to collect on high-dollar accounts, resolving claims discrepancies and assisting self-pay patients with financial plans

· Examined claims denials and work with various insurance companies on appeals

· Managed registration scheduling process and revenue cycle, by supervising Patient Financial Counselors with the collection of patient past due payments as well as insurance payments

· Monitored A/R for the Patient Financial Counselors as well as coding and billing procedures for outpatient/inpatient billing

· Implemented process and assisted with bring new physician offices into Advocate system

· Implemented new procedures for all front office staff

· Updated encounter billing forms for physicians annually

· Chaired revenue cycle committees charged with reviewing processes for efficiency improvement

· Created status reports for accounts receivable, scheduling, and various front-end duties SKILLS: Misys Optimum, Misys Vision, Misys Query, Terra Health, Nebo, Med E Connect, Meditech, IDX, GE/ IDX EWS, Flow cast, GE/IDX Group Cast, GE Practice Management, Cerner, Allegra, E-scriptions, Valco, HCIMS, Encoder, All Scripts, EOB Retrievals, Ecommerce, Commercial Insurance (PPO, POS, HMO), Self-Pay financial analysis/counseling, Medicare, IDPA, MS Excel, MS Word, MS PowerPoint, MS Visio, MS Outlook, Medical Terminology, Move it File Transfer Program, IMACROS. Move it file Transfer Appilcation

Note Pad ++

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