****B Russell RD

Westfield MA *****

413-***-****

adm86j@r.postjobfree.com

Laurie Fijal

Objective

Experience

To work for an organization where I can utilize my skills and grow professionally.

*/*019-Present –Meridian Medical Management (Formally Origin Healthcare Solutions)

Operations Services Manager:

Overview:

Super User for the operations teams and support the VP of operations during Projects

Responsibilities include power user for Vertexdr practice management system, training of operations staff, operations admin for phone system and PBI reporting to support Ops managers and ultimate accountability for the products used by operations.

Essential Functions/Responsibilities:

Client Satisfaction

Manage services and enhance toward the identified company objectives

Function effectively with IT personnel, operations manager and client service team and deliver consistant quality service

Execute program services, goals and expectations of and monitor the performance of requested goals

Maintain regular contact with Director and VP Operations, providing continuous updates to program services.

Operations and Efficiency:

Provider leadership for assigned areas by modeling the tone, goal and expectations for operational performance established by the VP of Operations

Implement and monitor services with corporate policy, productivity, cost efficiency and profitability standards defines by the Director of Operations

Follow up with Operations personnel as appropriate and necessary to assure that agreed-to directions and goals are being followed.

Subject matter expert of product services utilized by operations staff

Power user for Vertexdr PM system, triaging

Prioritizing system issues and enhancements

Operations admin for call center phone system and responsible for cube creation and assignment as needed

PBI analytics reporting support for operations management

Analyze, recommend and implement policies and procedures as needed to maximize reimbursement for all services rendered in compliance with established third party guidelines and client policy.

Full understanding of operations workflow for all product lines of operations.

Develops billing policies and procedures for new technology and services, and obtains timely client approval for implementation

Business Growth:

Develop talent to meet business growth expectations

Develop mechanism to process new business and integrate into new or existing vendor/offshore partners

Work with VP of Operations to clearly understand and clarify expectations of new business clients and effectively support the services to meet these expectations.

Corporate Relationships:

Knowledgeable of all resources available in corporate; appropriately and knowledgeably call upon corporate’s resources when necessary.

Provide strong and confident interface between corporate management, the client and areas for which responsible.

Insures that directors receive important client and administrative information in a timely manner.

9/2017-1/1/2019 –Meridian Medical Management (Formally Origin Healthcare Solutions)

Robotics Automation Manager:

Essential Functions/Responsibilities:

Creation, validation, and execution of detailed Robotics Process Automation plans, ensuring alignment with specified workflow and business requirements.

Identify opportunities for process and control improvement and efficiency gains as related to and impacting robotics processes.

Works in collaboration with development team and management to identify additional features and functionality as needed.

Along with development team, ensure completeness and accuracy of robotics function and output through use of thorough Quality Assurance process.

Maintain robotics database.

Active participation in robotics implementation process and interaction with clients to ensure workflow documentation/ mapping process is clarified and performed according to project timelines.

Use process flow diagrams, screen shots, and other visual documentation techniques to create virtual process documentation for use by technical/ development team.

Assist in resolving issues or problems as required.

Communication with robotics team and management on progress against approaching milestones as well as issues, risks, complexities, and additional opportunities.

Impact analysis; maintain reporting and ROI data on robotics.

Performs other duties as assigned

1/1/2017 – 1/1/2018 - Meridian Medical Management (Formally Origin Healthcare Solutions)

Task Force Team

Hand Picked by my peers to join a task force team of 6 individuals under the direct leadership of the CEO to work through billing procedures and policies to find and help facilitate more effective and efficient workflows. Completion of this program resulted in a savings of 2 million dollars and opened up the door to a new robotics automation program that ultimately landed me in my current robotic position. Some of the tasks achieved by the team are as follows:

Reduced paperwork and many manual, outdated processes to achieve a streamline and more economical work environment.

Working hand in hand with programming, the task force team assisted in the creation of an IVR Call system from proof of concept to execution allowing for the automation of credit card payments.

Working hand in hand with programming the task force team created an Inventory Management queue (SmartQ) from proof of concept to execution housing ALL outstanding, receivables, including:

– All ERA and EOB denials

– No response claims (claims where average processing time

lapsed with no denial or payment posted)

Ability to build worklists and assign to specific users.

Documented and mapped repeatable processes and worked with programming to bring these robotic automations to fruition including but not limited to Claim Status checks, SP Eligibility Checks, Workers Compensation Documentation retrieval and submission, Charge Loads & Auto Adjustments.

8/2003-9/1/2017 Meridian Medical Management (Formally Origin Healthcare Solutions)

Data Quality Team Leader:

Working under the direct supervision of the VP of Operations, my job responsibilities include but are not limited to:

Overseeing and assisting the data quality department, trafficking and assigning HDA tickets and ensuring the daily workflow and projects get completed in a timely manner.

Working one on one with management to assist with any issues that may arise in the day to day operations as well as coming up with more efficient and cost effective ways to handle work flow.

Working with our programming and QA department with testing software to assist in working out any bugs therefor ensuring a smooth work flow.

Working NEIC rejection reports for over 100 clients, building relationships along the way with RealMed support as well as many of the major insurance carriers and their EDI representatives.

Assisting with creating and maintaining monthly and quarterly financial comparison reports upon request using our PBI reporting software when needed.

Assisting with setting up and maintaining electronic claims as well as ERA with direct submission to Medicare, State Welfare of CT, Masshealth, Anthem BCBS and BCBS of MA as well as other states including RI, MD, TX, IL, NY and NJ when needed.

Setting up and maintaining databases for new clients and monitoring these databases to ensure a smooth transition.

I have built great relationships with some of our large Vendors including but not limited to, RealMed, LiveVox and Codecorrect working with each of these vendors one on one with not only day to day set up and maintenance but also assisting with larger more complex issues to help assist in getting a quick resolution.

Assisting billing departments with work overflow as needed.

Prior to advancing to my current position in 2006, I worked as a full time medical biller responsible for maintaining four medical offices. Duties included: Payment posting, charge posting, ATB, Refunds and Patient follow up with all major CT and MA insurance carriers.

2/2012-4/2013 Origin Healthcare Solutions Windsor CT

Credentialing Specialist

Sole responsible for all aspects of provider credentialing with a large multi-specialty group employing more than 200 providers.

My job responsibilities include but were not limited to:

Collection of all pertinent documentation

Completion of applications for all major Connecticut payers including Medicare and Medicaid

Constant communication with both the provider and the carriers to ensure timely completion.

Payer re-enrollment.

CAQH maintenance

I was also responsible for an extensive credentialing clean-up project that took place when we took over the clients billing/credentialing and in turn assisted the billing staff in collecting over a million dollars in revenue. As of today all outstanding inherited credentialing issues have been uncovered and resolved.

8/2001-5/2003 Phylogic Healthcare, LLC Springfield, MA

Medical Biller

Worked as a medical biller with this fast growing Medical Billing company. Helped build this company from the ground up working as a Medical Biller responsible for a large Pulmonologist group. Because this was a new company we worked these claims from front to back, including but not limited to: Charge posting, payment posting, ATB follow up, NEIC rejections, Patient calls, claim submissions & bank deposits.

I also worked hand in hand with our software vendor to assist them with streamlining their operating system to be more effective and user friendly for not only our company but other clients as well.

5/1996-8/2001 Avis Rent-A-Car Windsor Locks, CT

Preferred Representative/Team Lead

Was responsible for meeting and greeting all of our top preferred clients as well as gathering documentation and contracts and working in the field to ensure clients vehicles were service properly. I was later moved up to a second shift team lead working assisting customers and overseeing employees. Duties included scheduling, cash deposits and reconciliation as well as nightly closing procedures.

Education

2000-2013 Holyoke Community College Holyoke, MA

Web Page Design

Relevant Skills

Microsoft Office: (Outlook, Word, Excel, Visio), VertexDR, Omniform, Percision BI, some basic experience with Microsoft SQL Server Management Studio, UIPATH, Orchestra, Kabana, Centricity Business, Centricity Business Group Management, A/R Intelligence, SRS, Greenway, Allscripts.

Vendors: RealMed (Availity), Emdeon, Livevox, Medassets

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