James E. Miller Jr
OKLAHOMA CITY,OK
Summary
Logical health care professional with a strong background in revenue integrity and revenue cycle management. I routinely identify process improvements and maintain data accuracy through detailed analysis. I have sound experience in collaborating with cross-functional teams to manage analytics initiatives, ensuring that objectives are met, and performance is measured effectively. Proven ability to analyze key performance indicators to develop actionable strategies and implement new processes that leverage opportunities for growth. Consistent engagement with regulatory compliance, quality assurance, and an exceptional knowledge base in medical record management ensures alignment with industry best practices.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Revenue Integrity Chargemaster Analyst
INTEGRIS Health
OKLAHOMA CITY, OK
07.2020 - Current
- Identified opportunities for process improvements across the organization.
- Maintained accurate records of all data collected during analysis processes.
- Collaborated with cross-functional teams on projects related to analytics initiatives.
- Set specific goals for projects to measure progress and evaluate end results.
- Analyzed key performance indicators to identify effective strategies.
- Identified areas for improvement, narrowing focus for decision-makers in making necessary changes.
- Implemented processes to take advantage of new opportunities.
Denials and Appeal Specialist - CBO
INTEGRIS Health
Oklahoma City, OK
05.2018 - 07.2020
- Created and reviewed appeal requests to ensure the accuracy of the information submitted.
- I directly collaborated with other departments within the organization, such as the Health Information Management Department, to resolve issues related to appeals.
- Maintained up-to-date knowledge of current industry best practices related to appeals processes; for example, I am consistently researching CMS information.
- Prepared written summaries of key findings and timelines from active denials that were being disputed for senior management review.
Compliance Audit Coordinator
Stillwater Medical Center
Stillwater, OK
07.2015 - 01.2017
- Managed the workflow process for all commercial medical record ROI. My normal workday consisted of overseeing the retrieval of medical records for specific requesters, while adhering to facility policies and guidelines.
- Routinely tasked with providing financial status updates to the Director of Health Information Services and Upper Echelon Executive Officers.
- Assistant to the Coding Supervisor in the education of coding compliance audits for the Coding Team.
- Charged with coordinating physician review activities that pertained to claim denials, and drafted appropriate appeal letters.
- Served as the focal point for the Compliance Audit Response (CAR) Team.
- Directly responsible for managing the ROI of medical records to MACs and RACs to avoid ADR technical denials.
- Processed third-party audits, including probes, pull lists, validation, and utilization reviews, findings letters, and recoupment demand letters.
- Implemented web-based portal systems to electronically submit medical records; this dramatically allowed our ROI team to expedite medical record requests.
Academic Student (Full Time)
Southern Illinois University at Carbondale
OKLAHOMA CITY, OK
09.2009 - 07.2015
- University of Oklahoma, Norman, Oklahoma.
- Rose State College, Midwest City, Oklahoma.
- During this time frame, I was an unemployed, retired military veteran in pursuit of two professional degrees.
- Accepted for Stillwater Medical Center Coding Internship
Military Operation Supervisor
Armed Services Blood Donor Center
Okinawa, Japan
01.2005 - 09.2009
- Assisted with compliance and safety inspections for the American Association of Blood Banking, FDA, and Joint Commission.
- Provided orientation to medical staff, physicians, residents, and interns on current medical readiness policies and procedures.
- Implemented and improved customer service procedures while streamlining processes.
- Coordinated the training of 34 military and 5 civilian personnel.
Military Lead Laboratory Technician (Advanced)
Armed Forces Institute Of Pathology Forensic Tox
Washington, DC
02.2000 - 01.2005
- Annually, I performed advanced analytical testing on approximately 6,000 medical and legal cases with judicial implications.
- Participated in regular team meetings to discuss progress on projects or tasks.
- I personally, performed forensic testing on all 124 casualties of the 9/11 Pentagon Terrorist Attack and the potential 64 passengers on American Airlines flight 77.
Education
Bachelor of Science - Health Care Management
Southern Illinois University, Carbondale
Carbondale, IL12-2012
Associate of Applied Science - Health Information Technology
Rose State College
Oklahoma City, OK05-2015
Certificate of Technical Studies - Health Information Technology, Coding Specialist
Rose State College
Oklahoma City, OK05-2015
Certificate of Technical Studies - Medical Laboratory Technician (Advanced)
Naval School of Health Sciences Bethesda
Bethesda, MD11-1992
Skills
- Data analysis
- Process improvement
- Regulatory compliance
- Medical record management
- Project management
- Problem solving
- Written communication
- Cross-functional collaboration
- Statistical analysis
Certification
- Register Health Information Technician
Memberships
- Current AHIMA Member
- Current AAHAM Member
- OkHIMA Member
Timeline
Revenue Integrity Chargemaster Analyst
INTEGRIS Health
07.2020 - Current
Denials and Appeal Specialist - CBO
INTEGRIS Health
05.2018 - 07.2020
Compliance Audit Coordinator
Stillwater Medical Center
07.2015 - 01.2017
Academic Student (Full Time)
Southern Illinois University at Carbondale
09.2009 - 07.2015
Military Operation Supervisor
Armed Services Blood Donor Center
01.2005 - 09.2009
Military Lead Laboratory Technician (Advanced)
Armed Forces Institute Of Pathology Forensic Tox
02.2000 - 01.2005
Bachelor of Science - Health Care Management
Southern Illinois University, Carbondale
Associate of Applied Science - Health Information Technology
Rose State College
Certificate of Technical Studies - Health Information Technology, Coding Specialist
Rose State College
Certificate of Technical Studies - Medical Laboratory Technician (Advanced)
Naval School of Health Sciences Bethesda
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