Nadia Moguel
Los Angeles,CA
Summary
I'm a proactive and outcome-focused application specialist with a successful history in leading Epic revenue cycle enhancements and implementations. Over the last decade I've been able to collaborate with staff from a variety of personal and professional backgrounds, forming strong relationships, while achieving common objectives. My strengths include finding and addressing workflow inefficiencies, system redesign and optimization, and client/team relations. I'm committed to leveraging my skills to maximize reimbursement, ensuring that Epic Resolute operates with maximum efficiency and effectiveness.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Senior Epic Analyst (PB/HB)
CSI Companies
Denver, CO
09.2023 - Current
- Key player in providing expert guidance and strategic support to multiple large-scale clients to optimize their revenue cycle management through the implementation and enhancement of Epic Professional Billing and Hospital Billing
- Collaborate with stakeholders to analyze and understand business requirements and deliver tailored solutions that align with industry best practices
- Investigate and resolve complex issues related to Epic Professional Billing and Hospital Billing while working in tandem with client end-users, IT support, and other relevant teams
- Conduct in-depth analysis of client billing workflows to identify areas for improvement and optimization
- Recommend and implement changes to streamline processes, reduce errors, and enhance overall efficiency
- Facilitate knowledge transfer to ensure clients can independently manage and optimize their billing operations.
Senior Epic PB Analyst
Ettain Health
Boston, MA
08.2021 - 09.2023
- Charge Router lead for large-scale home infusion implementation and subsequent go-live of over 220 home infusion clinics.
- Led PB team in collaborating with end users and business operations to establish requirements for over 150 insurance payors for Resolute PB and Claims and facilitated the execution and validation of technical plan and application build between project team members and business owners
- Headed years-long training discussions with subject matter experts including billers, nurses, pharmacists, and oncologists, and together developed the most suitable and relevant instructional material for both QA/integrated testing and end-user training
- Facilitated delegation of assignments amongst PB members including NOVA notes, ServiceNow incidents, notable optimization requests, new acquisition planning, and outstanding SLG requests.
Epic Application Specialist II
Cedars-Sinai
Greater Los Angeles Area
08.2017 - 08.2021
- Responsible for the coordination and completion of projects and assignments surrounding Epic Professional billing, charge router and claims administration
- Built and maintained working relationships with team members, vendors, and other departments involved in the same projects/assignments
- Worked closely with key stakeholders and oversaw assignments by ensuring statuses are on track
- Primary contact for new departments and acquisitions, dashboards, charge router, follow-up, SER, and user security
- Led multi-year effort to maximize reimbursement by leveraging SER functionality from a PB and charge router standpoint
- I was able to identify key hurdles our credentialing was running into that were resulting in denials and low reimbursement rate
- The implementation and process improvement redesign resulted in significant reimbursement improvements and user work satisfaction
- Headed multi-year project involving the follow-up redesign released by Epic in 2019 including training discussions with subject matter experts, workflow redesigns, and instructional material
- The eventual implementation was successful, with staff reporting a significant rise in engagement as workflow and system functionality had significantly improved
- Additionally, Epic gold stars were awarded to the organization.
Epic Application Analyst
HCTec
Miami , FL
09.2015 - 08.2017
- Coordinated, designed and implemented the delivery of large complex projects/assignments that typically have high visibility and impact across multiple Epic entities and/or have direct impact on Epic Professional Billing strategic plan
- Worked closely with PB clients (Revenue Integrity, Charge Integrity, Credentialing, Corporate Compliance and Senior RCO Leadership), the appropriate IS resources, and vendors to ensure the efficiency and effectiveness of the associated Epic Professional Billing modules (Charge Router, PB Security, Charge Review, Cash Drawer, SER Maintenance) in support of business goals and objectives
- Primary contact for new department/acquisitions from discovery research to post-go-live support from a charge router standpoint for both PB and HB build
- Primary contact for all PB Security user access (go-lives, maintenance, optimization).
Epic HIM Documentation Specialist
Kasier Permanente
Los Angeles, CA
05.2014 - 11.2015
- Assigned proper medical terminology descriptions and patient identifiers to each document while indexing in HIM WQ within Epic
- Responsible for initial troubleshooting on tickets assigned to Epic HIM team to better delegate corresponding requests to appropriate analyst
- Aided clinicians in delivering efficient and effective comprehensive medical care through maintaining organized clinical documentation Epic HIM WQs
- Sorted outstanding batches in HIM patient WQs by priority
- Reviewed entered fields required for indexing ensuring that patient identifiers and other required keywords were correct
- Maintained indexing standards by identifying various documents used throughout the entire organization and how they correlated to Epic functionality.
Education
Bachelor of Science - BS - Health Informatics
USC
09-2017
Skills
- Epic Systems
- Healthcare Management
- Healthcare Information Technology
- Conflict Resolution Techniques
- Interdisciplinary Collaboration
- Team Leadership Abilities
- Process Improvement Initiatives
- Quality Assurance Testing
- Cross-Functional Communication
- Data Migration Planning
- Project Management Proficiency
- Software Troubleshooting
- Data Migration
- Software Implementation
- End-User Training
- System Configuration
- Application Testing
- Business Analysis
- Issue Resolution
- Requirements Gathering
Certification
- Resolute Professional Billing Administration
- Resolute Hospital Billing Administration
- Resolute Professional Billing Electronic Remittance
- Resolute Professional Billing Claims Administration
- Resolute Single Billing Office Administration
Timeline
Senior Epic Analyst (PB/HB)
CSI Companies
09.2023 - Current
Senior Epic PB Analyst
Ettain Health
08.2021 - 09.2023
Epic Application Specialist II
Cedars-Sinai
08.2017 - 08.2021
Epic Application Analyst
HCTec
09.2015 - 08.2017
Epic HIM Documentation Specialist
Kasier Permanente
05.2014 - 11.2015
Bachelor of Science - BS - Health Informatics
USC
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