Neil Criscuolo
Las Vegas,NV
Summary
Experienced consultant and technical solution implementation professional with healthcare revenue cycle experience in both pharmacy and physician practices. Skilled in working alongside customers and partners to leverage software, analytics, network solutions, and technology-enabled services to facilitate better patient outcomes. Specialized expertise in workflow analysis and training and development. Proficiency in healthcare software applications, billing, financial analysis, and reporting. Proven effectiveness and results in revenue management and end-user efficiency with direct impact on physician collections. Skillful liaison with experience in client relations with an emphasis on customer service and providing meaningful performance indicators. Process Improvement and Automation Revenue Cycle Best Practice Testing/Scripting/Documentation Business Communication Liaison Strategic Technology Planning Business Intelligence Workflow Analysis and Organizational Structure Billing, Collections, and Financial Eligibility Network and System Administration Create Policy & Procedure for Mass Distribution Major Software and System Implementation SQL Queries & Data Modeling Data Analysis and Decision Making User Acceptance Testing Learning Theories and Pedagogies Financial Analysis and Reporting Training Curriculum Development and Delivery Military Training and Overseas Experience
Overview
18
18
years of professional experience
Work History
Sr. Management Analyst, Systems
Optum
01.2015 - Current
- Advised and worked on analysis, design, documentation, development, testing, and implementation of activities related to development and modifications to existing healthcare systems
- Designed, built, and maintained software components for the claims adjudication system, reporting tools and related healthcare applications
- Lead analyst on implementation of Centricity Business system
- Designed and assisted in optimizing training documentation prior to go-live and designed and programmed custom modifications to Centricity to accommodate specific and unique business needs
- Created automated and scheduled tasks of previously manual, time-consuming processes using a combination of SQL, Expect, Shell, ObjectScript, and PERL processes to ensure contractual obligations were fulfilled
- Completed quality assurance for system integration and user acceptance testing enabling on-time, on-budget go-live of enterprise-wide implementations with an effect on 2,000 end-users domestically and abroad
- Work in partnership with vendors to develop unique and specific programming within software applications to allow clients to meet business goals
- Assisted with database administration and database performance to allow for timely transfer of daily data load to clients’ data warehouse for the creation of reports and dashboards
- Analyzed all aspects of server architecture and internal workings in order to lead the upgrade and migration for full suite of applications
- Developed a plan for sanity testing to ensure a smooth migration
- Assessed system needs from internal business units and end-users to minimize latency and downtime
- Created workflows to optimize the end-user experience with a focus on productivity metrics and outcomes
- Creation of daily and monthly reports to measure productivity and profitability
- Collaborated with stakeholder groups across the organization to ensure business and technology alignment through weekly meetings and on-site training.
- Conducted comprehensive audits of internal processes, identifying areas for improvement to ensure compliance with industry best practices.
- Developed comprehensive financial models to support budget planning and forecasting, ensuring fiscal responsibility.
Director of Operations, Training Manager
UT Medical Group
02.2014 - 06.2015
- Directed daily operations for central billing office
- Responsible for day-to-day processes of a medical billing and practice management company using contemporary technology to serve both hospital-based and private practice physicians, providing services to nearly 200 providers
- Direct supervision of eight managers and indirect management of over 90 full-time employees
- Accountable for the timely and accurate preparation of claims and payments
- Formulated high level skills of curriculum design that utilized a blended approach to learning and team development in order to accomplish a companywide upgrade to Centricity Business
- Ensured that departmental goals and workflows were evaluated to create higher levels of efficiencies for employees that directly impacted an increase in revenue
- Fostered internal process development that saw an overall increase in net revenue grow by 8% which had a net value of over a million dollars monthly
- Supported multiple facets of Revenue Cycle
- Built streamlined front-end processes to aid in patient satisfaction along with development in back-end infrastructure to create a collection system that will maintain steady revenue
- Develop policies and procedures to formalize business workflow changes and support billing systems
- Facilitated training and development sessions that focused users on the integration of problem-solving skills in conjunction with existing workflows
- Presented at GE Centricity Live 2015 on training and workflow efficiencies related to system implementation.
- Analyzed business operations and implemented strategies to improve operational cohesiveness.
- Collaborated with senior management to develop and execute long-term corporate goals and objectives.
Training Specialist
United BioSource, An Express Scripts Company
05.2012 - 02.2014
- Supervise, coach and document performance of trainees and evaluate employee performance prior to their release to their operational units
- Work in conjunction with internal program management teams and their respective clients to develop policies and procedures to facilitate patient access for medications with complex reimbursement strategies
- Make recommendations for training materials and curriculum; create job-aids when necessary, support SOP development as needed
- Coordinate the implementation and finalization of new training utilizing instructional design resources and various methods of delivery
- Construct and facilitate training curriculum and user training manuals
- Trained users in system applications supporting patient demographics, insurance and claim adjudications
- Developed comprehensive insurance-based presentation that was adopted companywide to provide new hires with a holistic approach to pharmacy reimbursement.
- Trained and mentored over 300 new personnel hired to fulfill various roles.
- Enhanced employee performance by developing and implementing comprehensive training programs.
Program Coordinator
Broward County Public Schools
01.2010 - 01.2012
- Created and facilitated lesson plans and activities for 180 students and 13 counselors in a county operate after-school care program.
News Editor
CBSSports
01.2007 - 01.2010
- Edited feature stories and rewrote copy; built stories, features, and blogs using AP style
- Created comprehensive packages for website using live art graphics, audio clips, and video.
Education
M.D. - Education
University of Southern California
Los Angeles, CA05.2011
Bachelor’s Degree - Multimedia Journalism
Florida Atlantic University
Boca Raton, FL08.2008
Skills
- Organizational development
- Business process improvement
- Innovation management
- Client relationship management
Timeline
Sr. Management Analyst, Systems
Optum
01.2015 - Current
Director of Operations, Training Manager
UT Medical Group
02.2014 - 06.2015
Training Specialist
United BioSource, An Express Scripts Company
05.2012 - 02.2014
Program Coordinator
Broward County Public Schools
01.2010 - 01.2012
News Editor
CBSSports
01.2007 - 01.2010
M.D. - Education
University of Southern California
Bachelor’s Degree - Multimedia Journalism
Florida Atlantic University
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