ROSALIND D. POWELL
Southfield,MI
Summary
Self motivated IT professional with over 20 years in the Health Information Management field. My combined experience with Health Care and IT provides me with an advanced insight into health analysis and research and the ability to use technology to reach the expected result.
Overview
20
20
years of professional experience
Work History
IT-HPB System Analyst II
BCBSM
01.2015 - Current
- Lead the License Desk Level Audit issues and resolutions
- Develop, document, and revise desk level system procedures, processes and quality standards. This allows for a clear & precise understanding of our goals and practices.
- Identify, research, collect, analyze, and maintain data to evaluate existing issues and potential issues.
- Analyze, evaluate, resolve and deliver technical and non-technical solutions to customer inquiries.
- Mentoring, coaching & guiding current employees through individual cross training methodologies.
- Lead & support project objectives by completing IT deliverables within the scope of, project planning, designing, developing, testing, and implementing IT system solutions.
- I’m involved in all NASCO pricing projects, helping teams, Corporate wide with the understanding of pricing strategies and methodologies. As well as communicating pricing information effectively
EIT System Analyst
Strategic Staffing Solution / BCBSM
01.2010 - 01.2015
- Develop, document, and revise desk level system procedures, processes and quality standards.
- Worked to resolve provider data, network, and reimbursement issues.
- Lead & support project objectives by completing IT deliverables within the scope of project planning, designing, developing, testing, and implementing IT system solutions.
- Support business strategies and goals by testing, maintaining, & monitoring computer programs and systems.
- Formulate and defines systems scope and objectives through research and fact finding, combined with an understanding of applicable business systems and industry requirements.
- Establishes a course of action to accomplish completion of assigned projects & deliverables as well as perform as a project lead for my team deliverables.
- Analyze, evaluate, resolve and deliver technical and non-technical solutions to customer inquiries.
- Exceeded issues/resolutions targets and achievements that apply to BCBSM many projects and department flows.
- Assist with audit issues & resolutions
- Support the NASCO environment, its established partners and clients.
- Healthcare claims resolution
- Healthcare provider issue resolution
- Coaches and mentors onboard training & EIT File Maintenance for new employee training and the less experienced business systems.
- Analysis and process NASCO Critical Impacts, Routine Impact, CSR’s. & SER’s.
Provider Information Coordinator
Molina Health Care
01.2007 - 01.2009
- Performed maintenance and system configuration
- Implement provider changes
- Devises or modifies procedures to solve business problems, considering people, process and system impacts.
- Completed project deliverables timely
- Researched departmental trends, and complex provider and member issues, including member enrollment and benefits.
Patient Finance Information System Analyst – PFISA
Detroit Medical Center
01.2005 - 01.2007
- Performed High level process improvement and issue resolutions
- Applied analytical methods for problem solving
- Charge master (CDM) updates & DMC Website maintenance
- Conducted enrollment specific plans and coverage training for NASCO claims processing.
- Investigated medical claims and billing issues to ensure accuracy
- Created and executed test bills for all insurance plans.
- Handled and balanced QMS & Metric
- Worked remedy help desk tickets
- ADHC Report writing
Education
Bachelor of Science - Information Technology
Kaplan University
01.2015
Associate of Applied Science - Computer Information Systems
Kaplan University
01.2011
Skills
- NASCO Processing System
- National Account Provider
- NAPS
- MOS
- Benefit File Manager (BFast)
- Project Data Management (PDM)
- Geno Tables
- Corporate Provider File (CPF)
- Portico
- Application Data Repository (ADR)
- Change Manager
- File Manager
- Enterprise Outpatient Solutions (EOS)
- MACESS
- Cherwell
- Microsoft Word
- Microsoft Excel
- Microsoft PowerPoint
- Microsoft Access
- Microsoft Outlook
- Microsoft SharePoint
- Access Database writing
- SQL
- Web Development
- User Interface (UI)
- ADHC RPT writing
- Adobe Prof
- Visio
- Visual Studio
- Software installation
- UAT & SIT testing
- Virtual Private Network (VPN)
- HTML
- Window Server 2008
- Siemens (SMS) Links
- Premise
- EPremise
- Remedy
- Cerner (CIS)
- Jing data snapshot files
- Quality Management System (QMS)
Accomplishments
- Redeveloped Provider training guides to shorten training time from 6 months to 8 weeks.
- Trained Provider Team on MACESS and supported MACESS when software questions arise.
- Developed the Facility Reimbursement Admin Process with Facility Reimburse-Southfield Team to automate their voucher process.
- Wrote the pseudo code that helped scripting develop code to add reimbursement rates to NAPS.
- Developed team pricing guides and procedures for determining how and when to load rates.
- Created a conversion crosswalk for analysts to be able to add, delete, & change any facility type in the National Account Provider System.
- Collaborated with Provider Reimbursement to Audit National Processing System and National Account Provider System to assure both subsystems were in synch with the Reimbursement systems.
- Led the work effort with various areas to solve Vision and Hearing claim issues.
Timeline
IT-HPB System Analyst II
BCBSM
01.2015 - Current
EIT System Analyst
Strategic Staffing Solution / BCBSM
01.2010 - 01.2015
Provider Information Coordinator
Molina Health Care
01.2007 - 01.2009
Patient Finance Information System Analyst – PFISA
Detroit Medical Center
01.2005 - 01.2007
Bachelor of Science - Information Technology
Kaplan University
Associate of Applied Science - Computer Information Systems
Kaplan University