Sylvia Smith

Manage accounts provisioning, modification, and maintenance processes for MHS GENESIS.also manage the scheduling of instructor-led training (ILT), assigns required Computer Based Trainings (CBT), and manage the local MTF Health Informatics (HI) training staff in conjunction with the local government POC. As well assist in the organization, planning, and implementation of training events targeted at enhancing end user understanding and functionality of MHS GENESIS, assign classrooms/computer rooms for training and provide calendar invites. Manage training rosters, user role assignments, and load provider credentials. Forecast manpower requirements for trainers (trainer staff onsite). Track and facilitate action items related to implementation and sustainment. Support site scheduled events deployment activities, and sustainment planning. Support and facilitate gap analysis of events’ output data. Submits tickets to initiate MHS Genesis account creation and provisioning for end users. Assist with preparing instructional aids and materials for training. Manage domain access, privileges and verify end user role and clinic responsibilities to ensure correct roles assignment for MHS GENESIS. Troubleshoot end user role issues and identify any role adjustments. Submit Global Service Center (GSC) tickets to initiate, modify, suspend, reactivate, and enable end user accounts. Present at meetings to address updates/changes to MHS Genesis. Extensive collaboration with Training Site Lead and Site Integrators to ensure end user roles and accounts are operating as designed. Assist with healthy learning environment for trainers and end user by ensuring training areas are adequate and have the required functional hardware. Collaborates with Training Roles Managers and other personnel working on MHS GENESIS related issues at other MTFs within the DHA enterprise. Provide support to Military Treatment Facilities (MTFs) outside the primary region, if needed, as directed by the Regional Project Manager.

Managed medical claims for various services including outpatient, pharmacy, and laboratory using AHIMA standards. Foreign military, diagnostic and lab services for manual billing or electronic submission, coding using the American Health Information Management Association (AHIMA), medical records review for accuracy and competition before entering into patient database while using the MHS Genesis, ABACUS, JLV, CHCS systems, audit researching and validating claims that was billable for initial and resubmitted claims with no less than 65 clean/accurately submission on all claims (depending on patient load) in a month. Track all open/delinquent accounts, work Highest-Dollar claims with an initial follow-up occurring in 30-days after claims submission, work all claims assigned within the additional 60-days, 90-days, and any additional days of claims remaining on A/R by completing a monthly average of at least 70 claim account in a month work all accounts receivable aging reports to correct and submit all claims by correcting a monthly average of 200, work all billing errors and respond to insurance carrier requests for additional information by correcting, Identify all medical services requiring preauthorization/pre-certification by pulling various reports according to third party collections guidelines with no more than 1 missed pre-authorization request per report review insurance policies for required other health insurance, updates made on patient accounts from contract changes and policies and procedures , updates made in MHS GENESIS, ABACUS, CHCS, work other health insurance recovery error report monthly based on policies found for transactions of accounts aged 21 days and older with no more than 1 week delay on processing updates and changes to other health insurance discovery modules. Perform weekly clinic visits throughout facility to answer any medical management question regarding form DD2569 and any other billing, health management and members benefits with questions for eligibility and processing, Scrub EOBs for correct account information, claim details, total charged by facility, paid by insurance carrier, copay, coinsurance, and/or deductibles applied, respond to denials within 7 business days, worked with budget analyst with basic administration and budgeting within GFEBS regarding accounts receivable. Provide additional support within the JAC office with clinical documentation to support the processing of a case with any occurred injuries that has been an assigned to the Office of the Staff Judge Advocate/Claims Division, provide customer service to ensure no complaints from all clinics within the MTF.

Oversaw project performance for MHS Genesis EHR deployment at Lyster Army Health Clinic and ensured comprehensive staff training. Daily planning and coordinating and supervising of all activities related to the integration of the project and management at Lyster Health Clinic, Provided an efficient interface with client and deploy various integration processes and administer all programming components to facilitate various growth activities, Coordinated with application services and to implement all integration strategies Administered all production support requests and prepare status reports for same and coordinate with development team to ensure change in all policies and procedures Maintained knowledge on all new technology and provide required training and coordinate with various teams to provide support to all new acquired sites Supported clinic staff with TEAMS invites and ensure that facility is engaged in service delivery, used comprehensive technical knowledge to identify customers information systems requirements, from initiation and planning to execution and closing, Ensured activities was completed in accordance with the project scope and within the approved schedule Demonstrated leadership to define requirements and plan project lifecycle deployment; defining resources and scheduling for project/program implementation, ensuring systems testing strategies, plans, or scenarios are completed on schedule, Established uniform file inventories, file plans, and indexing techniques as necessary to make it easier to use, integrate, and access information throughout the facility, Ensured appropriate standard project practices and procedures are established and followed, effectively communicated to team members, supervisors, executive level leaders through presentations, online meetings, emails and various reporting methodologies Informed management/command staff of unusual, sensitive, or potentially controversial issues, established and maintain good working relationships and interacts with all sections within the clinic, all active Military branches, department chiefs, commanding officers and all other support personnel, provided strategics procedures to increase the efficiency and productivity for the completion of the project.

Assisted in implementing record management policies, participated in training to stay updated on billing procedures, eviewed patient medical records and other medical data from physicians and other medical professionals analyzing and compiling medical information based on paper and electronic charts, investigating missing information, audit medical codes using the AMA system for compiling reports for researchers to prevent or recognize diseases entered, abstracted data such as pertinent diagnosis, prognosis, and treatment data from medical charts into the database, tracking routine statistics, analyzing variables in patients and reviewing data for completeness, and collecting follow-up data Identify ICD-9 and ICD-10 medical billing codes for procedures and create invoices for insurance billing purposes. Assisted the RMO in implementing records management policies within business lines or divisions, participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates and train specialists on updated processes. Reviews budget input for consistency and adequacy. Consolidates budgets and justifies content. Orchestrated daily operations of billing department and optimized processes for outpatient workload reporting, third party insurance revenue and relative value unit outcomes. Complied with all HIPAA Privacy and Security Regulations to protect patient’s medical records and information. Collaborated with subject matter experts on coding issues and assist with development of enhanced processes to improve accuracy. Reviewed program objectives and recommends revisions as needed, Applied knowledge of all applicable Federal laws, rules, and regulations regarding release if health information. Generated workload reports, distribute pending workload to staff, and monitor completion status, Reviewed and processed requests for patient protected health information (PHI), Ensured the timely release of health records in accordance with policies and procedures; compliance with accrediting agency and regulatory requirements; and corrective action is initiated, as needed.

Implemented databases and tools to ensure accurate MSA billing, resolving discrepancies. Provided comprehensive accounting support to medical billing department by utilizing databases and analysis tools to accurately process MSA billing and discover discrepancies. Analyzed each patient visit, retrieved insurance information, and applied proper medical billing codes to invoices, files and receipts using medical terminology knowledge. Analyzed fund execution accomplishment and identified and corrected weaknesses and direction. Ensured vital/essential records are identified, inventoried, and protected to continue key functions and activities in an emergency. Reviewed complex Explanation of Benefits forms, communicated with providers, and worked with attorneys to resolve patient billing errors. Able to justify, defend, or negotiate while representing the installation on matters pertaining to budget, resources, and compliance with established policies, regulations, or procedures. Experienced participator in conferences, meetings, hearings, and presentations involving problems or issues. Provided advice and assistance to directors, activity managers, and program directors on the acquisition and use of appropriated funds. Made recommendations to improve utilization of funds which could result in cost savings and effective accomplishment of mission and program objectives. Prepared charts, tables, and narrative analysis of performance progress Identify consistencies or errors in data, provided direct customer service to the Veteran (or third party), by providing copies of the Veteran's PHI, when a signed, written request is received, or upon the Veteran's valid authorization to a third party. Generated workload reports, distribute pending workload to staff, and monitor completion status Developed policies and procedures, performance standards, and position descriptions, and/or functional statements, developed a working understanding of the policies, procedures, guidelines, rules, and regulations governing records management.

Provided budgetary support by verifying financial statements and analyzing purchase orders for discrepancies. Led and directed a team of 120 personnel, delegated tasks, training of the basic principles, concepts, of Employee Benefits, ensured policies and procedures were followed in compliance with HIPPA privacy guidelines and federal, state, and local regulations. Performed human resources duties to ensure proper staffing levels by recruiting, hiring and established standards for performance and counseled, included making recommendations to changes in human resources policies, researched the HR policies, directives and regulations governing to all personnel functions to aid in advising management, experience preparing personnel actions reports for review and analysis purposes. performed onboarding for providers and maintain current credentials and licenses. Performed personnel management functions, developed short-and long-range work assignments, sets priorities to maintain productivity and established deadlines. • Provided budgetary support and performed all budgetary functions for the facility, verified and certified all official financial statements to include monthly accounting period and the fiscal year end summaries and reports, assisted with funding expenditures and took corrective action as necessary to ensure proper utilization of funds to prevent over-obligation of funds. Assisted with ensuring internal controls are in place, operational, and meet prescribed standards to manage government resources effectively and efficiently. Analyzed purchase orders and vendor payments to detect discrepancies, Identified opportunities for facility improvement and implemented solutions to enhance efficiency, quality and safety for patients, Performed utilization review and risk mitigation of operations in billing processes, trained team members with CPT and procedure codes and developed and executed policies and procedures to prevent denial of insurance claims and minimize claim appeals, monthly staff meetings, reviewed program objectives and recommends revisions as needed, reviewed funding and spending data to develop cost information reflecting program trends for region-wide programs. Analyzes financial status reports for overall program status, performed full supervisory responsibilities including preparing work assignments, monitoring the performance of release of information staff, evaluating employee performance, selecting staff, recommending awards and advancements, and taking disciplinary actions. Generated workload reports, distribute pending workload to staff, and monitor completion status, conducted in-depth management studies of a variety of clinic functional areas, organizational entities, and resources utilized by the medical activities, assessed issues relating to full time equivalents in relation to training and deployments that dramatically affect the health care of all beneficiary categories enrolled in this facility. Coordinated, review, edit, and archive new and existing Inter /Intra Service Agreements, Memorandums of Understanding, Memorandums of Agreements. Tracked clinic employee Financial Management certification, ensuring all hospital employees who require training are trained and remain in compliance with the regulations. Developed various applications and ad hoc reports for data capture and data quality improvement activities relating to a wide range of common worldwide automated medical workload and information reporting systems.