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Valrie Smith-Douglas

Bsc CIS, CHDS

About Me

Information System Specialist and Medical: Credentialer, Biller, Coder, Revenue Cycle Manager

Work Experience

DATAIPO LLC (www.dataipov.com)
Chief Executive Officer, Freelancer
January, 2015
  • Open to new opportunities, depending on availability.

  • -

  • January 2015, established my own business catering to:

  • On Site (local only) and Remote/ International clients.

  • Provide - Medical Data Services (Revenue Cycle Management - over 3 years experience): Provider Credentialing, Collect and Manage Provider (ID, Tax data, Panels, Fee Schedule), Data Entry (Authorizations, Demographic, Insurance Verification, Pre-Authorizations, Pre-Certifications), Data Storage, Medical: Coding, Billing, Accounts Receivable (Remittances), Transcription, Reporting, Analysis and Automation Services, set up and maintain Medical Coding and Billing Systems.

  • Provide - Business Data Project Services (over 10 years of experience): Documentation, Data (Entry, Analysis, Reports, Metrics), Project Coordination, Security Administration, Test Coordinating, Testing, as well as Training.

  • Scripting/Windows Automation.

  • Manage working with various clients.

  • * Applications/software = Clearinghouse (Office Ally),Google Drive and Google Applications, EZ Claim,Medicare / Connex, Medicaid / ePaces, Insurances 'Online', Uploads / Imports, Microsoft Office: Excel, Word, Access, PowerPoint, Project, Visio, Windows Automation, IDM/Provisioning, RSA/SSL-VPN, Maxim/Flow charts.


Robert Half Technology
, Professional Consultant: Medical Billing and Information Technology
January, 2017 - October, 2017
  • Open to new Contracts, depending on availability.
    Worked on Contracted Accounts by using and learning several types of software and procedures to ensure the correct and timely function of the Revenue Management Systems/Fiscal Departments. Worked with management, cross-functional teams and utilized reports to review and execute: procedures, claim creations and submissions, review the types of errors and using analytical tasks to resolve them. Also reviewed and posted Remittances (Payments). When applicable, assisted with documentation and training of permanent staff for the position.
    *Applications/Systems/Process used: eClinicalWorks, FundEz, Medisked, Cognos, ePaces (Medicaid), Medicare (Connex), Trizetto, eMedNY, Remittances, Quickbooks, navigating and working with several Major Insurance web sites, Importing, Exporting, Excel, Word and Data Analysis.


Various small local businesses
, Independent Consultant-Medical Coding, Billing and IT Specialist
September, 2013 - December, 2014
  • Networked, learned and got certified with a new skill (Medical Coding and Billing) and found temporary small, local opportunities:
    Created and managed client records (demographic, forms), generate and analyze provider reports.
    Managed Claim submissions (create claims assign codes, submit, monitor, and follow up on reimbursements).
    Client Services, designed and maintained the company web site to assist in growing of the business.
    Successfully set up and roll out Clearinghouses as Project Coordinator: did the data gathering, planning, presenting, scheduling, configuring and training of offices to enable a more efficient Revenue Management process.
    Saw that I could start my own business !


New York Life Insurance Company
, Senior Associate (Data Security, IDM Admin., Project Coordinator and Quality Assurance Analyst)
April, 2006 - May, 2013
  • Project Coordination & Business / Quality Assurance Analysis:
    Assisted in gathering and interpret the business needs of Stakeholders (SWOT analysis), met with Stakeholders to develop Statement of Work. Set up: Timelines, Schedules.
    Analyzed each Release and Wave data to develop comprehensive: Procedures, Knowledge Base Articles, User Manuals, Test: Plans, Scenarios, Data files and Scripts for each environment, lead QA, UA Testing and recorded the appropriate results; drove the development and integrity of a Problem Log database.
    Assisted in Cost Management, adhered to and tracked/reported the project milestones.
    We met every target completion date.
    Application was left in Steady State and was used by the Enterprise.
    -
    Information Security Admin./Customer Service:
    Provided excellent Customer Service, assist in maintaining identities of individuals in the company by monitoring the Production Application (IDM) and our Help Desk queue (Remedy) for any errors and I assisted in resolving issues that enabled us to exceed the SLA by 100%.
    Handled Identity and Access Management Application (IDM)/Provisioning: Administrator and
    Production Support, basic XML Debug , password resets, permissions, Active Directory Administration, RSA/ACE/ SSLVPN/ Smart Card/Remote Administration.
    -
    Technical Writing/ Corporate Educator:
    Able to read source code. Exercise good oral and written communication skills.
    Created documentation for the IDM application for various audiences (Technical, End User) with
    illustrations and Process Flow charts, validated and posted information in the: NYL Help Desk knowledge Base (KB), IDM Web KB (FAQs). Some knowledge of ITIL.
    -
    Administrative Assistant/Data Entry:
    Provided great Customer Service (resolved issues, answered how to questions).
    Managed Calendars/Events: scheduled: work sessions, meetings, e-meetings.
    Developed and maintained Metrics by gathering and manipulating raw data.


IBM
, Project Coordinator and System Administrator
April, 2000 - March, 2006
  • Provided excellent Customer Service, managed sensitive data daily.
    Lead the research for new/best technologies that lead to the creation of one service team and developed a centralized location of our best practices. This lead to significant increase in customer satisfaction.
    Documented best practices and placed them in the Notes Knowledge-base and Web page content.
    Lead Automation by developing scripts and cross-trained team members on using Winbatch. This improved customer satisfaction.
    Met with management and other cross-functional teams to discuss: goals, progress, achievements and concerns as required.


IBM
, Site Education Coordinator (new technology, best practices)
August, 1999 - April, 2000
  • Compiled and created appropriate and approved educational material.
    Educated employees on the IBM external and internal accounts.
    Investigated new educational opportunities, scheduled educational workshops and seminars and administered on-line educational programs.


IBM
, System Administrator/ Technical support (Help Desk)
July, 1998 - August, 1999
  • Worked as part of the Help Desk Team (Level 1 and Level 2): provided excellent Customer Service in resolving Technical and How To issues (handled: types of problem logs- via severity, and the phone queue with a sense of urgency). We met/exceeded our SLA.
    Worked as a Team Lead and cross-trained several new hires on our best practices for customer satisfaction. Several of these new hires eventually became Top Performers themselves.
    I was a Top Performer.


Education

At-Home Professions: Medical Billing, Transcription and Coding School Online, Diploma in Healthcare Documentation:Specializing in Coding, Billing and Transcription. CPC Trained, Health Services Administration
2014 - 2015
  • AAPC Member, since August 2014

  • Medical Billing: Proficient in completing CMS-1500, UB04 and Dental forms to submit claims to insurance companies in a timely manner, as well as reimbursement follow-up.
    Medical Coding: Skilled in using medical coding procedures and manuals (CPT, ICD-9, ICD-10, HCPCS) and use of the AAPC web site to confirm and assign accurate coding.
    Technology: Skilled in using EZ Claim, eCW, Clearing houses: OfficeAlly, Claimremedi, ChartScript, ExpressScribe and MedLook. Easily adapts to established, customized or new procedures and technologies that are compliant with AAPC standards.
    Knowledge: Medical, anatomy and physiology Terminology.
    Medical Transcription/Editing: Knowledge of the preparation and editing of EHRs/SRTs: Chart Notes, History and Physical Exam, Consultation, Discharge Summary and Operative reports as well as Physician letters for various specialties.


Andrews University, Bachelor of Science (BSc), Computer and Information Systems
1991 - 1994

Skills

  • MEDICAL BILLING
  • REVENUE CYCLE MANAGEMENT
  • MEDICAL CREDENTIALING
  • INSURANCE VERIFICATIONS
  • PRE AUTHORIZATIONS
  • PRE CERTIFICATIONS
  • REMITTANCES
  • ACCOUNTS RECEIVABLES
  • OFFICE ALLY
  • MEDICARE / CONNEX
  • MEDICAID / EPACES
  • TRANSCRIPTION
  • DATA ENTRY
  • GOOGLE APPLICATIONS
  • MICROSOFT WORD
  • MICROSOFT EXCEL
  • MICROSOFT ACCESS
  • MICROSOFT VISIO
  • MICROSOFT PROJECT
  • POWER POINT
  • DATA SECURITY
  • IDM / PROVISIONING
  • DOCUMENTATION
  • SSL / VPN
  • PROJECT COORDINATOR
  • FLOW CHART
  • ORGANIZATIONAL CHARTS
  • TEST COORDINATION
  • TESTER
  • HELP DESK SUPPORT
  • TECHNICAL WRITER
  • TRAINER
  • METRICS
  • REPORTING
  • SCHEDULING
  • CUSTOMER SERVICE
  • FRONT DESK
  • RECEPTIONIST

Languages

English

Native or bilingual proficiency

Networks