valerie sapp

* Managed staff of 20 members, managed large volume of workers compensation benefits for The State of Georgia Workers' Compensation. * Performed medical claim review on all high-dollar acute-care facility billing charge codes to ensure proper coordinated reimbursements from HMO, PPO, POS, Health Savings Accounts and Self Directed Health plans. * Advanced medical billing/coding knowledge on large volumes of medical claims. * Knowledge in CMS coding systems ICD-9, CPT, HCPCS, DRG and Pharmacy. * Managed new and existing business, evaluating contract agreement for new and existing clients, included preparation for financial reports.

* MCKESSON / PER SE TECHNOLOGIES ALPHARETTA, GA * Implemented the Pathways Image Manager product for 20 clients. * Trained end-users/physicians on all products within the Pathways Image Manager suite. * Built custom workflow maps for each individual client. * Wrote custom stored procedures using SQL. * Created custom reports with Crystal Reports software. * Performed extensive system testing to determine product stability. * ASCII fixed file formats, pipe delimited, and comma delimited. * Data modeling, mapping, complex SQL queries, quality assurance and regression testing.

* Provide implementations project management for new and existing insurance industry customer's standard performance improvement guidelines NCQA for HEDIS, MedAdvantage STAR and QARR. * Software implementation with hands on configuration and data preparation, mapping and loading. Managing data conversion activities for importing and exporting data. * Include the initial review of client data and approval of client based data formats, data values, validation and analysis of data and the coordination of implementation events and rates with the Customer Service Manager. * Collaborates with the Implementation Team to ensure consistency, quality and timeliness of customer's data. * Collaborate with internal partners to deliver customer requirements in a timely and accurate manner to ensure to meet key deliverables. * Configure insurance data, SQL, SSIS, Ultra Edit and Move It.