After developing, maintaining and operating pharmacy claims billing and adjudication systems for most of the past years, I have a significant pool of experience upon which to draw to assist other organizations in their efforts toward compliance with NCPDP Standards, real-time pharmacy claim processes, and HIPAA regulations. Additionally, I have more recently worked with the planning for Health Insurance Exchange implementation required by Affordable Care Act mandates and their integration with State Medicaid and Eligibility systems. My work with systems setup, operations and enhancement requests from both the client and internal perspectives also support my ability to contribute to Healthcare IT and PBM integration and migration projects that need an experienced resource that has a long history of bringing out the requirements of a business and turning it into a system that meets those needs. I look forward to sharing these skills and experiences with an organization in need of business andor technical analysis and support of their daily PBM operations, eligibility systems integration, HIPAA compliance efforts, participation in industry standards development and new business development. Specialties NCPDP Standards, real-time healthcare claims processing, HIPAA, eligibility systems, Affordable Care Act (ACA), Pharmacy Benefit Management (PBM)read more ...read less ...
java
healthcare
California State Polytechnic University
1982 - 1986
Pomonacomputer Science
Supervisor
Manager
Sr. Manager
Chairman
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