Joshua Maxwell

Joshua Maxwell

Skills

Skills

Project Management

Contingency Planning

Cost Analysis

Data Mining

Report Development

Work History

Work History
2010 - Present

Billing Manager

Quest Diagnostics

Oversee staff of 5 employees.  Responsible for LIS and BIS masterfiles for client setup, test setup, pricing and CPT coding.  Work directly with Billing IT programmers to design and test solutions for billing projects.  Investigate and design system fixes to resolve compliance issues in the Antrim billing system.  Act as a technical resource for the billing system conversion to BFE/QBS.  Coordinate technical projects for the Billing Department.  Identify and implement process improvements to lower costs and improve service.

Key Achievements:

  • Reduced staffing 33% through process improvement.
  • Oversaw implementation of 5010 for Nevada BU.
  •  Implemented mnemonic system for BIS test setup masterfiles to improve the parent-child relationship of a test and CPT coding.
2007 - Present

Interim IT&S Director

HCA – The Healthcare Company

Oversaw staff of 12 employees.  Responsible for IT support of 100 employee Medicare billing office.  Coordinated technical projects and allocated programming resources for billing office application development and financial reporting.  Identified and implemented process improvements that lowered costs and improved service.

Key Achievements:

  • Implemented help desk, one point of contact, for internal billing office and external customers.
  • Implemented new IIS, SQL and File Share servers and seamlessly migrated web applications and data to new servers without any impact to the customers.
  • Developed schematic which mapped voice and data ports in employee workspace to patch panels in MDF and IDF.
2004 - Present

SSI Technology Specialist

HCA – The Healthcare Company

Assisted in the FoxPro to SQL database conversion of the SSI ClickON Billing System.  Provided direct technical support to the Billing Department for the SSI system.  Maintained work orders submitted to SSI regarding provider edits and/or system problems.

Key Achievements:

  • Reduced system downtime by 95%.
  • Developed a detailed claims balancing process using Microsoft Access.
  • Created workflow management reporting for other Billing Managers.
2008 - 2010

Project Manager (Billing Systems)

Quest Diagnostics

Oversaw staff of 6 employees.  Responsible for LIS and BIS masterfiles for client setup, test setup, pricing and CPT coding.  Worked directly with Billing IT programmers to design and test solutions for billing projects.  Designed and developed databases to automatically pull work lists and track individual productivity.  Coordinated technical projects for the Billing Department.  Identified and implemented process improvements to lower costs and improve service.

Key Achievements:

  • Implemented over 100 programming changes per year.
  • Implemented multiple upfront eligibility process to reduce back-end denials.
  • Implemented QC processes for all BIS masterfile functions. 
2007 - 2008

Sr. Financial Analyst

Quest Diagnostics

Designed and developed databases to automatically pull work lists and track individual productivity.  Mined and compared A/R data to look for trends and issues that could be resolved to improve cash collections.  Coordinated technical projects for the Billing Department.  Identified and implemented process improvements to lower costs and improve service.

Key Achievements:

  • Eliminated 5-6 hours of daily manual data mining to provide work lists to the employees by using database applications.
  • Developed automated script to post electronic payments, which allowed 3 FTEs to be re-assigned to other tasks.
  • Reduced Medicare eligibility denials by 90% by implementing a screen scraping program to check eligibility before the claim is billed.
2006 - 2007

Managed Care / Commercial Billing Director

HCA – The Healthcare Company

Oversaw staff of 25 employees.  Responsible for billing functions, ensuring timeliness, accuracy, compliance in electronic and hardcopy claim submission.  Monitored unbilled and rebill summary reports and acted on trends and/or root causes.  Oversaw maintenance of all billing controls related to SOX audit requirements.  Coordinated technical projects for the Billing Department.  Identified and implemented process improvements that lowered costs and improved service.

Key Achievements:

  • Reduced daily SSI Unbilled by $10 million.
  • Reduced staffing 20% through process improvement.
  • Developed plan for design, testing and implementation of billing edits.
  • Developed process controls for SSI daily operations to ensure timely balancing of payer transmissions and validation of job performance.
  • Worked with Collections Department to implement claim status automation to improve collection performance.
  • Coordinated billing tasks for UB04 implementation.
  • Developed security audit reports for the SSI system that were adopted by HCA Corporate for quarterly SOX reviews.
2004 - 2006

SSI Database Manager

HCA – The Healthcare Company

Managed two staff employees.  Provided direct technical support to the Billing Department for the SSI system.  Managed and updated claims balancing process using Microsoft Access.  Maintained work orders submitted to SSI regarding provider edits and/or system problems.  Maintained all controls related to SOX audit requirements.  Coordinated technical projects for the Billing Department.

Key Achievements:

  • Created SQL queries to extract and update data from SSI database without manual intervention from staff.
  • Implemented SSI ClickON Test System, Audit Module, and CCSM.
2003 - 2004

Technology Specialist

HCA – The Healthcare Company

Repaired PCs and printers.  Logged help desk calls for office of 500+ users.  Assigned and monitored work orders through help desk software.  Reset user passwords in multiple systems.  Configured PCs for new user distribution.

Key Achievements:

  • Assisted with facility SSI data migrations.
1999 - 2003

I.S. Operator / PC Tech

HCA – The Healthcare Company

Repaired PCs and printers.  Administered 5 NT domain and file servers.  Set up and managed all network printers.  Managed nightly backups of all server data.  Maintained all WAN/LAN equipment for remote billing office. 

Key Achievements:

  • Coordinated and executed installation of new Cisco LAN at Good Samaritan Hospital and San Jose Market CBO.
  • Migrated 6 legacy NT 3.5 servers to new Y2K compliant NT 4.0 servers and re-established local domain trust relationships with HCA WAN.
1998 - 1999

Patient Financial Services Representative

HCA – The Healthcare Company

Processed electronic billing for 4 hospitals.  Assisted in site support for electronic billing system.  Created spreadsheets and document templates for billing supervisor.

Key Achievements:

  • Assisted in implementing The SSI Group as a new electronic billing vendor.

Education

Education

MBA

Western Governors University

Bachelor of Arts

San Jose State University