Nancy Livingston
Saint Charles
Summary
Highly dedicated Reimbursement Analyst known for multiple, concurrent projects with a track record of analyzing and resolving complex reimbursement issues. Strengths include problem-solving, cross-team collaboration, and a thorough understanding of data structures, healthcare pricing, provider contracts, and billing.
Overview
24
24
years of professional experience
Work History
Advanced Provider Reimbursement Programmer/Analyst
Health Care Service Corporation
Chicago
12.2002 - Current
- Develop solutions for implementation of pricing terms in provider contracts to ensure accuracy and efficiency in hospital and facility reimbursement.
- Work closely with contractors, IT professionals, data scientists, modelers, and other business areas to advise on reimbursement data processing, pricing methods, and system capabilities.
- Contributed to the development of a pilot program for provider contract intake that identifies and remedies potential issues that could result in configuration delays.
- Redesigned system for capturing CPT code updates by collaborating with business users to develop a process that is more streamlined, reliable and accurate.
- Manage the implementation of annual DRG and CPT code updates which includes analysis, coding, testing and documentation.
- Improved process of producing provider rate sheets, which reduced turnaround rate by 75%.
- Prepare technical documentation including flowcharts, diagrams, manuals and reports related to new automated processes.
Technical Consultant
Innovative Systems Group
07.2001 - 11.2002
- Provided technical, programming, and analytical support to the Provider Reimbursement Department at Health Care Service Corporation.
- Collaborated in the planning, testing, and implementation of a tailored reimbursement system for durable medical equipment (DME) providers.
Education
Computer Career Certificate -
Depaul University
Chicago, ILBachelor of Arts - Communications
Eastern Illinois University
Charleston, Illinois, ILSkills
- Healthcare data analysis
- SQL programming
- Reimbursement coding
- Technical documentation
- Process automation
- Managing cross-team relationships
- Data visualization using Power BI and Excel
- System implementation
Timeline
Advanced Provider Reimbursement Programmer/Analyst
Health Care Service Corporation
12.2002 - Current
Technical Consultant
Innovative Systems Group
07.2001 - 11.2002
Computer Career Certificate -
Depaul University
Bachelor of Arts - Communications
Eastern Illinois University