Paperless Claim - Bill Management System

Description:

As a lead developer, I designed, co-authored and implemented both the database and programming for an automated paperless process for workers compensation claims management and payment of provider bills.

Details:

This system was the pioneer application of an all-encompassing centralized system for the entire business model of the client. I personally interviewed critical point personnel from every department and documented all areas of functional requirements from start to end. I then hired, managed, and participated hands-on with the coding, delivery and implemention of each executable prior to the projected deadlines and below the approved budget limits.

The system included ...

• Data imports and exports using automated services for both data warehousing and client reporting. All applications were executed and processed hourly/daily/weekly from an independent automated server in a world class healthcare level of security as required by law.

• Billing models to accommodate dynamic contractual requirements for medical case management, bill review, and third party provider services withdrawing from client accounts.

• A document scanning application processing more than 70K documents each day and digitally time stamping and importing data directly to the database for automated bill pay.

I also played a key role in coding the three separate web applications that partnered company employees, HMO and PPO providers, Insurance Adjusters, Client personnel and injured workers world-wide (U.S., Canada, Asia) to maintain and update Workers Compensation Claims, approve or deny medical treatments and to locate and compensate providers for services.

Skillsets Used:

VFP, VS, VSS, TFS, VB, C#, CSLA, Infragistics, ODBC, Linq, Toad, Oracle 11g, SQL Server 2008 R2, ASP.net, AJAX, Javascript, JQuery, SSIS, BizTalk, OOP, WebForms, Web Services, Crystal Reports, GEO 3rd party software, Adobe Imaging, OCR & Scanning devices.

Visual Studio Eclipse SDK Android SDK Team Foundation Server Visual SourceSafe Tortoise SVN ASP.net C# VB VFP HTML HTML5
AJAX Javascript JQuery Java XML UML CSS MVC OOP PHP WebForms SSRS SSIS EDIs Web Services ADO ODBC Linq
Access MySQL SQL Server Oracle TOAD Agile Adobe Imaging OCR Crystal Reports Barcodes Corel PSP Citrix VPN MSOffice

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