Lisa Miller has over 30 years of experience in healthcare IT, programming, and website building. She holds several certifications including PMP, PM, CAPM, and CBAP. She has experience with many healthcare applications such as EMR, billing/accounts receivable, imaging, order entry, and more. Miller has worked in various roles for hospitals and healthcare organizations, including as an IT consultant, revenue integrity nurse, clinical financial specialist, and director of nursing. Her experience includes project management, billing audits, utilization review, case management, and staff training.

1. Lisa Anne Miller, IT Specialist, PMP
Owner of Memphis Life Force
Seattle, WA
lmillerrn@gmail.com
Professional Summary
Over 30 Years of Experience in Healthcare, IT, Programming, and Website Building
Certifications
 PMP Certification
 PM Certification
 CAPM Certification
 CBAP Certification
Application Experience
 Billing and Accounts Receivable (B/AR)
 Imaging and Therapeutic Services (ITS)
 Enterprise Medical Record (EMR)
 Bedside Medication Verification (BMV)
 Patient Care System (PCS), Quality Management (QM), Case Management (CM)
 Physician Care Manager (PCM) I & II
 Computerized Provider Order Entry (CPOE)
 Order Entry (OE)
 Operating Room Module (ORM)
 Microsoft Office, including Excel, PowerPoint, and Project
 Payor Websites
 Meaningful Use, Stage I & II
 Emergency Department Management (EDM)
 Assisted with MIS and M-Site

2.  Non-MEDITECH Interfaces (FormFast, Zynx, DFM, Drager)
 Provation and Zynx Care Plans and Order Sets
 MEDITECH (Magic, C/S, 5.64, 6.0, 6.06, 6.1)
 MEDITECH Upgrade Management and DTS Testing
 Midas+ Care Management
 Milliman and InterQual Care Guidelines
 Encoder Pro and 3M
 ICD-10
 CM, QM, RM Modules
 PMMC
Highlights
 Expertise in Utilization Review, Case Management, billing account resolution, CCI edits, quality
assessments, front and back business office workflow, process improvements, quality management,
regulatory compliance and reporting, performance evaluations, policy and procedure creation, protocol
development, claims. appeal and denial processes, coding and billing special projects, business office
collections, billing, and staff training
Work Experience
• Owner of Memphis Life Force, 2010-present; prior IT experience at Navin Haffty & Associates
Facility: Navin Haffty & Associates, 2012-2014 and Memphis Life Force 2010-Present
Multiple Hospitals Countrywide:
Adena Health Systems, Chillicothe, Ohio
 Reviewed processes to ensure claims were billed appropriately with supportive clinical documentation
 Ensured claims pricing was correct based on contract terms
 Documented denials trends with recommendations for improvement
 Provided education on the meaning of current contract management terms
 Performed Appeals and Denials for Case Management; payers included Medicaid Ohio (Permedion),
Humana Medicare, UHC, Cigna, and Blue Cross.

3.  Completed Insurance Defense Audits (retrospective) and performed exits with external auditors
 Reviewed UR trends and recommended processes for improvement (Inpatient Notification, Denials
Management, etc.)
 Communicated appeals statuses to external auditors, payers, Case Management, and Business Office
staff as indicated
 Assisted with staff training in best practices for Denials Management
 Accessed the PMMC tool and payer websites to complete appeals and retro authorization requests
 Compiled reports detailing payer recoveries
 Performed collection activities and monitored outcomes; details noted in Meditech B/AR
 Assisted with staff education on topics such as claims modifiers
 Reviewed medical records for payer audits of injections, infusions, J Code drugs, Pre-Existing
Conditions, LCDs, NCDs, and Medical Necessity
 Composed rebuttal letters for denials and submitted these to payers
St. Francis Hospital, Poughkeepsie, NY
2011- Oct. 2012
MEDITECH Solutions Consultant IG, Highlights:
Implemented PCS, BMV, OE, ITS, OR, and EMR modules for Meditech 6.0 and 6.06. Assisted with EDM
and PCM integration. Created end user training manuals and provided downtime policies and
procedures for these modules. Created PCM end user training manuals. Educated clients on best
practices for the EMR build (CDS, assessments, dictionaries, etc.). Educated staffs on the charge build
and reconciliation processes. Assisted client with compliant build for OMH, DMV, CMS, and Meaningful
Use Phase I. Assisted with upgrade management including DTS testing. Updated the Project
Management Plan and Risk and Issues Logs as appropriate. Performed Meditech task management.
Assisted facility staff with a successful Go Live post module implementation.
Highline Medical Center, Seattle, WA
2011
MEDITECH Solutions Consultant IG, Highlights:
Completed Meditech and Project Management task follow-up, completed B/AR education materials,
performed one to one staff in-services on the charge reconciliation process, conducted staff meetings to
resolve Meditech system issues (LAB, B/AR, PHA, etc.)

4. HCA – Hospital Corporation of America, Denver, CO
2007 - 2010
Revenue Integrity Nurse
 Promoted revenue cycle management by resolving account edits, re-billed claims for all payers when
edits were resolved, audited medical records for charge capture and completed coding special projects
 Constructed charge master codes for billing
 Educated nursing staff on charge systems and charge master issues
 Trained all new staff
 Completed concurrent, retrospective, and insurance defense audits
 Performed compliance audits for Medicare
 Resolved patient billing concerns.
National Healthcare Review, Hospitals Countrywide
2003 - 2011
Clinical Financial Specialist
 Performed concurrent, retrospective, and insurance defense audits
 Utilization Reviews and Case Management
 Assisted with claims rebills
 Performed Medi-Cal billing and appeals projects
 Performed Medicare RAC audits
 Traveled to hospitals across the US for business office special projects
 Participated in a number of projects including a three year-project for insurance appeals and denials,
and a coding special project
 Resolved OCE & CCI billing edits to drop clean claims, re-constructed charge master codes for all
payers including Medi-Cal, and performed in-depth charge master analysis.
 Identified billing compliance issues and educated hospital COOs, CEOs, and staff on trends.
 Educated staff within the hospital system on a number of issues, including: financial reimbursement
issues, billing and Medicare compliance, MEDITECH software functionality, and compliance education

5. Kittitas Valley Health and Rehabilitation
1990 – 1997 and 2002 - 2003
Multiple positions, including Director of Nursing
 Performed various roles while at Kittitas, including: Rehab Nurse, Wound Care RN, Resident Care
Manager, Utilization Review, Case Management, Assistant DNS, Staff Development Coordinator,
Infection Control Nurse, Charge Nurse, Medication Nurse, and Director of Nursing
 Implemented systems to ensure compliance with State and Federal regulations
 Led a successful annual JCAHO survey
 Audited Medical Records to ensure quality patient outcomes and participated in facility QA and QI
programs
Chinook Convalescent Center
1997 - 1998
Resident Care Manager
 Completed the MDS, Care-Planning, and Resident Assessment process, as well as performing
admission assessments on new patients and managing their clinical course
 Performed care management services, reviewed nursing documentation and educated staff on areas
requiring improvement
 Created and assessed individualized rehab and wound care programs
 Performed Utilization Review and Case Management
Harborview Medical Center
1988 - 1990
Registered Nurse
 Performed the duties of a Registered Nurse on all floors, as well as in the Emergency Department