LaToya S. Morgan has over 11 years of experience as an Epic analyst specializing in design, implementation, and support of healthcare billing systems. She has extensive expertise in applications such as Resolute Professional Billing, Tapestry, and Benefits Engine. Her experience includes roles as a consultant, analyst, and coordinator for large healthcare organizations such as Kaiser Permanente and Community Healthcare Systems.

1. LaToya S. Morgan
LaToya S. Morgan
Professional Summary
A detailed oriented, flexible, andanalyticalEpic analyst withover 11 years of practical andtechnical experience in design, build,
and implementation for hospitals andhealthcare agencies. Highlyorganized, with a keen eye for synthesizing andediting
informationto achieve businessobjectives, completing immediate and long-term goals andmeeting operational deadlines.
Core Strengths: Understanding of health care systems. Excellent communicator andteam player. Well versedinpresentation
and organizationalskills. High-caliber multi-tasking, negotiation, andclosingskills. Expert problemsolver and planner.
Subject matter expertise in EMR applications:Resolute Professional Billing, Hospital Billing, Tapestry, Cadence, Ambulatory,
UNIX, Benefits Engine, IRCS/CM, OptumWebstrat, McKessonClaimsXten, 3MCoding, CBCT(Coding BasedCharge Trigger)
Career Experience
Kaiser Permanente California Region 07/2012 - 08/2016
Tapestry Consultant Los Angeles/Oakland,CA 04/2011-08/2016
Provided mentoring and training in departmental functional units in the areas of system analysis, end user workflows, and client
methodologies.
 Prior to Go-Live, conducted assessments ineffort to designed instructor- led training materialsbasedonthe needs of
the functionalarea beingtrainedfor the session
 Facilitated training to Direct andIndirect endusers onnew claimsystemrelatedto:
o Claimtypes
o Examiningand/or editing claims (Retro/Rejected Claims/ Follow-Up)
o Understandingdifferent claimstatus types
o WorkingPend/Holdcodes
o Patient coverages, benefits, andclaim records
o Reviewing andunderstanding provider contracts
 Created engaginglearning activities such as Jeopardyfrom course content that enhancedretention
 Trainedendusers onnavigationthru the newsystemas wellas creating andfindinginformationwithin master files
 During Go-Live worked withClaims adjusters/examiners to understandandclear/add claimcodes for things suchas:
o Transferring claims over examiners limit
o Authorization not attachedto claim
o Duplicate claims
o Claims that requiredthird partypricing
o Coverage verification
 Maintainedproject documentationon issues intraining andproduction environments before andafter go-live
 Forecastedfor resource availability, including trainers, rooms, and workstations setup
 Assistedincredentialingnew trainers and acclimate new trainers on training policiesand format
PB/HB Sr. Consultant Los Angeles/Oakland,CA 07/2011-03/2016
Analyzed and design system configuration, implementation, and support related to EPIC 2012 Upgrade, Inter-Regional
integrations, ICD-10, 5010 conversions, and Tapestry between the organizations 7 regional hospitals and multiple medical
offices.
 Successfullybuilt effective relationships between the client, operations, IT, andbusiness stakeholders through all the
phases ofprojects to support completing operational goals conducting weeklystatus calls
 Forecastedfor resource availabilityandallocation for IT buildandtesting validation
o Ensuredresource availabilityand allocationfor IT build and testing validation
 Facilitated meetings betweenRevCycle, Patient Financial Services, andIT onoperational workflows ineffort to
definedbusiness requirements to support the development of technical solutions for assignedprojects

2. LaToya S. Morgan
 Created and maintainedcomprehensive documentationto monitor and track approvals, statuses, andescalations to
IT and Operational stakeholders
 Mitigated existing system issues ineffort not to carryover to the new system. I.e. Claims rejectedincorrectly
 Implementedsimple visit coding for services like radiology, lab, specimens, andreoccurring outpatient to allowstaff
the abilityto focus onaccounts requiringmanual intervention
 ConfiguredFilingOrder tables (FOT)to determine the correct primarycoverage basedon National Associationof
Insurance Commissioners (NAIC) andCenter for Medicare & Medicaidservices (CMS) rules
 Configuredthe 835 to suppress or input informationbasedonclaim for PB(visits) andHB(accounts)
o For voided/canceled/replacement claims, the 835’s received frompayors were configuredto have the ICN
(Internal Control Number)inorder to be processed
o Configuredsystem to generate reports to sendto the business offices when835 files were rejected
 Designedsystemto generate replacement claims based ontriggers identifiedbetweenPatient Financial Services (PFS)
and Revenue Cycle (RC)
 System configurationto reclassifyrevenue if initial claim wasadjudicated under one coverage and later adjudicated
under another via the 835
 ConfiguredLoader to sendandreceive 835/837/277 files basedon payors go live date to move claims to newclaims
platform
 Configuredthe Coverage manager(HB) and RetroProfile (PB) to trigger based onspecific coverage changes to original
claim
 Created claims platform to generate Remittance Advice (RA)inHIPPA compliant 835 electronic transactions in 5010
format to providers whosubmitted837(P) or 837(I) transactions.
 Worked withEpremison the system designto suppressconverting claims to the 5010 forma t for the payors who
hasn’t transitionedto ICD-10 diagnosis codes at time of go-live
o Files naming conventionandlocations for IT to pick upandmove to Health connect
 Configuredthe system to provide claim statuses (277’s) for every837 processedbythe EDI platform betweenthe
new claim systems andthe retiring systembasedonbusiness requirements
 Created test scripts for PB andHB according to businessrequirements inrelationto:
o Office visits, LabandRad, HOV
o Ingenix claim manager
o Code Editing(CAC/ CBCT/ 3M Coding)
o ED/HOB to Inpatient
o Patient andFamilyMOOP/DED
o Order entry
 Conducteduser acceptance testing inconjunctionwith other Epic applications
 Compliedwith the “Breakthe Glass” policies for the organization for testing protocol
 Clear understanding and analysis ofPB visits andHB accounts
o Open and DNB acct statuses
o Undo/Initiating billing
o Charge router reconciliationreports for visit or account analysis
 Providedproblem solvingandimplementation skills pre and post golive
o Utilizedthe charge router to investigate charges flow
 Created and maintainedWQ’s for implementations anddayto daymaintenance
 Reviewed recommendedrelease notes related to system or workflow enhancements
 AnalyzedandResolvedhelpdesk/ incident tickets
 Completed change management request submittedbybusiness offices
 Formatted filesto import for charge write-off’s, debit/credit matchingfor venture services, and collection activities
that didnot matchautomaticallyduring overnight processing

3. LaToya S. Morgan
Community Healthcare Systems
Resolute PB/HB Consultant Hammond,Indiana 05/2011-7/2012
Facilitated the design, system configuration, implementation, and support of Community Connect Clients and performed other
Resolute PB/ HB functions.
 Collaboratedin redesignefforts for External clinics transitioning to the Resolute PB system
 Assistedrevenue cycle teams in troubleshooting accounts that were being held in A/Rdue to chargingor
documentationdiscrepancies
 Analyzedissues andprovidedsolutions for helpdesktickets
 Completed change management request submittedbybusiness offices
 Supportedend-users duringtraining andpre/post-go live periods
 Performedtesting and data validationbased offbusiness requirements outlinedfor each facility
Designed, built, andcollaboratedon the following:
o Payers (EPM)
o Benefit Plans (EPP)
o Employer Groups (PPG)
o Adjudication tables (ADJ)
o Batch Jobs,Coding Workflow, Interfaces
o Charge Router Actions, Charge Router HandlerTasks, ChargeRouter WQs o Credit, Collections, Statements,Agency
Extracts
o HCFAand UB setup:
▪ (CDF) Claim definition file
▪ User/Master fileerrors
▪ Split billing
o Benefits setup:
▪ ComponentGroups (CMG)
▪ Fee Schedulegroups (FSG)
o Work queues: Account,Retro Review, Claim Edit, ItemProfiles, Follow up, FollowWQprofile, Charge Review, Credits
Kaiser Permanente Atlanta Region 02/2007- 05/2011
Resolute Application Coordinator 04/2010- 05/2011
Design, build, and validate Epic Resolute Professional Billing application in conjunction with other EMR systems.
 Designed, configuredandmaintained the Resolute application for the Revenue Cycle andHIMS(Coding) Dept.
 Analyzedissues anddeterminedresolution for matters that were escalated to the national team
 DesignedandcompletedEpic’s BeaconOncologymodule buildfor Professional Billing
 Completed regional change management request
 Supportedbusiness designactivities related to application software, data andpackagedsolutions
 Conducteduser acceptance testing inconjunctionwith other Practice Management applications
 Created test scripts for designatedoperational areas accordingto business requirements
 Perform testinganddata validation based off businessrequirements outlinedfor each facility
 Ran reports to pull all outstanding service request and/or incident tickets
 Facilitated weeklycallswith Businesspartners onissue resolution Designed, built, andtrainednew analyst onthe
following:
o Payers (EPM)
o Benefit Plans (EPP)
o Employer Groups (PPG)
o Adjudication tables (ADJ)
o Batch Jobs,Coding Workflow, Interfaces
o Charge Router Actions, Charge Router HandlerTasks, ChargeRouter WQs o Credit, Collections, Statements,Agency
Extracts
o HCFAand UB setup:
▪ (CDF) Claim definition file
▪ User/Master fileerrors

4. LaToya S. Morgan
▪ Split billing
o Benefits setup:
▪ ComponentGroups (CMG)
▪ Fee Schedulegroups (FSG)
o Work queues: Account,Retro Review, Claim Edit, ItemProfiles, Follow up, FollowWQprofile, Charge Review, Credits
Benefits Contract Analyst II 02/2007- 04/2010
Assist specificallyin Resolute/Tapestry/Benefits, and on the Managed Health Care (MHC) providing accurate and concise data
entry of group’s healthcare selections.
 Designed, built, andimplementedTapestryclaims system fromBenefits Adminperspective
 Providedpre and post go-live support withoptimization in collaborationwithClaims, QualityAssurance, andProvider
Contracts department
 Designedandmaintainbenefits of all group information, plans (EPP), andproducts) for all lines of businesses (HMO,
DHMO, MC, Medicare, Medicaid) withinTapestry, MHC(Managed Health Care)andEpic systems
 Trainedandsupportedend-users on newbenefit system build
 Benefit Packages(CMK)
 Plans (EPP)
 Components (CMP)
 Component Groups (CMG)
 Adjudication Tables (CML), Formulas(CMA)
 Limit/Payment variables
 Conductedaudits onbenefit build andfunctionalities
 Developedtimelines anddefine deliverablesinconjunction withapplication project managers andteams
 Created a step bystep document onfor newandexisting features for newbenefit systemchanges
 Adept inperformance testing, applicationverificationtesting, anddata validation
 Peered reviewandtracked information that was processedbyother analysts on the MHCand EPICdesk
 Pulledaudit andtrackingreports for status workflowupdates
 Completed weeklysummaryreports
Certifications/Credentialing
Resolute Professional BillingAdministration Certification ‐ Epic 2015
Tapestry Core Certification ‐ Epic 2015
Tapestry AP Claims and Contracts Certification ‐ Epic 2015
Benefits Engine Basics and Health plan Certification ‐ Epic 2015
Benefits Engine AP Claims Certification ‐ Epic 2015
Education
Southern University of New Orleans 08/2004 – 05/2006
CriminalJustice/ Business Administration
Delgado Community College 01/2002 – 05 /2004
Business Administration