JUDITH F.

JONES SCOTTSDALE, ARIZONA 85267 Phone: (623-341-4918| Email:

Judith.jones@bryanuniversity.edu

PROFESSIONAL PROFILE: DEPARTMENT CHAIR/ DIRECTOR OF HEALTH INFORMATION/MEDICAID SERVICES

DRIVING EFFICIENCY DEVISING STRATEGY ~TRANSFORMING OPERATIONS.
Working knowledge of the revenue cycle. Working knowledge of Prescription HCPCS codes, Bin
numbers and different payment methodologies. Knowledge of data sets, Uniformed Hospital
Discharge Data Set (UHDDS), Healthcare Effectiveness Data and Information Set (HEDIS), passed the
national exam that covered questions on data sets. Credentialed as a Registered Health Information
Technician with extensive medical research, strategy development, staff leadership, sales and
operations management experience. Performed audits for the NCQA. More than 20 years of health
insurance experience. Working knowledge of Medicare and Medicaid operations. Improved systems
to monitor and coordinate correct payment structure was in place to ensure proper payments
adjudicated by the system on behalf of Medicaid recipients.

A high capacity leader with a strong reputation for improving operations, impacting business growth
and maximizing profits through achievements in strategic planning, claims management, research,
patient relationship management, and business process re-engineering. Innovative change agent,
acknowledged for using technology to drive efficiency.
Additional focus:
Healthcare Statistics
Data analytics
Monitor Trends
Medical Management Services
Six Sigma Lean Operations Methodologies
Identifying Overpayments
New Business Development
Develop workflow ONC/ICD-10 Implementation
Robust Process & Controls Implementation
Health Data Classification Systems
HIPAA & Privacy/ HITECH
CDI

Credentialed as RHIT & ICD-10-PCS-CM Coder & AHIMA Educational Trainer

ACCOMPLISHMENTS

Under my leadership, American National University received CAHIIM accreditation on June 23, 2014

TEACHING EXPERIENCE
Bryan University March 2015-Present
Tempe, Arizona 85281
Director of Health Information Management

Provide support to Adjunct Faculty and the Staff. Monitor, supervise and mentor new instructors.
Teach up to two classes per sessions. Participate and have budget oversight. In charge of managing
the program. Manage and monitor the Health Information Management Technology Program. Develop
and maintain the H.I.T curriculum. Provide academic counseling. Participate in activities related to
growing the program. Manage the PPE program. Administer mock exams for practice for the RHIT
exam. Manage the International student recruitment initiative for the university.

Course taught:
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Phone: (623-341-4918| Email:Jones.3617@osu.edu

ICD 10 CM/PCS Healthcare

Statistics
Data Analytics Healthcare
Datasets
Medical Terminology Healthcare
Law & Ethics

American National University

Westerville, Ohio 43231 September 2012-
March, 2015
Director of Health Information Technology
Provide management to a core group of staff and demonstrate leadership in and outside of the
classroom. Budget Management, which consist of maintaining fiscal control and responsibility. Update
and maintain student databases. Support the efforts of students pursuing a career in Health
Information Technology. Manage and coordinate the activities of adjunct staff members. Introduce
and explore computer systems and guide students and faculty through data dictionaries, and other
pertinent systems, necessary in pursuing this science. Also facilitate and monitor the collections and
maintenance of various surveys, student records, and accreditation reports; Provide oversight for
curriculum development and system implementation; Provide direction and oversight to additional
core instructional faculty; coordinating effective communication with all parties involved with the
program. Additional roles consist of working in the capacity of Practicum Coordinator for the Health
Information Technology externs.

Phoenix College, Phoenix, Arizona| August 2010-

August 2013
Part time Instructor
Teaching with technology is one of the ways I provide learning instruction to a diverse group of
students. Poll anywhere is one technique utilized to engage students into questions pertaining to a
certain subject matter. Teach students how to write and prepare presentations. Provide specialize
instruction in the area of health information management, and demonstrate to students the
importance of documentation in an acute hospital setting. Provide students with knowledge on how
to apply conventional methods using state-of-the art lab assimilation. Introduce students to the
AHIMA virtual lab where students gain hands-on-experience on how to organize and manage health
information data through various program applications that focus on quality, accuracy, accessibility,
and security in both paper and electronic systems. The students are also taught how to use various
classification systems to code and categorize patient information for reimbursement purposes.
Students are task in many health Information technology roles, and become graduates in the area of
Health Information Technology. Coach and mentor students.

HEALTH INSURANCE EXPERIENCE

Aetna Health Care Insurance

Scottsdale, Arizona 85251

May 1995-August 2012

Manager (Acting Vice President)

In charge of coordination of benefits between Medicaid/Medicare & other private payers overseen my
Coventry/Aetna Working knowledge of models, such as MCO PPO, HMO, ACO
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Medicare/Medicaid, self-administered and cafeteria policies. Provide statistical reporting on dollar

errors to Office of Personnel Management, and Department of Health and Human Services.

Administer insurance benefits for Federal contracts, in addition to handling the processing of claims
for the Mail Handlers benefits Plan.
Working knowledge of HIPAA, Coordination of benefits as it applies to all contracts. Familiar with the
birthday rule. Have worked as an Auditor. Familiar with how the different Standards organizations,
such as NCQA, and Joint Commission, may impact the business. Familiar with healthcare exchanges.
Worked on a project developing the 50/10 screen expansion for ICD10.

Manage employees. Report to Senior Management and Office of Personnel Management, which
oversees the

Federal Employees Benefit Plan, on the daily progress of claims processed. Work to improve
system processes.
Maintain a 10% year-after-year increase in membership and above average retention rate. In charge
of budget. Improve processes and procedures.
Working knowledge of all coding methodology, such as ICD 9, 10, HCPCS, CPT 50/10 expansion
screens. Audit and adjudicate complex claims.
Provide frontline leadership and functioning as central point of contact for members, hospitals and
internal departments.
Acknowledged as a Process SME, handle escalated phone calls, resolve customer service issues and
review and answer written inquiries.
Compile and generate reports for Office of Personnel Management, Health Care Finance
Administration, and HIPAA.
Function in the capacity of Program Manager, accountable for the logistics aspect of the Provider and
Patient Service Visit Program by sending representatives to conduct on-site visits to address critical
issues.

HOSPITAL EXPERIENCE
Scottsdale Lincoln Health care
Phoenix, Arizona 85020 February 2005-June 2009
Manager of General Admissions & ER. (Part-time)

Managed a staff of 75 Admissions and billing personnel. Primary role as an Admissions Supervisor was to
manage the operations of the department, which consisted of ensuring the flow of revenue was being handled in
the proper manner. Monitored to ensure copays were collected or that Medicaid applications were in processing.
Assisted with the verification of insurance benefits. Assisted with obtaining prior approval for hospital
procedures by verifying the appropriate CPT and diagnosis codes matched the physicians surgery request.
Maintained the Master Patient Index. Responsible for all other duties as it related to department operations.

Phoenix Indian Medical Center

Phoenix, Arizona 85021 June 2011- September 2012

(Part- time)
Coding Educator
Report directly to the Coding Manager. Provide annual training on coding guidelines to about 20 Coders. Provide
refresher coding trainer upon request by the Manager. Educate Coders on common errors affecting
reimbursement. Provide updates on Medicare guidelines as it affect coding.
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EDUCATION & PROFESSIONAL DEVELOPMENT

Doctorate, DDBA, Walden University December 2017
MBA Graduate Franklin University
DEVRY University- Associate Degree in Health Information Technology
B.A., Journalism, The Ohio State University
Certification(s): Registered Health Information Technician, September 2009

PROFESSIONAL ORGANIZATIONS
AHIMA State Advocacy Council Member
Member of The Ohio State Alumni of Columbus & Phoenix

JUDITH F. JONES, RHIT

Scottsdale, Arizona 85267 | Phone: (623-341-4918| Email: Jones.3617@osu.edu

March 25, 2017

Dear Human Resources:

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Phone: (623-341-4918| Email:Jones.3617@osu.edu

Let me preface by stating, I currently provide coding education to a group of Coders as well as
educate the Provider community. I also have working knowledge of Revenue Cycle Management,
including the new Medicare Incentive Payment and the
Advanced Payment Model.

For the past 5 years, I have worked in higher education working to produce strong outcomes for
students and reduce the dropout rate. Prior to working in the education arena, I spent over 20 years
working in the healthcare industry helping mid to large size enterprises tighten internal controls;
streamline processes; motivate and supervise top talent, and drive higher levels of overall efficiency
and profitability. My background represents a progressive career with a diverse skill set. To this end,
I have attached a copy of my resume for your consideration for the position of Remote Coder
Educator.

Maintaining an unwavering commitment to excellence has been the cornerstone of my approach to

academics, business and life. I would be honored to join your company and drive the type of results
that far exceed expectations. I would greatly appreciate the opportunity to speak with you to discuss
the contributions that I would be able to make.
I thank you for your time and consideration and I look forward to hearing from you soon.

Sincerely,

Judith Jones
Enclosure: Resume