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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Palisade AvenueUnion City, NJ Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEA bilingual professional with over 20 years in revenue cycle experience seeking an opportunity for further growthEXPERIENCE:Rethink First June 2019-April 2020New York, NYBilling Manager/Implementation Specialist*Implemented processes for the set up of a new billing system* Set up the new billing process, payment posting, and denial processing* Handled all provider clearinghouse enrollments while serving as liaison between clearinghouse and providers* Set up new facilities with payors, clearinghouses, and banking* Maintained active client relationships and advised, in a proactive manner, market trends and needs in order to meet monthly goals* Monitored receivables in aging, days in A/R, and bad debt* Made sure that staff spooled claims and submitted electronic submission via Emdeon, Gateway EDI, and Realmed, Kareo, Availity daily. I also made sure that any rejections were handled in a timely manner and found ways to reduce errors*Coordinated, directed, and managed day-to-day operations, ensuring policies, procedures, and best practices by the A/R and implementation departments.*Performed demos of our billing platform for prospective new clients*Implemented new practice within our systems and held best practice demos for new clients* Ran weekly and monthly reports for all clientsJuvo Autism and Behavioral Health Services January 2018-June 2019Hackensack, NJAccount ManagerCoordinated, directed, and managed day-to-day operations, ensuring policies, procedures, and best practices by the A/R, data entry, and coding departmentsContributed to the development, enhancement and ongoing education of all team membersMade sure that staff spooled claims and submitted electronic submission via Emdeon, Gateway EDI, and Office Ally on a daily basis. I also made sure that any rejections were handled in a timely manner and found ways to reduce errorsRan weekly/daily meetings with collections and revenue staff to ensure best practices for collections.Kept in daily communication with the Director of Finance in order to ensure payments were posted in a timely manner.Set up the new billing process, payment posting, and denial processingGave weekly forecasts to the CFO to ensure revenue goalsMaintained active client relationships and advised, in a proactive manner, market trends and needs in order to meet monthly goalsMonitored receivables in aging, days in A/R, and bad debt.Performed any related duties and special revenue cycle projects as requiredSet up a new authorization and eligibility check to ensure services were not provided that would need to be adjusted off due to incorrect informationHandled all provider Clearinghouse enrollmentSet up new facilities with payors, clearinghouses, and bankingIntermedix February 2015-October 2017Brooklyn, NYClient Relations ManagerAttended departmental meetings on a routine basis to ensure communication, productivity, and organizational initiatives in order to meet monthly revenue goalsHandled all client requests and inquiries in regards to patient requests, account balances, claim status, and monthly collectionsRan weekly collections reports to present to clientRan monthly invoice reports for billing to clientHandled any communication for the credentialing department and ensured that clients were correctly enrolled with carrier requests in a timely mannerMaintained active client relationships and advised, in a proactive manner, market trends and needs in order to meet monthly goals.Monitored receivables in aging, days in A/R, and bad debtManaged data entry team in regards to demographics, payments, and adjustments.Origin Health Services February 2008-February 2014Rutherford, NJDirector of Revenue Cycle OperationsCoordinated, directed, and managed day-to-day operations, ensuring policies, procedures, and best practices by the A/R, data entry, and coding departmentsHandled any communication for the credentialing department and ensured that clients were correctly enrolled with carrier requests in a timely mannerHandled all provider Clearinghouse enrollmentContributed to the development, enhancement and ongoing education of all team membersMade sure that staff spooled claims and submitted electronic submission via Emdeon, Gateway EDI, and Realmed on a daily basis. I also made sure that any rejections were handled in a timely manner and found ways to reduce errorsHandled all Staff Performance reviews and dealt with any Human Resource issues with staffMaintained active client relationships and advised, in a proactive manner, market trends and needs in order to meet monthly goalsMonitored receivables in aging, days in A/R, and bad debt.Attended departmental meetings on a routine basis to ensure communication, productivity, and organizational initiatives in order to meet monthly revenue goalsReported to the Vice President of Operations with monthly reports for all clients and attended monthly meetings with clients in order to discuss A/R and operating process. Monthly reports were run on the Cognos Impromptu program.Performed any related duties and special revenue cycle projects as requiredDealt with any patient issues and calls in regards to billsRider University, Lawrenceville, NJ September 1994 to May 1996Major: Secondary EducationSKILLS:Fluent in SpanishMicrosoft Office Suite (Word, PowerPoint, Excel)AdobeGE Centricity IDX GPMSElectronic Claims Submission (Emdeon, Gateway EDI, RealMed, Availity, Kareo)Cognos Impromptu (Analyzer)NHXS- EOB ResolveExperienced in various medical billing software programs; Medisoft, ADS, JHJ, Mr. Bill, Misys, Advantix, Central Reach, and GE SystemsReferences Furnished Upon Request |
