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Click here or scroll down to respond to this candidateCandidate's Name
Brooklyn, NY Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLESummary of QualificationsOver 18 years of experience supporting high-volume, deadline-orientated workloads and recognized ability to handle every facet of a project with skill, professionalism, and attention to detail. Monitor and analyze department work to develop more efficient procedures and use of resources while maintaining high accuracy. I maintain revenue by implementing coding claims protocol and managing medical billing staff with strong interpersonal, supervisory, and customer service skills.Skills SummaryStrong Attention to DetailResearchers and Reporting ExpertiseStaff SupervisionContract act NegotiationDetailed leaded RecordkeepingCustomer Service SkillsConfidential and HIPAA CompliantWorking knowledge of healthcare software: Cerner, Eagle 2000, MultiMate/MultiMate Advance IIMicrosoft Office: Word, Excel, PowerPointEPIC Software, Telea-TrackingEducationBachelor of Science - Health Care Administration August 2022University of Phoenix AZ GPA: 2.50Secretarial Science Certification 1986YMCA Technical School Brooklyn, NYBusiness Management Certification 1982Pace University New York, NYProfessional ExperienceNew York-Presbyterian Brooklyn Methodist Hospital November 2007 PresentProgram Coordinator of Cardiology Outreach ProgramA voluntary, acute-care teaching hospital, New York Methodist Hospital's mission is to provide compassionate and humane healthcare services to the people who live and work in Brooklyn and its surrounding areas.Manage and provide leadership to a staff of 50, ensuring that the appropriate codes are used to generate proper billing.Obtain authorization codes for admission and verify patient insurance coverage and claims.Meet financial billing standards by providing weekly billing and collection information.Coordinate patient registration in the Eagle system and follow up on outstanding insurance payments.Outreach Coordinator duties: facilitate contracts for 40+ outreach sites; develop and maintain outreach schedule for 12 echo technicians and nine (9) physicians; and organize test and visit invoices for physicians.Wyckoff Heights Medical Center May 2016 March 2019Patient Access Service RepresentativeCompletes the admitting process for all emergency, elective admissions, maternity/newborns, and patient transfers.Distributes the Patient Information Guide that includes Patient Rights and Responsibilities, Advance Directives, and other required information.Accepts and documents deposits from patients for charges not covered by insurance; accepts payments from patients without insurance coverage.Ensures the integrity of the information entered in the system; corrects and revises patient information while coordinating with hospital departments (Medical Records, Patient Accounts, etc.). Facilitates transfers in-house and to other facilities.Oversees and coordinates the assignment of beds for Emergency Room and Elective admissions; coordinates the in-house transfer of patients, ensuring patients are placed in locations appropriate to their diagnosis, course of treatment, or other criteria established by clinical services.Complete the Death Certificate promptly.Central Brooklyn Medical Group August 2005 November 2008Billing ManagerNow known as Preferred Health Partners, the company is the most extensive multi-specialty, physician-owned medical group practice in Brooklyn, providing patients with outstanding service, quality care, and convenience.Created and developed a medical billing department for ten diversified medical practices, including software acquisition policies and procedures.Liaison with the CEO, CFO, and medical staff to provide guidance and direction on billing practices and centralized billing system unit.Reviewed old claims by medical billers, determined their defects, and set new policy guidelines to prevent recurring and future difficulties.Developed policy and procedures for implementation of Medicare Part D claims to process.Cypress Hill Local Development Corporation January 2005 August 2005Assistant Director (Interim Assignment)The mission of CHLDC is to build a strong, sustainable Cypress Hills/East New York, where youth and adults achieve educational and economic success and develop leadership skills to transform their lives and community.Developed summer job opportunities for adolescents and instructed adults in job search/interviewing techniques; prepared 30 applicants on a bi-weekly cycle.Educated job search candidates on the different health insurance options available in the workplace.Easy Choice Health Plan (formerly Atlantis Health Plan) September 2002 January 2005Manager, Grievances, and AppealsAs a New York State Licensed HMO, the companys central goal is to advance the cost-effective delivery of high-quality healthcare to New Yorkers by harnessing the skill, experience, and knowledge of Physicians and other healthcare professionals at every step of the healthcare management and delivery process.Managed seven (7) departments that responded to public complaints and grievances received through the New York State Department of Insurance the unit responded to complaints within 15 business days.Coordinated with doctors to obtain information and investigated claim codes (CPT & ICD9) to confirm that the claims were accurate and complete; liaison with senior management to provide updates/reports.Affinity Health Plan September 2001 September 2002Claims ManagerManaged the claims processing department; provided leadership to 32 employees, including a supervisor and two senior claims analysts.Maintained assurance standards, developed performance evaluations for the staff and arranged training.Processed hospital claims, responded to member questions, and resolved complaints.Developed and implemented work schedules to ensure maximum coverage.Assured that all corporate policies and procedures were followed.Earlier CareerHealthfirst August 2000 September 2001Claims Department ManagerManaged and provided leadership to 150+ employees, including two supervisors who processed the claims processing of this prominent HMO. Coordinated receiving claims for Medicare, 1199, Commercial, CHP Plus, and Medicaid.Maintained accurate statistics of all transactions; audited 40% to 100% of the transactions.Assured the quality of all operations performed; adherence to corporate policies and procedures.Developed performance appraisals, tracked attendance, and generated the payroll.Managed the evening data entry function.Columbia Presbyterian Medical Center February 1994 August 2000Emergency Systems Support ManagerManaged a clerical staff of 62 employees assigned to the Adult, Pediatric, and Psychiatric Emergency Rooms; handled increasing responsibilities from clerk to shift supervisor to emergency room manager.Prepared financial reports and implemented all medical center policies/procedures. Developed and assured the accuracy of financial and comprehensive statistical data/reports.Effectively managed staff by communicating job expectations; planned, monitored, and appraising job contributions; implemented employee disciplinary procedures, as needed.Conducted daily meetings regarding patient care in the ERs; responsible for patient transfers to other hospitals or satellite clinics.Community InvolvementCrown Heights Youth Development, Mentor since 2010EPC Womens Group, Member since 2008 |
