Medical Billing, Collections, Accounts Receivale

SUMMARY:

Medical Billing Professional responsible for the coordination of multi-

specialty practices,

accounts receivable management/collections and workflow documentation to

optimize reimbursements. Proficient supervising billing personnel.

Developed and implemented curriculum to train physicians, administrators

and staff in the use of applications. Utilized strong written,

communication and analytical skills to identify, research and implement

procedures to optimize goals.

TECHNOLOGY:

Proficient in IDX/GE Centricity, PCS, Patient Keeper, E-ClinicalWorks,

McKesson, Cerner, Microsoft Word and Excel, Medical Terminology, ICD-9 and

CPT Coding.

EMPLOYMENT:

Putnam Hospital, Carmel, NY

8/2013-11/2013

Patient Registration Representative

. Served as a representative in the Patient Access Department. Obtained

demographic information, insurance coverage and verified accurate

information with patients in the ER, central registration and

radiology departments. ICD-9 Coding. Participated in training in

McKesson and transition to Cerner systems. Resolved edits in FirstNet

and HQNet.

Caduceus, Inc.

04/2010 -01/2013 Medical Billing Site Coordinator

. Served as liaison, transitioning practices and billing operations for

fourteen Departments at Westchester Medical Center, Valhalla, NY,

including Burn Center, Cardiology, Trauma, OB/GYN, GYN/Oncology,

Neurosurgery, Transplant (Liver/Kidney), Pathology, Radiology,

Physiatry, and Vascular.

. Developed procedures and workflow assessments for routine data entry,

coding, and resolution of edits, ICD-9 Coding

. Supervised and trained of staff of 5 FTE

. Implemented/managed reconciliation of high dollar procedures

(surgeries, deliveries, cardiac procedures).

. Collaborated with practices and IT support in verifying an IDX

dictionary, creating edits, and fee schedules, and processing

interface charges.

. Participated in key meetings providing input to broader operational

and strategic discussions regarding client site management.

University Pathology

12/1999-12/2009

Billing Manager/Collections Specialist

. Managed daily operations for private practices consisting of 10

physicians at seven locations.

. Supervised and trained staff of 5 FTE

. Provided staff in-service training to ensure the accuracy of

demographic information, medical necessity, ICD-9 Coding, collection

of co-payments, and Medicaid eligibility.

. Reorganized Billing Department and cross trained staff in claim

denials, appeals and utilization of aging reports to increase

collections and maximize reimbursements.

. Implemented correct coding procedures for Medical Necessity and

Compliance with physicians' practices and laboratory staff in

processing Advanced Beneficiary

. Notification (ABN).

. Interacted with referring physicians and staff to ensure accurate

diagnosis for tests ordered.

. Participated in contract negotiations, credentialing and resolution of

fee schedules with insurance carriers and provider relations

representatives.

. Coordinated with sales team in transitioning new physician practices.

Westchester Bone & Joint Associates

11/1998 - 04/1999

Accounts Receivable Supervisor

. Implemented compliance program, policies and procedures.

. Initiated surgical spreadsheet to monitor accurate coding and billing

of surgical cases for weekly and monthly audit reports.

. Trained staff on claim denials, appeals, pre-certification

requirements, and counseling of patients inquiries.

. Interfaced with registration staff and management to ensure accuracy

of data and collections.

. Trained staff for proper ICD-9 coding and use of modifiers.

. Created and maintained fee schedule and data on an electronic medical

billing system.

Montefiore Medical Center 05/1991 -11/1998

Billing Supervisor Department of Radiation Oncology

. Assured smooth operation of the billing group for a 10 physician

practice on IDX Billing System.

. Coordinated registration and financial counseling of patients at Moses

and Einstein Divisions.

. Managed accounts receivable to maximize billing production and

collections., ICD-9 Coding.

. Performed monthly closing activities and preparation of reports.

. Supervised and trained staff of 6 FTE to achieve objectives of the

practice group.

. Responsible for on site chart review of professional component and

global billing.

. Performed quality assurance review of charges entered.

. Processed electronic submissions to Blue Shield, Medicaid, Medicare,

and third party billing.

S. Biology/Chemistry : Lehman College, City University of New York

EDUCATION:

Completion CPC Medical Billing and Coding Program, Dutchess Community

College, December 2013

B.

Contact this candidate