Revenue Cycle Lead
Resume:
LORNA BUNTIN
*** ***** **** *****, ** *****
718-***-**** (H) 646-***-**** (C)
212-***-**** (W)
ad6luo@r.postjobfree.com
OBJECTIVE: An effective team player with excellent analytical, organizational,
Communication skills, as well as a self-starter.
EXPERIENCE:
Columbia University Medical Center New York, NY May 6, 2022- Present
Department of Psychiatry
Revenue Cycle Lead Supervisor
Manage, lead, and develop the billing and collection’s team to provide operational reporting, cash flow and efficiency analysis, and workflow support through Epic.
Have my team will be responsible for identifying, analyzing, and problem-solving billing and self-pay issues. Provide guidance and policy and procedures for coding, billing and follow-up with staff related to patient financial information including eligibility, authorization, co-pays and deductibles, charging, billing, and adjustments.
Resolving pre-bill claim edits and ensure claims are clean and submitted daily.
Reviewing daily clearinghouse rejections, resolving, and resubmitting accounts
Review aged accounts and take steps to resolve for payment by contacting payors for claim status, process rebilling requests and escalating issues when needed.
Reviews denied claims to resolve by resubmitting corrected claims or filing claim reconsiderations.
Provide a monthly summary of the status of outstanding charges greater than 90 days in the Accounts Receivable Aging report.
Provide monthly report on the status of credit balances. Hires, trains, and provides direct supervision to Billing staff, and/or other assigned department staff. Plan and schedule on-going workload assignments set and adjust work to be accomplished by staff; and prepare schedules for work completion. Conduct at a minimum bi-weekly supervision meetings with staff.
Meets with patients to discuss financial terms of treatment; acts as a liaison between patient, physicians, technical and administrative staff; responds to patient queries about bills and follows up to resolve problems.
Columbia University Medical Center New York, NY 09/07/2021-May 6, 2022
Department of Psychiatry
Administrative Aide
Work closely with the Director to manage day to day functions of the Dept of Psychiatric.
Responsible for proper functioning of all aspects of Epic Cadence and the Epic work queues and workflows.
Submit and track responses for Service Now tickets sent to Epic Together systems staff as needed.
Monitors reconciliation of batch transactions of Private.
Verify patient eligibility and coverage for outpatient in both office and hospital settings. Responsible for obtaining referrals/authorizations, documentation of information into Epic and must be the department specialist in payer policies relating to Psychiatric clinical services. Supports and participates in a collaborative team-oriented environment, collaborates with all co-workers, and follows up as appropriate regarding reported complaints and problems of patients.
HOSPITAL FOR SPECIAL SURGERY New York, NY 02/2011-08/27/2021
A/R Representative II Billing Professional
Working with Billing Manager on post-payment transaction reviews. Provide general oversight of all billing activities, as they relate to compliance, within the department.
Reconciliation of accounts, monitoring client accounts for non-payments, delayed payments and appeal.
Submitting secondary claims to insurance.
Proficiency in health insurance billing, collections, and eligibility as it pertains to commercial and managed care, and self-pay reimbursement concepts and overall operational impact.
Over seeing Commercial Insurance, Workers’ Compensation Carriers and Medicare
Update patients' demographics using the Epic system.
Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary.
Reviews and sends patient statements for self-pay
Identifies and resolves patient billing complaints
Responsible for completion and submission of ePremis Provider Setup Dictionary forms and maintenance of such setups. Responsible for setup of Electronic Funds Transfer, Electronic Remittance Statements and Electronic submissions as required by carrier. Assist with obtaining provider third party ID#'s and effective dates as required. Maintain, organize and prioritize workflow to ensure timely and accurate completion and follow-up using tracking system.
Report issues or problems regarding any provider information. Responsible for contact and communication with carrier and/or physicians, administrators and coordinators regarding completion of proper documents.
ROOSEVELT HOSPITAL New York, NY 4/2010 - 12/2010
Patient Representative Service
Enter registration data of patient into Eagle.
Perform specialty coding for services and medical office visits.
Authorization and Insurance Verification: Verifies insurance for Non-Invasive procedures and obtains authorization and referrals when needed. Obtains clinical data such as previous reports and lab results from referring physicians to expedite authorizations. Enter all patients' correct demographics and insurance info into IDX and Eagle.
Cash Control: Logs payments in the system. Monitors reconciliation of cash transactions. Creates and monitors refunds in the system. Prepares cashier reports as requested.
Answer the telephone. Customer Service Inquiries: Responds to patient statement inquiries, patient complaints, and works patient correspondence on timely.
Beth Israel Medical Center New York, NY 2/2004 – 4/2010
Senior Patient Financial Representative
Follow up on outstanding accounts receivable.
Respond professionally to written and/or telephone billing inquiries
Contact insurance companies to expedite payments of outstanding claims and prepare appeals for denials and rejections.
Assisting with resolving simple systems edits from the electronic billing systems to facilitate the accurate and timely payment of claims.
Process and mail out printed claims.
Mail and correspondence management along with other department administrative functions
Responsible for customer service and the timely billing and third-party payment information for insurance.
Knowledge of coding and compliance for services rendered
Verify and update patient pre-certification for outpatient surgeries and inpatient admissions
Following up on Commercial Insurance and Worker Compensation payment for outpatient
Work with high balance account receivable
Serve as back-up for other projects as needed
NY Presbyterian Hospital New York, NY 9/1997 – 12/2004
Patient Financial Advisor/Patient Representative (Per Diem)/Unit Clerk/Private Duty
Worked in the outpatient clinic registering and verifying insurance for patients in the Eagle
System.
Open and close visit with the CPT/ICD9 Codes
Schedule appointments for patients
Maintain patient’s records in order
Knowledge of Third Party Payer contractual requirements
Picked up Doctor’s orders and transcribe them in patient’s medication sheet and charts.
Answer the telephone
Worked closely with Nurses in regards to the function of the unit, chart admission and
discharges.
Scheduled tests for patients as Doctor ordered in charts.
Discuss health proxy with patients
Coverage for the Department
Assign RNs, LPNs, and Nurse Attendants with private patients in order to provide medical
care on a one on one basis
Fordham-Tremont CMHC Bronx, NY 12/1984 – 08/1997
Unit Registration Clerk
Register and record patients entering into the waiting area, into the daily log
Billed and reimbursed patients eligible for transportation to and from the clinic
Patient registration and inquiries, verifying insurance eligibility when applicable.
Insure all clinical care has been approved by day's end.
Collect payments and issue receipts.
Verifying patient demographic information and financial data on computer.
Run and review daily clinical reports for managing of patient accounts.
Maintaining and competence in working with patients in areas such as crisis intervention
and medical insurance issue.
Computer entry and word processing
EDUCATION:
Manhattan Institute New York, NY 4/2009 – 5/2009
Major: Dialysis Tech Certificate
Columbia University (Health Sciences) New York, NY 3/2002 – 5/2002
Major: Professional Medical Coding Certificate
Bronx Worker Career Center Bronx, NY 2/1997 – 9/1997
Major: Medical Records/Billing/Coding Certificate
Borough of Manhattan Community College New York, NY 9/1984 – 2/1988
Major: Business Management
Cathedral High School New York, NY 9/1980 – 6/1984
Major: High School Diploma
SKILLS:
Type 35 wpm, Eagle, MS Win03, Word Perfect 5.1 and 6.0, Excel, Medical Terminology, Stockamp Trac, Omnipro, Climax and ePremis.
LANGAUGE: Fluent in Spanish
References furnished upon request
Contact this candidate