Customer Service Patient Access
Resume:
Evelin Y. Reyes
Brentwood, N.Y, *****
***************@*****.***
Summary:
Self-motivated and detail-oriented with excellent customer service skills and Knowledge of current ICD-10, CPT Codes, HIPAA and Patient Privacy rights. Able to work with limited supervision. Possess strong computer skills, organized, dedicated, team-oriented able to multi-task and meet deadlines. Fast learner and work well under peer pressure. Looking for new opportunities and obtain a meaningful and challenging position that enables me to learn and allows for advancement. Experience:
NUMC Hospital, East Meadow, NY January 2024 - Present Admissions Officer 1/ Patient Access
• Screens admission calls as to a degree of emergency and eligibility.
• Dispatches ambulances
• Interviews patients or families to obtain personal data
• Explains hospital regulations, assigns patients to wards.
• Receives and processes death notices; secures autopsy permission; makes arrangements to release bodies.
• Receives and processes birth notices
• Answers queries regarding patient’s condition.
• Takes census of patients admitted and discharged.
• Performs duties requiring limited use of the typewriter Sight Growth Partners, Hauppauge, NY October 2022 - August 2023 Surgical Charge Poster
• Validated all Clinical Service Lines for accuracy and guidelines (HCPCS, CPT, diagnosis, units, etc.)
• High volumed of daily claims to be submitted for a large organization.
• Monitored multiple accounts and maintain compliance, with rules and regulations.
• Maintained quality relationships with Revenue Cycle managers, supervisors, and other office staff.
• Post super-bills, surgeries and cycles for the various offices as assigned by the surgical coordinator’s
• Accurately reviewed accounts and post payments and prepayments to provider and facility
• Post charges within and in excess of target daily, weekly and monthly
• Audited and reviewed batches for accuracy
• Daily reconciliation of claims posting and financial totals
• Identified coding or billing trends or issues and reviewed with the Surgical coordinator
• Prepared for the month end closing by managing workload efficiently
• Other duties as assigned which may include preparing various account receivable or departmental reports as assigned. Focused Medical Billing, Merrick, NY April 2021 – May 2023 Biller and Coder Specialist
• Completed claims processing the same day received and daily charges. With secure VPN log in, which I was able to access the billing information from providers current software.
• Responsible for appropriately submitting charges to patients’ insurance companies and monitored and post payments of medical bills, transmitted electronic claims, and dealing directly with insurance companies through proper diagnostic linkage to technical components of professional services, maintaining accuracy through the in-depth knowledge of coding techniques, payment policies, and carrier guidelines, to ensure full reimbursement.
• Managed and tracked payments, and outstanding bills. Ran reports monthly to ensure that the accounts were balanced.
• Proficient in a variety of billing software including: Medisoft, Management Plus, NextGen, MedWare, Medical Manager and more.
• Identified and resolved patient billing complaints and answered any questions.
• Identified and corrected billing errors and resubmitted claims to insurance carriers
• Ensured patient information were accurate.
• Verified patients Eligibility through insurance websites.
• Requested any missing patient information from providers as Referral, Authorizations, OP-Reports and Medical Records.
• Contacted patients when necessary to obtain correct information to get the claim billed
• Called insurance company when necessary to find out why claims were rejected, and follow through by correcting information and resubmitted the claims for payments.
• Meet timely deadlines specified by management when billing charges. NYU Langone Diagnostics LLC, Hicksville, NY. July 2018 – April 2021 Medical Billing Specialist/ Payment Poster/ Denials
• Entered patient demographic information and diagnosis code information into the computer system for billing purposes with speed and accuracy.
• Performed accurate, timely, and compliant data entry of medical bills. Verified both commercial and government insurances.
• Navigated insurance websites reading EOB’S and answered customer insurance questions.
• Completed special projects as needed.
• Assisted team members with various billing tasks as needed.
• Answered Billing related inquiries from patients, physicians and insurances companies.
• Accepted and processed payments from insurance companies
• Researched, problem-solving and follow-up on issues
• Post, corrected and/or resubmitted open or denied claims.
• Applied payments, adjustments, and write-offs to accounts as required
• Entered patients, clients, billing and test information into the Laboratory Information System
• Ensured accuracy throughout the process as entered information are critical to other laboratory operations Deitz Court Reporting, Rockville Center, NY. December 2017- July 2018 Data Entry Clerk/ Client Service Representative (Temp)
• Answered and forwarded incoming phone calls. Also, transferred caller to an associate’s voice mailbox when the associate were unavailable.
• Professionally handled incoming client requests via phone, ensuring that issues are resolved both promptly and thoroughly.
• Provided quality support in the areas of handling questions, troubleshooting, and account
• Worked with other departments as client advocates to ensured resolution
• Updated calendars and scheduled meetings
• Performed other clerical receptionist duties such as filing, photocopying, transcribing and faxing
• Printed Statements and Invoices for the Billing department Heritage NY Medical PC, Garden City, NY. July 2017- December 2017 Priority Care Coordinator (Temp)
• Telephonically completed questionnaires (Health Risk Assessment and Initial Health Survey) to gather essential information which allows the Case Manager to refer to members to medical, mental health social services, social workers and or/ pharmacists in a timely manner
• Assisted the Case Manager by gathering specific information which helps track the members progress on a regular basis towards the mutually agreed upon goals in the members care plan
• Ensured that member/caregiver have all pertinent contact information for PCC, the Case Manager, and after hours emergency phone line and addressed issues, answered questions, provided resource, telephone numbers and/or to transfer member/ caregiver to appropriate staff
• Assisted the Case Manager in transition of care by gathering pertinent information when initiating the Hospital and SNF Discharge calls
• Called PCP office to notify PCP of transition of care events
• Assisted with referrals, by calling PCP/provider to ensure that member is able to receive the necessary services in a timely manner
• Assisted members/caregivers in finding providers in their geographic areas, as well as scheduling appointments assisted with coordinating transportation for the member
• Explained covered benefits for the member/caregiver
• Assisted in obtaining accurate member/caregiver contact information and continually updated and maintained accurate member demographics
• Gathered information from the members/caregivers while building a rapport and trust with members/caregivers to provide a positive member experience
• By phone assisted the members/caregivers in calling providers offices, faxing forms, requesting documentation
• Participated in the Interdisciplinary Care Team meetings
• Assisted Case Manager by the following up with the member/caregiver and provider office to ensure that the member attended appointment
• Assisted Case Manager by following up with the member/caregiver, prescribing provider and DME vendor to ensure that necessary DME was received and that the member/caregiver feels comfortable using it
• Send basic health education materials as well as advanced directives and healthcare proxy forms
• Assisted Case Manager by gathering information regarding services provided by external entities such as Fee-For-Service Medicaid, Managed Long Term Care (MLTC), PCS and ADHC John T. Mather Memorial Hospital, Port Jefferson, NY. January 2017- April 2017 Internship/ Imaging Services Department Administrative
• Shadowed Assistant Vice- President Administration.
• Maintained budgets and maintain work schedule for staff.
• Kept records of expenses and suggest ways to minimize cost.
• Ensured compliance with current healthcare regulations.
• Created work schedule for staff members.
• Maintained performance appraisals.
Tritech Healthcare Management, Melville, NY October 2014- July 2017 Data Entry/ Clerical
• Entered claims into and billed out of the Tritech billing system. This ensures that the client’s claim is submitted with the correct procedure codes and charges.
• Consistently performed specific assigned daily and general duties and meet deadlines.
• Printed patient’s reports for Winthrop Hospital from Electronic Health Records (EHR) and Electronic Medical Records
(EMR) system and updated patient insurance and input financials status.
• Printed patient’s reports for Nassau University Medical Center (NUMC) from EHR, and EMR system: patients’ information, health/car insurance and workers compositions.
• Stamped reports and sorted in alphabetical order.
• Created Excel sheets to keep in track of each patient documents. Skills:
Language: Fluent in Spanish
Computer: Microsoft Word, Excel, PowerPoint, Outlook, Internet Research, Social Media Education:
Briarcliffe College, Bethpage, NY
Bachelor of Science in Healthcare Administration
January 2014 - May 2017
Hempstead High school, Hempstead, NY
High school Diploma
September 2004 - June 2008
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