Highly dynamic, devoted, and articulate management professional, offering strong qualifications in financial management developed over 20 years of extensive experience in auditing and medical billing field. Acknowledged for effective supervisory and leadership abilities; proficient at setting, expecting, and achieving high standards of quality and building cohesive, productive team. Is multilingual proficient in English, Spanish, and Italian.
Auditing and Forecasting
Team Leadership Microsoft Office Suite (Word and Excel), PatCom, SMS, Climacs, ePACES, OmniPro, EPIC credential trainer
ICD-10 (International Classification of Disease Systems)
Billing and collection procedures expert
Outpatient surgery coding specialist
HCPCS Coding Guidelines
Insurance and collections procedures
DRG and PC grouping
Billing Manager, 01/2009 to 03/2017 PMI Medical Management, Inc – New York, NY
Assume primary accountability in overseeing the entire facet of medical billing process, such as data entry, claims submissions, follow-up, appeals, and check posting.
Prepare comprehensive financial report and facilitate monthly meeting with the client regarding analysis of the reports.
Administer the billing for the two successful orthopedic surgeons.
Manage billing for the entire surgical and evaluation and management services to every all third party payers, including NYS Medicaid and Medicare programs.
Handle data entry and charges; analyze payments to ensure that claims are processed and paid correctly in conformity with the current Management Care Contracts; and process appeals for any claim with unpaid contracts.
Perform third party follow-up such as calling insurance companies to ensure prompt payment of claims and analyzing outstanding claims for referral to external collection agencies.
Monitor monthly aged trial balance reports, including verifying patient inquiries and setting up payment plans.
Supervise the entire support personnel performing various tasks in the same department.
Precisely completed appropriate claims paperwork, documentation and system entry.
Assistant Manager, 01/2008 to 01/2009 FRR Recovery-Self Pay Collection – Melville, NY
Executed various tasks including but not limited to monitoring entire facet of operations and financial management.
Provided leadership to all self-pay collectors by conducting training and assessing their work performance.
Ensure that operational functions were in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and Fair Debt Collection Practice Act (FDCPA) guidelines.
Forecasted collection to prevent fall within FDCPA guidelines.
Directed and motivated collectors to achieve 125 calls per day.
Successfully drove and completed various projects assigned by the president of FRR.
Organized the transfer of accounts from FRR computer system to appropriate collector routes.
Designed "dialer pools" for accurate dialer use and efficient operation by the department.
Compiled accounts in correct dispositions for billing and follow-up.
Examined payments of collectors for accurate posting and credit management.
Processed checks and credit card payments for collectors.
Presented and discussed collection activities and department issues to with the president.
Supervisor, 01/2006 to 01/2008 Jamaica Hospital Medical Centers, Collection – Jamaica, NY
Rendered support to the daily operations of the Collection Department through following instructions from the Director of Patient Accounts.
Organized documenting system of all accounts transferred to collections and returned from external collection agencies.
Examined reports for the transfer of collection accounts following three data mailers.
Conducted various follow-up with the billing staff and insurance companies regarding outstanding commercial claims.
Presented and filed the documentation for Medicare bad debt.
Liaised between collection agencies and the hospital regarding biller concerns.
Spearheaded the removal of old files from hospital and agency systems, for agencies with no connection with the current operation.
Bachelor of Arts: Economics, 2017 Baruch College - New York, NY