Motivated Accounting Clerk with a verifiable record of accurate bookkeeping and skill in working with customers, vendors and management.
Detailed-oriented Senior Financial Analyst with over 15 years of comprehensive knowledge
and hands on experience in billing, collections, financial reporting, insurances, methods
of insurance reimbursements, statistical analysis and forecasting Rapidly adapt to new
technologies and possess expertise with MS Word, PowerPoint, Excel, Access, and a broad
range of statistical software
07/2011 to 09/2016
Financial Accounts SpecialistNECPAC - North East Consolidated Patient Account Center － Lebanon, PA
Proficiently operated computer statistical system Huron managing third party reimbursable
claims with effective claim status accurately and exceeding daily quota standard.
Accessed several insurance carrier websites to facilitate the tracking of filed claims
efficiently working with provider tool systems ensuring accuracy off each individual line
item billed based on coding diagnoses, service, supplies and procedures is contractually
Work with Accounts Management manager, supervisors and financial specialists on
high priority projects.
Review claims issues from non complaint cases and took
appropriate action to finalize claims for payment.
Prompt and aggressive follow-up action
on a timely basis utilizing every reasonable effort consistent with contracts to appeal
Analyze payments and contacted payers having claims reprocessed ensuring
payments are accurate and in accordance of Service Level Agreements.
expert providing guidance and training and assistance to Accounts Management staff in
mastering the reimbursement process.
Informing other team members of insurance company
policies and procedures that define how claims are paid.
Provided job aids for electronic
data interchange, electronic fund transfers and electronic remittance advices by defining
their menu options and functions to enable successful analysis.
collaborated with other CPAC departments such as Payer Relations staff, Utilization Review
nurses, Facility Revenue Managers, Insurance Verification staff , Billing staff and
clients to ensure effective reporting solutions and over all increased revenue working as
Entrusted to train new hires providing timely, courteous and knowledgeable response to
information requests and enabled new staff to meet standards in appealing and processing
third party claims to be paid.
Worked closely with Accounts Management supervisor to develop ways to resolve problems
and insure successful program implementation.
Responsible for end-to-end ownership and success of reporting patient account financial
Knowledge and thorough understanding of policies, laws, rules, and regulations related to
billing and collections for healthcare services and the attendant reporting requirements.
Established and maintained effective working relationships with other throughout the
organization as well as externally including department officials, to effectively achieve
Protected printed and electronic files containing sensitive data in accordance with the
provisions of the Privacy Act of 1974 and other applicable laws, federal regulations, VA
statutes and VHA policy.
Protected data from unauthorized release or from loss, alteration, or unauthorized
Followed applicable regulations and instructions regarding access to computerize files,
release of access codes and medical records.
Provided training assistant to identify opportunities to improve revenue and client
Facilitated innovative application of industry and agency best practices
and quality management.
Processed various claim denials and back log validating content and resolving various
issues that were unaddressed as NE CPAC transferred to each new VA facility.
Researched and provided Accounts Management Supervisor with detailed information on high
dollar bulk payments that were unapplied and suspense from specific third party payers to
assist Cash Management and Accounting on finding/posting payment.
Consistently maintain excellent quality reviews.
Recognized as a subject matter expert by Training Facilitator and Accounts Management
Selected to assist the Training Facilitator with a presentation of position description
and process for the Accounts Management class for a week.
Provided guidance, job aids and organizational strategies to identify more efficient
07/2001 to 08/2011
Accounts Receivable TechnicianJames J Peters Veterans Affairs Medical Center, Veterans Health Administration － Bronx, NY
Accurately processed payments from Debt Management Center (DMC), Treasury Offset Program,
(TOP), Insurance carriers and Regional Counsel settlements.
Tactfully worked with Health
Revenue Center (HRC) for all first party and third party patient discrepancies sent via
HRC PM Portal.
Collaborated with Accounts Receivable, Insurance, Billing and Coding
supervisors reviewing claims to correct errors, rectify omissions and investigate
Analyzed claims explanation of benefits and refund request were
consistent and in accordance with policy and contract provisions.
Developed thorough knowledge and understanding of the full range of the VA healthcare
support functions and revenue operations such as accounts receivable management, billing,
health information management, patient access, compliance, insurance and financial
We exceeded department goal for collections for two consecutive years.
Surpassed goal by
1.2 million in fiscal year 2008 and by 2 million in fiscal year 2009.
Developed a strong understanding of insurance policy contracts through hands on
Aggressively followed up on hundreds of third-party claims, reducing outstanding
receivables and increasing collections.
Provided optimum service to patients regarding payment plans, waivers, service-connected
medication charges and general account information.
Selected by supervisor to assist in and resolve complex payment-processing issues.
Maintained a superior quality in payment processing calculating figures and amounts
accurately reimbursing patient's accounts according to insurance payment.
Managed cash-flow at Co-pay Cashier office.
Demonstrated the ability to fill in at a moment's notice, quickly mastering new systems,
processes and workflows.
Met the needs of customers while supporting VA missions.
Consistently communicated and treated customers (veterans, their representatives,
visitors and family and all VA staff) in a courteous, tactful and respectful manner.
Provided patient's with consistent information according to established policies and
Handling conflict and problems constructively and appropriately.
Developed new ways to resolve major administrative problems to insure successful program
Developed standard operating procedures for processing insurance checks, TDA's from Champ
VA, Tricare, journal vouchers from Debt Management Center and Treasury Offset Program.
Received certificate for professional exemplary customer care with patients from
Additional educational training pertaining to VA revenue operations:
VA University Training / Financial Management Training Nashville, Tennessee
-Federal Accounting Fundamentals
Agent CashierFinancial Service Center FSC － Austin, Texas