Team-oriented, quality focused healthcare professional with a fundamental understanding of health insurance policies, practice management, government programs, and financial management. I seek to employ root cause analysis to identify issues and develop process improvements that result in organizational savings.
Education and Training
BBA:HEALTHCARE SYSTEMS MANAGEMENT2016Metropolitan College of New York, New York, NY
Associate of Applied Science:Applied Science Liberal Arts2007Borough of Manhattan Community College, New York, NY
Team Work| Communication| Initiative| Adaptability| Reliability| Problem Solving| Analytical Thinking| Results Orientated
MS Office(Word, Excel, Access)| Cerner|Centricity|DaVincian| Eagle|IDX| HDX| Mosaiq|SLIM CD|
MOUNT SINAI HOSPITALNew York, NYFinancial Analyst08/2013 to Current
Provided administrative support to Mt. Sinai Healthcare system member Hospitals(MS Beth Israel, MS St. Luke's, MS West)
Managed front and back billing and financial related operations for a practice of 7 physicians at 2 locations.
In charge of overseeing credentialing and payer contracts for practice providers as well as maintaining providers medical,DEA licenses, and CAQH profiles.
Assisted management by providing analysis related to new physician/clinical initiatives.
Partnered with revenue cycle managers and departmental administrators to identify revenue/expense trends in
order to formulate preliminary conclusions with faculty practice departments.
Thoroughly investigated past due invoices with the goal of minimizing number of unpaid patient accounts.
Implemented standards and methods to improve physician accounts receivables aging schedule
correctly identified errors and re-filed denied/rejected claims as they were received from the hospital or by
patient account representatives.
As directed by Administrative and Clinical Managers assigned additional diagnosis codes based on specific clinical findings to support financial related initiatives.
Proactively followed up on error reports and charges in edits status in order to make the appropriate modifications to production charge capture files for the 3 mayor hospital in the Health System. Conservative estimates concluded that this generated over $100,000 in receipts in accounts receivables in a 9 month timespan.
Accurately entered procedure codes, diagnosis codes and patient information into the EMR software.
Reviewed invoices to ensure proper reimbursements were received or recovered according to standing contracts or pre arranged agreements.
Oversaw daily front-end collections,denials, billing and appeals process for the a practice in the Health System.
Resolved issues insurance issues related to Medical/Hospital billing while promptly addressing patients' queries regarding their insurance.
Maintained and deposited departmental funds for budgeting, operational, and procurement.
Performed daily ad-hoc analysis and reporting
Collected and managed data in order to formulate preliminary findings related to the departments finances
Monitored and evaluated the departmental charge capture and CDI performance to maintain and improve cash flow and data integrity.
Ensured compliance with all regulatory requirements.
MOUNT SINAI HOSPITALNew York, NYMedical Billing Clerk11/2009 to 07/2013
Followed up on and monitored the processing of claims for reimbursement, while ensuring all pertinent
information and documentation were provided in a timely manner.
Monitored any unpaid claims, and if needed resubmitted claims with appropriate corrections and documentation.
Reviewed EOB's and verified the third party payer paid according to predetermined contracted rates.
Posted rejections from insurance carries and submitted any additional remaining balances to secondary carrier,
self-pay, or back to the primary carrier if not paid at the contracted rates.
Balanced cash, checks and credit card payments and reviewed any rejections above our threshold with
management to assure prompt action.
Managed and updated database entry's, reconciled rejections and mailed correspondents both manually and
Answered and directed inbound phone calls regarding accounts.
Received vendor's calls and sorted their queries regarding payment.
Maintained and updated insurance information for all patients on file
When necessary proactively called insurance carrier to make sure payment via check or electronic remittance
advice (ERA) was in process of being received.
Maintained the strictest patient/employee confidentiality while adhering to all HIPPA and Federal Payer guidelines and regulations.
The National Society of Leadership and Success, 2012