In Patient Interim Supervisor Resume Melville, NY - Hire IT People

SUMMARY

Detail - oriented with good analytical problem-solving skills
Excellent computer, time management, organizational and analytical skills with proficiency in Excel and Microsoft Office Suite as well as A/R systems and associated applications.
Outlook experience
Ability to work independently, exercising good judgment, and multi-task in a high stress, fast-pace service environment with patients, insurance carriers and leadership
Excellent customer service skills to communicate effectively with insurance carriers, patients, and colleagues.
Knowledge of CPT, ICD9 utilized in medical billing and medical terminology.
Established and demonstrated competency in accounts receivable systems and associated application ( Relay Health Assurance, STAR)
Ability to maintain professional conduct and good working relationships with staff, management, and payers.
10 Years experience in Health care billing and Customer service.
1 year in Management of staff - Patient Revenue Realization - IP billing/follow up

PROFESSIONAL EXPERIENCE

Confidential, Melville, NY

In Patient Interim Supervisor

Responsibilities:

Coordinate the daily activities of the A/R operation ensuring that the aging accounts are reviewed and resolved, collector work files are completed on a daily basis and appropriate actions are taken by staff to ensure timely and correct claim payment’s
Assists in development of and participates in ongoing staff educational programs
Communication with Dept Heads for all Inpatient Denials.
Prepares Monthly spreadsheets for VP’S.
Prepares Budget reports
Coordinates Aging reports/ spreadsheets for staff.
Supervise 28 staff members
Created two new depts. Within In Patient to better handle volume and accountability
Help define Work Station criteria for rebuilding of employees Workstation.
Communication with Directors of all 6 Hospitals to get bills out and for follow up payment
Monthly meeting with finance to discuss A/R balances.

Confidential, Melville, NY

EDI Specialist

Responsibilities:

Billing of all inpatient & outpatient facility bills for all 6 hospitals
Work claims on 277 reports. (denials)
Research/resolve discrepancies on claims for all payer and patient types
Communication with personnel and Department heads to resolve processes related to transmission of claims to all payers’
Creation of reports/spreadsheets of all claims failing in system & communicating with sites to resolve
Obtain and balance claims transmission data to ensure the claims are received by payers
Education of staff t assist in avoiding billing delays
Creation of job aides/procedures to outline specific processes EDI staff needs to follow.
Building of bridge routines to RELAY (our billing system) to solve billing issues.
Reviews billing work queues and reports to determine accounts/claims requiring action.
Ensures claims are crossed over to secondary and tertiary payers and reports any delays in unbilled claims.
Collaborates with internal departments, external vendors and IT for issue resolution and operational effectiveness.

Confidential, Melville, NY

Patient account representative

Responsibilities:

Process Workman s comp/NF insurance claims for outpatient accounts using electronic billing system
Work all reports pertaining to billing of Out Patient Accounts (failed claims, late charge, and dx/da reports, two a day)
Heavy contact with hospital staff/dept to obtain correct dx, hcpcs, modifiers etc to validate claims in timely manner.
Knowledge of Medicare, No - Fault and Workman comp rules and regulations
Proficient in electronic billing system.
Proficient in Denial and Appeal follow up.
Proficient in Omni Pro.
Proficient in Micro Soft Excel
Excellent interpersonal communication skills