CHE SCOTT

** ** ***** ******, ***** Gardens, Florida 33169

718-***-**** acvu3g@r.postjobfree.com

Performance-driven, insightful professional with a proven ability to achieve and exceed all business and revenue goals in aggressive environments

Skilled EPIC user

Skilled at analyzing financial reports and developing strategic solutions

A profit-oriented, dedicated and congenial professional possessing the unique ability to work independently as well as in a team environment where bottom-line revenues are of the utmost importance

Superior verbal and written communication skills and computer proficiency.

Specialize in managing sizeable improvement projects, with demonstrated success in maximizing security and reducing operational costs

Professional Experience

UNITED STATES MEDICAL SUPPLY, Miami, FL February 2016 – June 2016

Accounts Receivable Associate Specialist

Process remittances & claim rejections for Medicare, patients and third parties

Post Medicare, third party, and patient remittances received either electronically or manually into patient records

Verify that auto post from EDI 835 Medicare transmittal & other remittance postings are complete, accurate and timely

Investigate claims from Medicare, supplemental, and patients and properly resolve by follow-up and disposition

Process Medicare, supplemental and other third party denials and rejections for re-submission (billing) in accordance with company policy, regulations or third party policy

Ensure that Customer Service department is aware of denials in order to update patient records and other required file and documentations

Update patient files for insurance information, Medicare status and other changes as necessary or required. Ensure accurate changes, data entry of patient records including service issues

Provide pertinent billing/receivables information to accounting department as requested

Provided customer service regarding collection issues, process customer refunds, process and review account adjustments, resolve client discrepancies and short payments. Responsible for monitoring and maintaining assigned accounts- Customer calls, account adjustments, small balance write off, customer reconciliations and processing credit memos

CENTRIS GROUP, Rockville Centre, N.Y March 2015 – May 2015

IT Medicaid Billing Specialist

Respond to queries related to Medicaid Direct or IEP Direct either in person or over the phone

Evaluate project tasks for feasibility, technical merit, and data use compliance. Provide technical assistance and support for incoming queries and issues related to Medicaid Direct or IEP Direct software systems

Respond to email messages for customers seeking help using IEP Direct or Medicaid Direct

Maintain daily performance of Medicaid Direct or IEP Direct software systems

Provide instructions and guidance to individuals within and outside of the immediate organization concerning programmatic activities in Medicaid Direct or IEP Direct

Run diagnostic programs to resolve problems in Medicaid Direct or IEP Direct

Follow up with customers to ensure issue has been resolved

Gain feedback from customers about software usage

Run reports to determine malfunctions that continue to occur

Create spreadsheets for schools districts throughout New York State to help them bill Medicaid for reimbursement for students they provided services to

Develop or modify written procedures, instructions, or policies to serve as guidance for others

Perform Go To Assistance for school personnel who aren’t able to trouble shoot system issues on their own

Proficient in performing Internet Boolean and keyword searches to locate, interpret and cite open source information

Review and evaluate established program policies and procedures to determine gaps where additional guidance is needed

NYU LANGONE MEDICAL CENTER, New York, N.Y Aug 2004 – Nov 2014

Revenue Cycle Supervisor (Dec 2007 – Nov 2014)

Reported directly, provide timely and accurate information to the Director of Outpatient Billing Revenue Cycle using account information generated from the EPIC system

Analyzed and follow up on all non-government accounts using EPIC to locate those accounts with a balance over $3000.00 for late charge billing.

Managed inpatient & outpatient conversion accounts through EPIC but not limited to (e.g. create registrations for each patient, follow up on accounts to make certain information is accurate, expedite billing, post charges, coordinate with medical records to ensure all accounts have been coded timely & properly).

Managed Board of Education billing via EPIC to ensure expediting billing, managing A/R and coordinating with Board of Education department to make sure the Medical Center receives the maximum reimbursement.

Provided and analyze information to perform pre-billing functions using EPIC to ensure that all third party insurance bills, forms and patient statements reflect accurate information

Ensured maximum reimbursement to the Medical Center using EPIC through charge posting, collections and cashiering.

Experience and excellent working knowledge of Medicaid, Medicare, and managed Care contracted plans

Using EPIC responsible for reviewing patient folders, registration forms and documents to ensure information completeness and accuracy

Supervised billing and collection staff

Ensured that all staff projects were completed and delivered accurately and on time

Collaborate with senior management and initiate debt write off and negotiate all settlements with all collection procedures

Successfully managed relationships between staff members and upper management

Resolved client-billing problems and rescued accounts receivable delinquency

Identified issues attributing to account delinquency and discussed with upper management

Reconcile customer disputes as they pertain to payment of outstanding balances that are due

Maintained strictest confidentiality; adheres to all HIPPA guidelines and regulations

Streamline all collection processes and recommend improvements to process appeal to all third party payors

Senior Revenue Cycle Analyst (Aug 2004 – Dec 2007)

Assisted Manager/Director with quarterly, year-end closings and other accounting related duties and analyzed claims that have been paid and adjust them accordingly to the contractual agreement.

Maintained the Financial Assistance budgeting through the development and implementation of financial models and reports. Recognized, establish and attend to priorities promptly.

Provided and analyze information to perform pre-billing functions ensuring that all third party insurance bills, forms and patient statements reflect accurate information

Ensured maximum reimbursement to the Medical Center through charge posting, collections and cashiering. Reviewed in patient folders, registration forms and documents to ensure information completeness and accuracy

Reconcile customer disputes as they pertain to payment of outstanding balances that are due

Maintained strictest confidentiality; adheres to all HIPPA guidelines and regulations

Education & Credentials

Bachelors of Science, Business Administration & Accounting, Barber-Scotia College, NC (2002)

Associates of Arts, Liberal Arts, Champlain College, (1997 – 1999)

Proficient in Microsoft Office Professional and applicable Financial systems- i.e American Health Ware System (Eagle), Health Technology System (HTS), Epremis, Onbase Omni Pro, EPIC, IEP Direct, Medicaid Direct, eClinicalWorks, ICD-9, Emedeon, Nobel

REFERENCES

Available upon request

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