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Manager Insurance

Location:
Rosedale, New York, 11422, United States
Posted:
May 26, 2010

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***** T. ******

***-** ***** ****

Rosedale, NY *1422

917-***-****

OBJECTIVE: Obtain a position as a Healthcare Manager in a company where I

can utilize my education and expertise in revenue cycle and practice

management.

QUALIFICATIONS:

Instrumental in increasing reimbursement and lowering account

receivables. Skilled at analyzing financial data to improve insurance

collections. Knowledgeable of non-par and par provider billing; Strong

leadership skills, Great at investigating billing problems and

formulating solutions, working knowledge of PowerPoint, excel and

Touchpoint reporting program.

EDUCATION:

2010-present Mercy College- MA Healthcare

Administration- Expected Graduation Spring of 2011

2006-2008 SUNY Old Westbury College - BS Sociology

2000-2004 Nassau Community College - AAS Liberal Arts

Certificates:

2008 Successful Spine Coding

EMPLOYMENT

3/2009-3/2010 Revenue Cycle Management Company

Account Manager Hauppauge, NY

Increasing clients' revenue 10% by monitoring and analyzing

denial trends, and also training their non-clinical staff on

a more efficient way to work. Setting realistic monthly

financial goals for each team to reach. Weekly discussions

with team leads and assistant mangers on projects that I

designated to be completed. Monitoring charges and payments

billed by the practice on a daily basis. Reviewing practice

reports, comparing current month to prior month averages to

determine trends and underperformance. Prepare action plans

to get accounts back on track. Yearly fee schedule review.

Quarterly site visit with clients to go over financial and

operational performance. Review and negotiate contractual

agreements and non participating reimbursement. Evaluate

claim that exceeds appropriate state guidelines.

12/2008-2/2009 Innovative Anesthesia Solutions Office

Manager Great Neck, NY

2/2008-11/2008 Business Dynamics Limited Claims

Auditor Garden City, NY

Evaluate claim status that exceeds appropriate state

guidelines, evaluate payments and identify reimbursement

issues. Keeping accounts receivable in check by running

reports and spreadsheets for review. Ensuring timely payment

and challenge timely filing delays. Writing first and second

level appeal for all insurance companies including workers

compensation/no-fault.

9/2002-6/2008 Hillcrest Radiology Associates

Senior Biller Jamaica, NY

Supervising a group of seven experienced medical

billers on a daily basis, training new hires and retraining

of current staff on how to write appeals to the insurance

companies and effective ways to bill/collect. I kept track of

the work flow by running monthly accounts receivable reports

and delegating the work. Appeal denial and payments from the

insurance companies on behalf of the doctors. Dealing with

Medicare, Medicaid, Workers Compensation and No-fault and

Commercial insurance by following there guidelines and making

sure that the doctor's are being reimbursed according to

their fee schedule. Credentialing of the doctors, Negotiating

payments with patients and insurance companies.

1999-2002 Professional Billing Control

Biller/Collector Freeport,

NY

Coding, posting payments and

charges, helping patients with billing questions, appealing

denials from insurance companies,

patient collections, follow-up. Dealing with the doctors

on a daily basis, training new

employees, keeping up with monthly quotas.

References Available Upon Request



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