Customer Service High School

*** ******** **** **** ******, NY *****? Tel: 516-***-**** ? Email:

********@***.***

QUALIFICATION SUMMARY

Inventive, energetic, and committed professional with proven managerial and

organizational skills. Seventeen years of experience in accounts receivable

and revenue enhancement. Strong communication, leadership and problem

solving skills.

PROFESSIONAL EXPERIENCE

North Shore Long Island Jewish Health Systems, Westbury, NY

Edit Manager- Clinical Practice Plan, Edit Department

2005- May 09

. Maintain proper electronic claim submission through Claim Logic for

revenue enhancement.

. Managed and maintained provider information into GE Centricity for

claim submissions to ensure proper payment.

. Managed, identified and correct GE Centricity edits from claim

submission to receive efficient and proper payment.

. Developed the extraction and rule bank for eligibility verification

through Medeconnect as part of a small project team.

. Specialize in PCS, BAR, DBMS, SMS, RIS, Custom Coder and

Medeconnect billing and management applications.

. Developed and managed queries to reflect appropriate billing

practices

. Managed electronic charge submission from hospital system to GE

Centricity

. Managed electronic charges from Patient Keeper to GE Centricity

. Responsible for solving issues within and out of the department

relating to provider claim submission, charges, and eligibility.

. Responsible for updating and informing Director of payor, systems,

Medeconnect, charge interface, and edit issues.

. Directly responsible for a staff of twenty representatives

. Manage all personnel issues, scheduling, and payroll

. Responsible for training of new hires and departmental

representatives.

. Developed training manuals, workflows, as well as policy and

procedures

North Shore Long Island Jewish Health Systems, Westbury, NY

Assistant Supervisor - Clinical Practice Plan, Collections Department

1998 - 2005

. Directly responsible for a team of fifteen collection

representatives, their training and day to day necessities.

. Manage all facets of physician billing, account management,

contract management and patient satisfaction.

. Administer the monthly reconciliation of the collection agency's

commission reports.

. Establish and implement workflow strategies and policies to improve

the overall department's functions.

. Effectively administer account receivable initiatives to identify

possible revenue opportunities.

. Maintain and streamline monthly write off procedures.

. Specialize in PCS, BAR, DBMS and SMS billing and management

applications.

North Shore Cornell Health Systems, Westbury, NY

Collection Representative - Clinical Practice Plan, Collections Department

1992 - 1998

. Data entry and telephone specialist responsible for the collection

of Clinical Practice Plan accounts receivable.

. Customer service representative specializing in support and

information services for patient accounts.

. Cash applications reporting and procedures.

. Third party billing liaison for Clinical Practice Plan.

Collection Representative - Clinical Practice Plan, Collections Department

1991 - 1992

. Part time collection representative responsible for the collection

of Clinical Practice Plan accounts receivable.

EDUCATION

East Meadow High School, High School Degree

1982

COMPUTER SKILLS

Programs: Excel, Outlook, Word, Custom Coder, GE Centricity, SMS, RIS,

DBMS, Medceonnect, Claim Logic.

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