Medical Manager

Title:ARONOWITZ CHAIKEN & HARDESTY CPAs Staff Accountant

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

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NAME:,

ADDRESS:

ADDRESS2:

CITY:

STATE:

ZIP:

CANDIDATE ID: 2929469

US CITIZENSHIP:

EDUCATION:

EXPERIENCE: 0

WILL RELOCATE: No -

JOB WANTED:

RATE NEEDED:

TELEPHONE:

EMAIL: **********@*******.***

HOMEPAGE:

HOTTEST SKILLS: claim, claim, patient, medical, billing, payment, surgery, attorney,

trial, accounting, audit, receivable

REVISION: 08-SEP-02

RESUME:

NAME: LISA BEST

ADDRESS: 60 WEST 142ND STREET

CITY: NEW YORK

STATE/PROVINCE: NY

ZIP/POSTAL CODE: 10037

COUNTRY: USA

EMAIL: **********@*******.***

PHONE:

CANDIDATE ID: 218150

CITIZENSHIP: US

Citizen

EDUCATION: Undergraduate Work

EXPERIENCE: 13

WILL RELOCATE: Open

RELOCATION INFO:

JOB WANTED: Any

RATE NEEDED:

HOMEPAGE:

COMMENTS:

HOTSKILLS: Patient Account Specialist

ESUME

LISA A. BEST

60 West 142 St. #8H New York, NY 10037 (212) 281-

7907 (H) **********@***.***

Employment Experience:

The Rogosin Institute, New York, NY 2001Patient Account Specialist

Perform billing and collections for the Institute. Monitor collection

patterns, insurance receivable and identify problem areas. Take appropriate

action, adjustments, write-offs and make collection referral on delinquent

accounts. Also resolve issues with third party payors, explain billing

procedures to companies and patients. Review monthly aged trial balance, enter

charges, receipts and adjustments via IDX. Correspond with insurance companies

and serve as a resource to personnel regarding CPT and ICD-9 code.

Montefiore Medical Center, Bronx, NY 1998 - 2000Medical Audit Analyst

Duties included research and documentation of a sequence of events concerning

patient hospital stays. Code diagnoses according to ICD9 and for CPT-4

coding. Ensure appropriate DRG assignment for optimal reimbursement. Prepare

necessary records and reports. Train and educate new employees.

HIP of Greater New York, New York, NY 1997Medical Claims Examiner

Prepare, investigate and review outpatient and inpatient claims for proper

payment, which involves application of contractual provisions, riders, waivers,

and HIP policies and procedures. Investigate, intervene, communicate and

follow-up, either orally or in writing with a variety of internal and external

sources; including but not limited to providers, medical group personnel,

members, attorneys, third party administrators, and other carriers on any claim

related issues. Assign procedure codes (CPT), diagnosis codes (ICD9), place

and type of service based on medical information provided. Process adjustments

for previously paid or denied claims.

Empire Blue Cross and Blue Shield, New York, NY 1988 - 1997

Benefits Determination Claims Examiner, 1991 - 1997

Examined claims submitted by pre-coding examiners for accuracy, proper coding,

and eligibility. Generated correspondence to patients and providers submitting

claims. Investigated secondary insurance policies for claims denied and/or

delayed. Initiated processing, payment and/or resection of all completed

claims. Extensive knowledge of CS90 and ICS claims processing systems,

interfaced.

Pre-Computer Claims Examiner, 1988-1991

Performed the initial review evaluation and processing of claims. Utilized the

ICD9 and CPT4 codes. Acquired extensive knowledge and interpretation of

outpatient procedures (operative reports, surgery, and consultations).

Educational Background:

Bronx Community College,

Bronx, NY 1985-1986

Accounting

Major

City College of New York,

New York, NY 1983-1984

Computer Science

Major

SKILLS:

ICD9 and CPT4 coding. Extensive knowledge of medical terminology. Computer

literate. Knowledge of IDX Medical Manager, OMNIPRO, CS90, RIS and Famous

Last Word. Operational knowledge of QCare system.

REFERENCES:

Available upon request

Contact this candidate