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Medical Customer Service

Location:
Cambria Heights, New York, 11411, United States
Posted:
November 11, 2017

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Ja’neen Hurst

(347) ***-**** ac29gb@r.postjobfree.com

Executive Assistant / Billing & Operations Administration

Expertise in Customer Relations, Public Relations, and Office Management

Core Competencies

Strategic Planning Program Management Scheduling Risk Assessment Executive Assistance

Staff Training & Mentoring Billing & A/R, A/P Conflict Resolution Policy Evaluation and Compliance

Client & Vendor Engagement Corrective Action Plans Process Improvements

Hands-on and proactive administration management professional with 10 years’ experience in creating well-received service and billing programs having collaborated with key decision makers and thought leaders. Tenacious operations leader well-known for seeking out overlooked opportunities to improving business functions. Calculated risk taker to get processes moving quickly in transforming ideas into action; highly skilled in connecting complex and disparate information into a distinct concept and aggressive process campaign. Change agent and agile thinker highly regarded for mobilizing transformation across organizational boundaries for maximum impact. Lauded for shedding the status quo and embracing fresh, alternative thinking to address complex business problems.

Robust history in delivering extraordinary customer service and for fostering an environment for colleagues to do the same; well-known for exercising tact and diplomacy with exceptionally contentious customers to quickly de-escalate and contain the issue at hand.

Proven capacity to clearly and effectively communicate to audiences from a variety of cultural and educational backgrounds.

Strong history in delivering complex projects on-time and within budget despite shifting priorities, demanding expectations, and stringent deadlines.

Career Highlights

Lead billing staff and development training to ensure compliance with Federal and State billing regulations.

Collaborate with administration and physicians to collect data for claims as a primary liaison with insurance organizations.

Highly regarded for delivering complex projects on-time and within budget despite shifting priorities, demanding expectations, and stringent deadlines.

Solid leadership skills across teams to embrace a positive outcome for billing and accounting issues.

Robust reputation for providing extraordinary patient service and for cultivating an environment for colleagues to do the same.

Professional Experience

Able To, New York, NY September 2015 – January 2017

Billing Manager/Specialist

Partnered with internal billing service to process billing for a technology-enabled behavioral health provider focused on improving overall medical outcomes.

Interacted with Aetna as the company’s largest insurance carrier.

Trained new Billing Specialists on job duties.

Dr. Charles Edward Robins, Psychologist PC, New York, NY January 2014 – September 2015

Medical Collections Specialist

Completed billing, collection, and reporting functions in keeping with set deadlines. Collected daily billing worksheet, accounts receivable, and patient coverage verification.

Investigated and resolved customer queries by way of telephone, email, and face-to-face.

Prepared monthly metrics and assisted with month-end closing.

Ja’neen Hurst Page 2

PCB Professional Credit Bureau, Garden City, NY December 2012 – December 2013

Medical Collection Specialist

Completed daily billing worksheet, accounts receivable, and correspondences. Verified patient coverage. Obtained authorizations to process refunds for patients and insurance companies.

Managed 400+ patient accounts.

Informed customers of account delinquency and negotiate payment options.

Maxwell Medical Physical Therapy & Chiropractic, New York, NY April 2012 – October 2012

Medical Collections Specialist

Verified patient coverage; requested and gathered medical records. Obtained authorizations to process insurance.

Coordinated taxi and ambulate transportation for homebound patients.

Prepared and completed diagnostic forms upon patient discharge.

Analyzed and re-billed insurance claims, prepared collection letters, and established payment plans.

Columbia University / Center for Women’s Reproductive Care (CWRC)

New York, NY August 2008 – February 2012

Medical Biller / Accounts Receivable Specialist

Maintained insurance charts for all patients covered under CWRC participating carrier. Completed daily Terms of Service logs; emailed logs throughout departments. Managed accounts receivables and resolved balances and payment concerns. Filed appeals on denied claims. Managed and reported account payables. Verified patient coverage; requested and gathered medical records.

Reviewed claim edits and e-commerce edits on a weekly basis to clear accounts for submission.

Concluded and verified aging reports.

Answered patient inquiries, reported changes, and modified ICD9 and CPT codes.

Collaborated with patients to arrange for payments and resolve outstanding accounts.

Queens Long Island Medical Group, Jamaica, NY February 2006 – June 2008

Administrative Assistant, Billing & Claims

Verified and updated patients’ demographics; scheduled and confirmed appointments. Obtained referrals and preauthorizations; executed insurance eligibility verifications for patients prior to appointments. Maintained accurate documentation in case management database.

Reviewed denied claims, appealed rejected claims, and verified insurance including Medicare/Medicaid.

Processed Workers Compensation and no-fault claims cases.

Interacted with hospital-based medical record departments and radiology serves to ensure patient records and diagnostic information was received.

Scheduled luncheons, boardroom meetings, and travel arrangements.

Downtown Women OB-GYN, New York, NY June 2003 – February 2006

Billing Supervisor

Supervised and assisted staff in billing and coding procedures. Reviewed files for delinquent accounts. Reviewed codes, checked for accuracy, entered ICD-9 and CPT4 codes. Obtained referrals and preauthorizations. Generated correspondences and managed flow of files.

Implemented guidelines for daily work standards and trained staff on them

Monitored office supplies and vaccine inventory on a weekly basis; created requisitions to order supplies.

Consulted with management on staff scheduling.

Education

Certificate, Medial Billing and Coding, Sanford-Brown Institute, New York, NY

Certificate, Professional Medical Coding Curriculum, Med Consultants, Inc., New York, NY



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