PROFESSIONAL EXPERIENCE:

St Nicks Alliance Homecare, Brooklyn, NY July 2017-.

Accounts Receivable Analyst

Review weekly claim denials, EOB’s, bill claims on a weekly basis

Accounts and Aging reports for MCO/MLTC programs to ensure timely billing and follow up

Create excel spreadsheets for unpaid and denied claims for review by MCO

Collect delinquent accounts by monitoring payments

Eligibility check for CDPAP/HRA (Medicaid) members

Prepare claims for billing

Responsible for preparing and sending new or corrected claims on paper forms UB04- HCFA1500 on a weekly basis

Submit electronic claims to MCO/MLTC companies

Review contracts and liaise with MLTC companies to retrieve any outstanding payments

Centers Plan for Healthy Living MLTC, Staten Island, NY June 2016 - July 2017

Provider Claims Resolution Analyst

Processes claims for payments for both Medicare and MLTC claims

Resolve claim denials with Providers via phone

Upload, process Claim reconsiderations

Work alongside Provider Relations with claims that needs their contract updated

Knowledge of Medicare Products (FIDA and D-SNP)

Train new hires into the company’s method of processing claims

Inputting claims from the UB-04 and HCFA 1500 for processing

White Glove Homecare Agency, Brooklyn, NY February 2016 – June 2016

Accounts Receivable Resolution Specialist

Enter check payments and post payments when received

Resolve claim denials

Process unapplied cash and Recoupments via Excel spreadsheet

Resubmit corrected claims via online and at times using the HCFA forms (1500)

Apple Home Care/Meditrans Ambulette, Brooklyn, NY April 2014 – February 2016

Billing clerk

Bill on a weekly basis for Medicaid, Aetna/WellCare, MLTC

Process payments for various health insurance into Deerfield/Routing Box

Process Excel spreadsheets and PDF’s for claims processing and payment

Weekly adjustments of procedure codes and modifiers for Medicaid billing

Verify non-emergency transportation authorization for clients

Lutheran Medical Center (now NYU) Brooklyn, NY October 2015 – March 2015

Human Resource Assistant (voluntary).

Substantiates applicants' skills by administering and scoring tests.

Welcomes new employees to the organization by conducting orientation.

Submits employee data reports by assembling, preparing, and analyzing data.

Maintains employee information by entering and updating employment and status-change data.

Provides secretarial support by entering, formatting, and printing information; organizing work; answering the telephone; relaying messages; maintaining equipment and supplies.

Maintains employee confidence and protects operations by keeping human resource information confidential.

Maintains quality service by following organization standards.

Contributes to team effort by accomplishing related results as needed.

EDUCATION:

Berkeley College, New York City, NY Jan 2010 – May 2016

B.B.A., for Health Service Management

SKILLS: MCO- (Manage Care Optimizer), Case Trakker, Deerfield/Routing box, Microsoft Word, Excel, Outlook, Power Point, Knowledge of Human Resources, Adobe, ICD-9 and 10 Coding and HCPCS Coding, HHA Exchange

Volunteered at Lutheran Hospital (NYU) from November 2013-April 2014

**LICENSED CERTIFIED NURSING ASSISTANT 2010**

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