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Medical Home Health

Location:
Ridgewood, New York, United States
Posted:
August 21, 2018

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Resume:

SUZIE M. JEAN-BAPTISTE

772-***-****

ac6rhw@r.postjobfree.com

Objective

A dynamic, challenging position using my education in healthcare management, my CPC certification and my extensive medical billing knowledge and experience in the allied health field.

Skills/Certificates

Proficient in Microsoft Office, Excel, Outlook & PP

Excellent analytical and communication skills

Fluent English, Haitian Creole and French

Excellent knowledge of EPIC, eClinicalWorks & Nextgen

Certified Professional Coder – CPC

Detail-oriented and excellent problem solver

Advanced knowledge of Medicare, Medicaid and Managed care regulations and guidelines

Education

08/17 – 12/18 Executive Masters of Healthcare Administration Florida Atlantic University

08/2016 Bachelor of Science: Health Care Management Indian River State College

12/2013 Associate in Arts: Health Services Management Indian River State College

Relevant Experience

07/17 – 01/18 NYU Langone Health New York, NY

Multi-specialty Medical Office Supervisor

Accomplish staff job results by coaching, counseling, and disciplining employees; planning, monitoring, and appraising job results

Conduct training; implementing enforcing systems, policies, and procedures

Maintain safe and healthy work environment by establishing and enforcing organization standards

Adhere to legal regulations, provide quality service by enforcing quality and customer service standards

Conduct coding, billing and claims audits

Handle payroll for 15+ employees

09/16 – 07/17 NYU Langone Health New York, NY

Authorization and Referrals Specialist

Obtain authorization for high grade radiology, surgeries, physical therapy, injections, pain management, Durable Medical Equipment, home health, home infusion, wound care and office visits

Follow up with insurances for authorization requests

Review schedules daily and ensures appropriate insurance and authorization has been obtained and documented

Coordinates outgoing referrals by compiling necessary documents to be sent to the outside referral physician or facility

Review scheduling system so verifications are accurate and completed prior to patient appointment to avoid billing and/or payment errors

Ensure that patient’s healthcare benefits cover the required procedures

Obtain and/or verify patient insurance benefits and/or coverage by use of insurance websites, and by reaching out to insurance carriers prior to patient appointment

Strong knowledge and understanding of Medicare, Managed Care, HMO/PPO plans and Authorization/Referral requirements

Medical Biller/ Coder - Authorization and Referrals Team Lead

07/14 – 07/16 Heart and Family Health Institute Port Saint Lucie, FL

Reading and analyzing patient records

Determine the correct code for patient records

Interacting with physicians to ensure accuracy in documentation and coding

Denial management

Claims submission and processing

Cash posting

Obtain authorization for high grade radiology, surgeries, physical therapy, injections, pain management, Durable Medical Equipment, home health, home infusion, wound care and office visits

Follow up with insurances for authorization requests

Review schedules daily and ensures appropriate insurance and authorization has been obtained and documented

Coordinates outgoing referrals by compiling necessary documents to be sent to the outside referral physician or facility

Review scheduling system so verifications are accurate and completed prior to patient appointment to avoid billing and/or payment errors

Ensure that patient’s healthcare benefits cover the required procedures

06/13 – 07/14 Liberator Medical Supply Stuart, FL

Accounts Receivable Specialist

Denial management

Claims submission and processing

Submit second and third levels of appeal to Medicare by Reconsideration and Administrative Law Judge (ALJ)

Follow up on outstanding A/R with all payers and/or including self-pay including resolutions of denials

Handling correspondence related to insurance or patient accounts, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve profitability

10/06 - 03/13 Liberty Medical Supply Port Saint Lucie, FL

Denials management

Claims submission and processing

Submit second and third levels of appeal to Medicare by Reconsideration and Administrative Law Judge (ALJ)

Follow up on outstanding A/R with all payers and/or including self-pay including resolutions of denials

Handling correspondence related to insurance or patient accounts, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve profitability

Medical Biller/Collector

07/05 - 08/06 Fleet Billing Service Boynton Beach, FL

Hospital Billing

Contract review

Denial management

Claims submission and processing

Submit second and third levels of appeal to Medicare by Reconsideration and Administrative Law Judge (ALJ)

Follow up on outstanding A/R with all payers and/or including self-pay including resolutions of denials

Handling correspondence related to insurance or patient accounts, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve profitability



Contact this candidate