Medical Home Health
Resume:
SUZIE M. JEAN-BAPTISTE
***********@*****.***
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