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Billing Administrator

Linden, New Jersey, United States
February 03, 2019

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** ******* ***** ******, ** ***** 908-***-****



Kean University, Bachelor of Science in Management Science, January 1997

Dean’s List Spring 1996 & Fall 1996


Advanced Neurosurgery Associates (3/1/16-Present) Rutherford, NJ

Billing Administrator (4/1/18-Present)

Billing Manager (3/1/16- 3/31/18)

Developed and implemented best practices to bring billing operations in-house from an outside billing company.

Oversee operation of the billing office with a hands-on approach while supervising 2 billing staff.

Ensure all surgeries, hospital and office visits are all billed accordingly for 4 neurosurgeons, 2 physician assistants,

and 2 advanced practice nurses at 5 locations.

Run end of day, month end, and yearly financial reports as well as ad hoc analysis.

Reconcile monthly bank statements with accountant for all billing department deposits.

Responsible for credentialing of new and existing doctors.

Monitor patient and insurance account receivables.

Conduct monthly and quarterly meetings with doctors, physician’s assistants, accountants, billing, and

front desk staff.

Interviewed and screened candidates for billing positions.

Negotiate payments for out of network visits and surgeries with insurance companies.

Initiate single case agreements and gap exceptions.

Appeal claims and send corrected claims and medical records requests as needed.

Investigate, follow up, and resolve insurance claim rejections and denials.

Obtain and review patients out of network medical benefits for deductibles and coinsurance.

Setup insurance plans for electronic fund transfers directly to bank.

Assist with entering office visits and hospital charges and post insurance and patient payments.

Send insurance claims and patient statements electronically daily.

Administer websites such as Change Healthcare, Navinet, Payspan, Optum, CAQH, and PECOS.

Educate patients on deductibles, coinsurance obligations, and coordination of benefit inquiries.

Knowledge of HIPAA, Medicare, Medicaid, ICD-9, ICD-10, CPT-4.

Knowledge of Microsoft Word, Excel & Outlook.

Knowledge of Dr. Chrono, Practice Manager (STI) medical billing software, and MD Logic (EHR)

Medical Diagnostic Associates (8/03-12/15) Clark, NJ

Billing Manager (10/10-12/15)

Assistant Billing Manager (10/08-9/10)

Senior Biller (8/03-9/08)

Oversee overall operation of the billing office while supervising up to 20 billing staff employees at 11 locations.

Make certain all charges were billed accordingly for 38 providers.

Investigate, follow up and resolve insurance claim rejections.

Appeal claims to insurance companies as needed.

Monitor patient and insurance account receivables and rejected claims.

Educate patients on deductibles, coinsurance obligations, and coordination of benefit inquiries.

Offer alternative payment arrangements to patients with overdue balances.

Conduct monthly meetings with billing staff.

Knowledge of Microsoft Word and Excel.

Knowledge of Navinet and Emdeon.

Perform annual reviews of billing department staff.

Interviewed and screened candidates for billing positions.

Knowledge of ICD-9, ICD-10, CPT-4, and HCPCS coding.

Knowledge of Medical Manager, STI/Perfect Care software & Chartmaker Clinical EHR.

Enter Gastroenterology office and hospital visits as well as endoscopy surgical procedures.

Generate Colonoscopy and EGD recall letters for Gastroenterology patients.

Enter charges for Family Practice, Endocrinology, Internal Medicine, Nutrition, and Infectious Disease as needed.

Post insurance and patient payments.

Electronic transmission of all medical claims and patient statements.

WebMD Medical Manager (10/99-8/03) Fairfield, NJ

System Support Analyst

Diagnose and troubleshoot client calls related to Medical Manager software, hardware, and

telecommunication problems.

Document events leading to resolution in Clientele software program.

Knowledge of UNIX, AIX, MMWIN, PC Anywhere, Tiny Term, and modems.

Westfield Associates in Internal Medicine and Gastroenterology (9/98-10/99) Westfield, NJ

Business Office Manager

Oversee overall operation of the business office, and supervise two billing employees.

Apply insurance and patient payments and electronic transmission of medical claims.

Investigate insurance claim rejections and monitor all accounts receivables.

Run productivity and aging reports and conduct weekly meetings with doctors and staff.

Pay practice expenses using QuickBooks 98.

Knowledge of Medical Manager software.

MetLife (5/98-8/98) Bridgewater, NJ

Procedure Analyst

Develop procedures on how to handle the State Insurance Department class action lawsuit.

Develop procedures and guidelines for various projects and making them readily available using Adobe Acrobat.

Prudential (3/97-5/98) Edison, NJ

Claims Examiner

Investigate and rectify policy owner’s complaint cases received from the State Insurance Departments within the United States involving life insurance and variable contracts.

Develop and negotiate settlement offer letters, calculate refunds, dividends and premium payments.

Conference Call Service (4/97-7/97) Mountainside, NJ

Conference Call Operator

Conduct operator-assisted conference calls by calling, greeting and connecting all callers

while introducing any key speakers.

Consumer Health Network (9/96-12/96, Fall Semester) Piscataway, NJ

Provider Relations Intern

Review doctor’s files for missing and expired information for credentialing purposes and

request additional information as needed.

Assigned to special projects that include deadlines in getting specific doctor groups credentialed.

Received three college credits for completion of Cooperative Education Program/Internship.

Garden State Community Bank (8/92-8/96) Union, NJ

Senior Member Service Representative (9/94-8/96)

Member Service Representative (7/93-8/94)

Member Service Clerk (8/92-6/93)

Accountable for overall operation of on-site branch of Merck employees.

Record accurate transactions, prove cash, checks, and loan payments to the end of the business

day totals.

Resolve members concerns and cross-sell all products and services.

United Counties Trust (7/90-7/92) Elizabeth, NJ

Bank Teller

Record accurate transactions, prove cash, checks, and loan payments to the end of the business

day totals.

Identify customer needs of any products and services and resolve customer concerns.

Baysons Corporation (2/86-7/90) Elizabeth, NJ

Assistant Manager

Manage family owned Shell gasoline service station.

Supervise shift employees and overall operation of gasoline station.

Order gasoline and products such as oil, transmission fluid, and brake fluid.

Collect cash and credit card sales of gasoline and automotive products.

Identify customer needs of any products or service.

Prove cash and credit card payments to the end of the shift.


Bilingual in Spanish

Member of American Academy of Professional Coders (AAPC)

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