Prakash Makhijani

* ******* **** ******** *****, Cortlandt Manor, NY, 10567

914-***-**** ad2dgs@r.postjobfree.com

Education

Mumbai University School of Commerce June 1983

Bachelor of Commerce

Work Experience

Mount Sinai Urology, NYC, NY March 2022 – Present

Revenue Cycle Operations Manager

Successfully handled credentialing for the Urology Department, ensuring compliance with Medicare, Medicaid, and Commercial Plans.

Diligently reviewed and addressed billing and coding-related issues, including daily review of specific codes and follow-up on rejected claims, resulting in optimized revenue collection, and minimized billing discrepancies.

Proficiently managed various administrative tasks, including pre-certification and authorization follow-up, distributing reports, coordinating with other departments, and handling cash deposits.

Managed multiple locations, including MSW 425 West 59th Street, NY, MSM: 1090 Amsterdam Avenue NY, and 286 Fort Washington Avenue.

Mount Sinai Hospital, Westchester, NY April 2010 – March 2022

Revenue Cycle Manager

Successfully completed rigorous Epic billing training in April 2021 following Mount Sinai's transition to the Epic platform. Proficiently handled billing testing and hospital charges, meticulously addressing errors in the Charge Edit, WQ, and Claims WQ.

Demonstrated leadership by overseeing all patient account activities and optimizing staff performance, ensuring the efficient utilization of resources and the maximization of cash collections.

Spearheaded the preparation of comprehensive monthly financial reports and took charge of conducting monthly financial review meetings, showcasing a strong commitment to financial transparency and strategic decision-making.

Riverside Medical Group, PLLC, Yonkers, NY June 1994 – April 2010

Billing Manager

Proficiently managed insurance billing, processing claims for both insurance and private pay clients. Skillfully submitted corrected claims and appeals, fostering productive interactions with provider representatives.

Leveraged in-depth knowledge of insurance denials to strategically overturn procedures in alignment with contract terms, ensuring maximum reimbursement.

Dr. Usha & Dilip Mukhtyar, MDs, Bronx, NY June 1992 – April 1994

Billing Manager

Proficient in billing across diverse healthcare settings including Physician, Hospital, Home Health, and Nursing Home environments.

Thoroughly verified insurance eligibility and obtained necessary authorizations, ensuring seamless and compliant operations.

Skills

NYC, NY April 1994 – Present

Worked with Change Health Care and Greenway (Emdeon and Payer Connectivity Services), MD Online, and PNT Data.

Utilized efficient review of billing reports through MS Excel and VBA Editor and ensured accurate follow-up.

Implemented and oversaw HL-7 interface with Omni-MD and Intergy Updated translation tables

corrected any errors on mismatched transaction to ensure 100% import of patient demographics and charges.

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