Managed Care Liaison

Loraida Steinberger ** Jay Court, Carmel NY *****

Cell: 646-***-**** - *******@*****.***

Professional Summary

Over the past four years I have worked as a Medicaid Managed Care Liaison. This was a new position created by the state to help facilitate with the Childrens managed care transition and 29i licensure. It has been extremely rewarding and challenging at times. Working with different departments to facilitate billing, electronic records and auditing procedures.

I helped build the EMR with procedure and diagnosis codes updated regularly. Followed the children’s Medicaid transition closely,

Contracted all providers and agency with Medicaid managed care organizations as well as private/commercial insurances.

Scrubbed, corrected and submit HCBS/CFTSS and 29i claims weekly Checked insurance eligibility for all children and reached out to parents when there were lapses and or loss of insurance.

Trained providers on EMR (Encounterworks), coding and medical notes Worked with pharmacy to get PCN, Group and Bin numbers Requested prior authorizations and submit coordination of care forms and treatment plans to managed care organizations.

Spoke with parents/guardians regularly about Medicaid eligibility and Updated insurance information.

Skill Highlights

Excellent analytical and problem solving skills

Detail oriented and highly organized with a proven track record of expanding a business. Dependable with the ability to manage multiple projects concurrently. Professional communication skills, both written and verbal. Credentialing Doctors and businesses to Medicaid, Medicare, And Private Insurances

Billing all insurances as well as collections and patient-billing. Insurance and contract training and continuing education of front-of- the- house employees, office managers, doctors as well as patients on current insurance rules and contract changes. Clearing house and EMR software customization and upkeep both in person and remotely. Professional Experience

Medicaid Managed Care Liaison

January 2018-Present

GreenChimneys, Children’s Services Inc.-Brewster, NY Helped build EMR with procedure and diagnosis codes updated regularly. Followed the children’s Medicaid transition closely Contracted all providers and agency with Medicaid managed care organizations as well as private/commercial insurances.

Scrubbed, corrected and submit HCBS/CFTSS claims weekly Checked insurance eligibility for all children and reached out when there were lapses and or loss of insurance.

Trained providers on EMR (Encounterworks), coding and medical notes Worked with pharmacy to get PCN, Group and Bin numbers Requested prior authorizations and submit coordination of care forms and treatment plans to managed care organizations.

Spoke with parents/guardians regularly about Medicaid eligibility and process. Loraida Steinberger 12 Jay Court, Carmel NY 10512

Cell: 646-***-**** - *******@*****.***

Revenue Cycle/Credentialing Manager

September 2012 to January 2018

Harlem Vision Inc New York City, NY

Billing Manager for five locations.

Effectively helped to expand the business from three locations to five. Training and maintaining staff efficiency

On-call for questions from Doctors, Patients, and Insurance companies after business hours and on weekends.

Specialized in Ophthalmology, Optometry, and Optician billing As a Revenue Cycle and Credentialing Manager, I was responsible for leading and planning the billing-operations for a five person department. Collaboratively creating, implementing and enforcing policies and procedures, as well as streamlining effective billing, collections, posting, archiving and creating monthly financial reports for five different locations. Biller/Credentialing Specialist

September 2011 to September 2012

Devington Technology Queens, NY

Billing and credentialing for a billing company/clearinghouse that created its own software. Credentialed and billed for all Specialties.

Education and Training

Certificate- Medical Billing and Coding, 2008

U.D.I Career Training Woodside, NY, USA

Notary Public-Putnam County, New York Expiration 2023 NYSOH Assister-2019

Associate Degree-Fashion and Merchandising 1998

54 of required 60 credits toward Bachelor of Science: Merchandise Management State University of New York/FIT New York, NY, USA

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