Sas Institute Collection Representative
Resume:
REGINALD SOMMERVIL
*** ****** ***** ********* ** 11550 516-***-****)
Email:*****************@*****.***
EXPERIENCE
Unlimited Care, Inc. 10/09- 06/20/17
White Plains, NY
Account Receivable Analyst
Provided billing and collection support for the receivable team
Monitored current and aging accounts
Prepare daily accounting report to staff for insurance and third
Party billing.
Physician billing Consultant 11/07 to 12/08
Provided billing services to private Physicians
Obtained billing approval from insurance carriers
Ensured current billing issues are resolved
Kept detailed records of transactions made and reconciled billing records
Star Multi care Services
Huntington, NY
Operation Coordinator (1/2004 to 10/07)
Review daily operation of the billing department to ensure compliance and standards.
Oversee the out-patient admissions functions, bed assignments, and completion of preliminary
Work with medical, nursing and accounting staff to ensure appropriate patient placement Confirm that all benefits coverage meets standards of admission as dictated by the nursing home policy
New York Presbyterian Medical Center,
New York, NY
Patient Accounts Supervisor (11/95 to 12/2003)
Department Of Patient Financial Services
Supervised the business services and patient accounting operations
Supervised claim processing, patient billing, follow-up / collections, third-party appeals, cash posting, data reconciliation, accounts receivable management
Provided extended assistance to Patient and Insurance Carriers
Motivated staff to maintain the accounts receivable goals and to implement the policies and procedures for all divisional related areas of the department
Assisted patient access, medical records, and patient care management to ensure that accurate patient demographic data, diagnostic coding, and medical necessity certification is obtained for timely processing of claims to third-party payers.
Monitored all billing and claim processing functions to ensure adherence to Federal and State compliance and billing requirements (HIPAA compliance)
Worked closely with Information Systems to ensure that all automated data processing operational business functions are optimized for maximum productivity and efficiency
Maintained positive relations with patients, physicians, and other public or contracted entities that interact with the Business Office
Participated in the development of operating goals and objectives for the unit; recommend, implement, and administer methods and procedures to enhance operations.
Performed miscellaneous job-related duties as assigned
New York Presbyterian Medical Center,
New York, NY
Senior Patient Accounts Collection Representative (10/93 to 11/95)
Department Of Patient Financial Services
Initiated phone contact to Patients and Insurance Carriers to facilitate prompt payment
Arranged payment date and amount of payment; follow-up in a timely manner to ensure receipt of payment
Processed Patients and Insurance Carriers refunds
Posted Patient and Insurance Carrier’s payments to patient accounts
Escalated requests for payment from clerical accounts payable staff to supervisor to Manager/Controller to Administrator and/or other executive level to facilitate payments
Identified any billing disputes related to charges, rate, number of billed days and any other issue that may cause delay, and forwarded the account to a Resolution Specialist
Initiated and applied credit adjustments for entry by the Resolution Specialist when appropriate
Advised Patient Account Supervisor of severe collection problems
Recommended credit hold to Patient Account Supervisor when all attempts to resolve payments have failed
Involved daily with insurance carriers, (Medicare, Medicaid, HMO, NOF WC) third party billing and self-pay patients
Aggressively reduced Medicaid and no fault fraud
Prepared and generated numerous departmental computerized reports.
Utilized PMPA (Patient Management Patient Accounts), Eagle 2000 and Health Charge Systems
New York Presbyterian Medical Center,
New York, NY
Admitting Representative (05/91 to 10/93)
Admitting Department
Coordinated the admitting process with the Medical, Nursing and Accounting staff to ensure appropriate placement of Patient and compliance with third-party payers and other regulations
Processed Patient admissions and discharges
Maintained liaison with insurance companies, health maintenance organizations, managed care contract companies and other third parties to obtain insurance verification data and approval for admission
Assisted with special reports as requested by management
SKILLS:
Operating Systems: Windows 95, Windows 98, Windows NT, Dos, MVS
Billing Systems: Eagle 2000, Health Charge, PMPA (Patient Management Patient Accounting)
Software: MS Excel, WordPerfect, MS Word, MS Access, MS Word 97, MS Excel 97
Languages: SAS
EDUCATION:
Atlantic Union College, South Lancaster, MA
B.S., Business Administration
CERTIFICATE: SAS INSTITUTE NY, SAS Programming
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