Medical Billing Customer Service

Cecile Pottinger

Brooklyn, New York ***** Tel: 347-***-**** ***************@*******.***

CAREER PROFILE

Accomplished Senior Billing professional with over 20 years’ experience in claims and billing insurance administration, partnering with third parties, addressing patient needs and paying attention to every detail for accuracy, timeliness and prompt payments. Thrive in a fast paced environment processing between 40 to 60 claims daily. Recognized by WTC Clinic Center for diligently and quickly handling claims matters, investigating and bringing issues to resolution. Quickly adapted to new processes and online claims procedures established during COVID. Cultivate strong relationships across departments and with external partners, displaying teamwork, a pleasant demeanor and strong work ethic. Receive letters of appreciation from thankful patients and WTC Clinical Center. Earlier in career assumed a temporary role for Lenox Hill Hospital responsible for overdue accounts receivable collections. Successfully resolved over 65% of claims issues before collections utilizing a calm approach, negotiation skills and tenacity. Resulted in an offer for a permanent position. Strong knowledge of commercial insurance and Workers Compensation no fault insurance. Flexible and open to learning new aspects of insurance, welcoming the opportunity to manage front end patient registration, overall revenue cycle process or medical billing administration.

AREAS OF EXPERTISE

Worker’s Compensation No Fault Billing Accounts Receivable High Claims Volume Registration Insurance

1500 Forms Medicaid Medicare HMOs Relationship Building Communications Multi-task Cash Flow Analytical

HIPAA Reconciliations Attention to Detail Teamwork Problem Solving Customer Service EPIC Excel

WORK EXPERIENCE

Senior Billing Representative, NYU Medical Center, New York, NY Aug 2001 – June 2021

Responsible for managing a high volume of patient and third party insurance claims. Proactively address Workers compensation no fault billing insurance matters with submissions ranging from 40 to 60 claims daily.

Selected as Team Member training and mentoring new staff on claims process and navigating within EPIC system. Share best practices, monitor performance and guide new team members.

Offer exceptional customer service resolving patient issues, verifying accuracy of information and obtaining authorizations. Initiate weekly follow ups with insurance carriers to confirm receipt of claims, validate accuracy and make every effort to ensure timeliness of claims payments.

Work closely with FDNY and NYPD successfully administering timely 9/11 claims. Perform WTC claims reviews to verify patients are certified, correct diagnostic codes are in place and all appropriate data is included. Investigate and promptly addressed any denials of claims or delays in payment.

Primary point of contact for Radiology and MRI departments for a variety of questions and information sharing.

Cultivate strong relationships with insurance claims examiner which has resulted in quick claims processing.

Financial Analysis Administrator, Beth Israel Medical Center, New York, NY Mar 1997 – Aug 2001

Managed accounts receivables for approximately 60 accounts, diligently evaluating claims for accuracy and proactively resolving any outstanding balances. Handled over 50 generated or submitted claims daily. Worked with Medicare and third parties.

Secured significant revenue for department through proactive measures to ensure accuracy of 1500 form, eligibility verifications, and careful monitoring of outstanding claims for timely reimbursement.

Trained and mentored new staff members sharing expertise of systems and processes.

Partnered with attorney to address claims issue for clients, submitting all the required data and securing internal accounts receivable payments.

EDUCATION TRAINING

SUNY Education Center, Brooklyn, NY, Medical Billing 2 Year Program Certification: ICD & CPT billing codes

Third Party 1500 Forms Medicare Software Medical Manager

Jefferson Business School, Watertown, NY, Word Processing Program Certification

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