Account Receivable/ Payment Poster
Resume:
Jael Cancel
Deltona, FLORIDA ***** / 954-***-**** call or text / *******@***.***
SUMMARY OF QUALIFICATIONS A dedicated, team oriented, multi-tasked professional with an expansive knowledge of patient care, accounts receivable and insurance guidelines. Experience in decision-making and problem solving while following company policies and procedures. Proficient in coordinating and prioritizing complex jobs, assigning duties and responsibilities to coworkers. While creating a safe, fun, secure, productive, family-like environment for all staff members.
WORK HISTORY
Alcanza Clinical Research LLC 2/2022 to 9/2024
Payment Posting / Account Receivable Specialist
Maintain Documentation for 18+ clinical trials, in accordance with contractual terms & guidelines.
Conduct audits to ensure patient visits, fixed budget items and elements have been invoiced and paid.
Generate accurate invoices & billing for site/subject to sponsors/CROs.
Payment Posting and Allocate cash properly
Identify outstanding invoices & Contact Client to provide documents to resolve complex overdue payments.
Report and resolve payment discrepancies: underpayments, denials, offset, Recoupments
Analyze, reconcile and recouped over $2.2 Mil of lost revenue
Synergy Billing LLC 5/2019 to 01/2022
Patient Care / A/R Resolution Specialist
Follow up with customers (Spanish and English) on all billing questions/concerns, payment, insurance, and collection issues.
Apply Discount slide to claims / Patient balance.
Verify insurance benefits, update chart and claims.
Payment posting, apply credits and request refund to patients and insurance companies.
Ensure timely follow-up and resolution of internal and external inquiries of billing issues.
Research, appeal, and resolve unpaid insurance claims.
Work special projects as assigned by department manager.
Ability to adapt to flexible schedule and prioritize and organize work.
On 2 Feet, LLC (Dr. Jefferson Mennuti DPM) 8/2017 to 5/2019
Office Manager
● Supervise front office, assist in check in, copay collection, check out.
● Update and/or design employee handbook, patient forms, Surgical forms, billing letters and notices to both patients and insurance Company.
● Responsible for training and updating staff of any changes to the practice.
● Review medical records, make sure all information is correctly updated and scanned.
● Traveling between satellite offices: Orange City and Sanford.
● Help with verification / authorization of office visits/ surgical procedures before service date.
● Schedule procedures in Surgical Centers and/or Hospital.
● Manage billing and collection. Set up payment plans with patients. Help billing with denials and appeals.
● Maintain good patient/provider relations including handling patients concerns.
● Update Physician on schedule and/or changes of surgeries and home visits.
● Maintain inventory of office and medical supplies and equipment
● Review contracts and negotiate reimbursement rates from Insurance companies.
● Make sure all licenses and certifications are current.
● Any additional duties and projects needed as assigned by Physician
Central Medical Systems, Inc. (CMSI) 7/2005 to 8/2017
Office Manager
● Manages & monitor the work performance of 12+ Employees and Department to ensure that quality and quantity expectations are met or exceeded. Ensure employees follow company and governmental procedures. Provide ongoing training/retraining to employees to ensure that they are prepared to meet or exceed the productivity standards for their function.
● Strong communication skills: write reports, business correspondence, and produce company manuals. Effectively present information and respond to questions from groups of managers, clients, customers, and the public.
● Conduct, prepare & run monthly reports of new and reorders, outstanding claims by insurance company. Manages/participates in collection of monthly company data, analysis, and reporting of stats.
● Warehouse / Material Management : Purchase/negotiate/communicate with vendors while maintaining the highest quality of products and reducing cost for the company. Update database of all new items/pricing.
● Update staff of all new Items and coverage. Explain HCPC coverage and regulations on items. ● Train staff of safety practices in the warehouse. Update staff of any changes in state laws.
● Run monthly inventory reports. Make sure all items are moving.
● Maintain Log of lot # and expiration date on supplies.
● Receive and send shipment Via UPS, FedEx, and USPS.
● Process returns, refunds, damage items.
● Ensure that inventory and invoices from vendors are accurate and paid.
● AR Management : deposit, invoice and run quarterly reports of all outstanding claims. Payment posting, work denials and resubmit claims.
● Negotiate reimbursement rate from insurance companies.
● Participate in special projects and performs other duties as assigned.
● Take initiative to continuously improve area and processes.
Liberty Medical Supply 08/2004 - 06/2005
Account Receivable Agent
● Research and resolve open accounts with customers and/or insurance companies
● Reimbursement on overpayment from customer and/or insurance companies
● Post, Adjust, transfer, and re submit claims to insurance companies or Medicare Regions.
● Match, batch, code and enter payment into accounts.
Florida Hospital Fish Memorial 11/2000 - 05/2004
Office Coordinator, Center for Wound Care (CWC) & Diabetes Outreach Program
● Ran all functions of the front office, check in, copay collection, check out.
● Book staff meetings, updates of new policies and products.
● Advise Physicians and nurses of daily schedules.
● Submit monthly stats of patients visits in and out of Hospital for both Depts.
● Registration/ insurance verification / secure physician referrals.
● Route calls and distribute messages / process incoming and outgoing mail.
● Entering Department billing with ICD-9 attachments.
● Assure charts are filled out and signed by patients, nurses and physicians.
Cigna Dental Health 09/1996 - 06/2000
Member Service Representative
● Unload supervisor with incoming irate callers, regular mail, and payout/ reimbursement.
● Assist new member service Reps on policies, guidelines, and system navigation
● Active team rep of the “Cigna for Senior”, explain special guidelines to our Medicare/Medicaid members.
● Provide quality customer service though investigative research and second follow-up to resolve client’s concerns.
● Explain protocol and guidelines to members, dental offices, and benefits Dept. (Spanish and English)
● Achieved all Department standards including 95% customer accessibility, knowledge of all dental plans. (Indemnity, PPO & DHMO)
Core SKILLS
● General office duties & equipment
● Excellent in record keeping / compose, type, proof letter and memos
● Maintain productivity statistics
● Knowledge of Account Receivable & Payable / Payment posting / Invoicing / collections / audits management and budget and forecasting.
● Warehouse / Material Management
● Bookkeeping, posting, batching and reimbursement / cash register operations
● ADA dental, ICD-10 (wound care & Podiatry), CPT, HCPC Code
● Understanding different plan and guidelines (indemnity, PPO, POS, HMO, DHMO)
● Fluent in English and Spanish
● Computer literate: Microsoft Office / Windows / Excel / PowerPoint / Publisher Outlook / Citrix Virtual Office / Google Office: Docs / Sheet / Gmail / Slide / Navigate Multiple Insurance Portals: eligibility and claims / Meditech (Hospital System) / Emdeon / Microfiche.
EHR / EMR Systems: AR Express: Billing System / Cerner Care / (ECW)eClinicalWorks / E Medical Practice / NextGen / Brightree (DME) / Centricity /Epic /Athenahealth / Clinical Conductor
EDUCATION
● Degree Associate of Science (PI): City College, Ft Lauderdale, FL
● Diploma: High School: Paterson Adult School: Paterson, NJ
● Early Childhood Education: Martin Luther King, Paterson, NJ
REFERENCES: Available upon request
Again, if you have any questions, please feel free to call or text me with any questions you may have.
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