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Work Background
Columbia University Irving Medical CenterRevenue Cycle - Insurance follow up Analyst
May. 2022United States• Resolution of unpaid, denied, or rejected insurance claims, ensuring adherence to timelines and quality standards.
• Implemented strategies for efficient appeals and submission of medical documentation, resulting in increased revenue realization.
• Identified persistent issues and trends, initiating corrective actions to streamline processes and improve outcomes.
• Collaborated cross-functionally, managing communication with insurance companies, patients, and stakeholders for prompt claim resolutions.
UnitedHealth GroupCase Investigator and Contact Tracer
Jan. 2021 - Apr. 2022United States• Directed contact tracing efforts, overseeing communication channels and managing a high call volume to track and document COVID-19 exposure.
• Provided education and support to affected individuals, utilizing diverse platforms to disseminate information and resources effectively.
• Contributed to Vaccine Outreach Projects, orchestrating appointments, and facilitating COVID-19 vaccination initiatives.
BronxCare Health SystemPatient Financial Services
Feb. 2019 - Mar. 2020Bronx, New York, United States• Ensured compliance with billing guidelines and regulations while managing accounts receivable and denial reports for timely resolution.
• Collaborated with the Care Management Team, providing insights on denied cases and coordinating necessary clinical information for appeal purposes.
• Maintained meticulous records, reviewed claim denials, and followed up on unpaid accounts post-payment.
• Prepared billing summaries and reports, validated insurance data for benefits coordination.
• Managed high-volume customer inquiries, assisted with billing statements, and supported special projects.
Mosaic Mental Health Senior Billing Specialist
Mar. 2017 - Dec. 2018• Oversaw all aspects of medical billing, including payment, denials, and adjustments, demonstrating a strong grasp of EOBs and reimbursement structures.
• Proactively researched and resolved insurance and billing issues, contributing to increased revenue through effective claims submission and reimbursement enhancement.
• Reduced receivables by diligently reconciling trial balances, effectively managing delinquent accounts, and streamlining billing processes.
• Employed Anasazi software to process insurance claims, ensuring accuracy and compliance.
ElderServeClaims Specialist
Aug. 2016 - Mar. 2017• Processed medical insurance claims and maintained excellent customer service, resolving discrepancies, and conducting thorough investigations into pending claims.
• Leveraged expertise in medical insurance coding, terminology, and software systems to enhance efficiency in claims processing and customer interactions.
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G.E.B. MEDICAL MANAGEMENTBilling Specialist
Oct. 2013 - Jul. 2016515 Madison Avenue• Performed the daily functions of a multi-specialty medical billing department, frequently overseeing billing, collections, and financial reporting for diverse medical practices.
• Played a pivotal role in maintaining compliance with insurance guidelines, conducting verifications, authorizations, and implementing streamlined billing processes.
New York Family PracticeOffice Manager / Medical Biller
Jun. 2007 - Aug. 2014Greater New York City Area• Healthcare Administration: EMR systems, revenue cycle management, CPT, ICD-10, claims processing and billing procedures.
• Facilitated data entry for medical billing systems • Spearheaded insurance benefit verification across multiple insurance types, • Managed daily office operations and inventory.
• Communicated effectively in Spanish, enhancing interactions with Spanish-speaking patients and providers.
• Effectively coordinated diverse healthcare tasks and operations, ensuring compliance and optimal performance.
New York Medicaid ChoiceEnrollment Counselor
Jul. 2006 - Jun. 2007Greater New York City AreaCall center operations, answered and directed clients to perspective counties. Processed exemptions and exclusions. Experience with MAXSTAR and EMEVS.
Affinity Health PlanMarketing Representative
Jan. 2005 - Feb. 2006Greater New York City AreaAssisted clients in completing applications and collecting correct back up documentation. Maintained confidential documents. Marketing Affinity Health Plan at sites and events.
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