Experience

• 

  Ny hospital –weill cornell medical center

  Jan 1996 - Jan 1997

  Data entry clerk

  Verifications and COB , demographic data input, processing secondary claims.

• 

  Dewitt rehabilitation & nursing center inc

  Jan 1997 - Jan 2014

  Responsible for all Skilled Nursing facility(499 beds) billing including Medicare part A and Part B, Medicaid, HMO (Aetna, UNH, BCBS, Cigna, GHI, HIP, Evercare, Healthfirst, etc.), Commercial insurances, Workman’s Comp, No-Fault. Coordinated and provided training assistance to all billing staff. Performed daily collection actions, including contacting insurance companies, contacting sites, correcting and resubmitting claims. Participated in the implementation of new systems, updates regarding claim submissions, appeals, grievance procedures and policy changes.Medicare Part A Reimbursement Rate: 99.0%($9,600,000.00)Medicaid Reimbursement Rate: 97.5% ($31,200,000.00)HMO & Commercial Ins. Reimbursement Rate: 90.0% ($7,100,000.00)Hospice Reimbursement Rate: 100% ($960,000.00) Show less Performed tasks related to rebilling, voids, adjustments and corrections in order to lower the outstanding balances in A/R. Executed daily collection, insurance follow-ups, denials and rejections on a weekly basis, including insurance appeal process. Analyzed and resolved problematic billing issues. Utilized applications and websites to retrieve claims status, billing guidelines, authorizations to correct claim submissions.Collected $270,000.00 on back log Medicare Part A billing during year 2005Participated in implementation of billing system updates including testing, process changes and new instructionsProvided financial counseling for residents and familyNegotiated all-inclusive prices with insurance companies to get maximum reimbursement Show less Operated with different Medical Billing software: LTCS, Reliable, and Medical Manager. Posting all insurance payment (checks, cash, Medicaid, Medicare electronic uploads), handling patient’s NAMI journals and refund checks. Maintained patients accounts transactions (beauty care, laundry, newspaper, patient allowance, TV, etc.)Responded to requests from Medicare, Workman’s Comp and No-Fault for medical records.Reduced Medicaid outstanding balance for the year 1998 by $1.7 million Increased Medicare Part B billing to 100% ($180,000.00)Developed new policies and procedures in the workplace Show less

  • Billing Coordinator

    Jan 2005 - Jan 2014

  • A/R Analyst

    Jan 1999 - Jan 2005

  • Medical Biller

    Jan 1997 - Jan 1999
• 

  Nursing home managers

  Jun 1997 - Dec 2014

  Billing manager

  Medicare, Medicaid , HMO claims submission and follow up account activities that maximize insurance reimbursement. Investigate, analyze and resolve problematic billing issues. Participate in development new systems /procedures related to billing and assisted the staff with updates

• 

  H&r block

  Aug 2014 - now

  Senior tax analyst
• 

  Isabella geriatric center-700 beds

  Apr 2015 - Jul 2016

  Account receivable/billing coordinator

  Generated all Medicaid billings, charges and the posting of corresponding collections and adjustment to receivable and maintaining records. Prepared A/R reports, reconciled billing and transactions report to GL records. Followed up on denials and collection of old aging 2011-2015. Extensive knowledge in Census Coordinator and Cashier positions. Worked closely with Medicaid MLTC plans: VNS Choice, Guildnet, CCM, ICS, SHP as well as with FIDA Complete product. Made Appeals for old outstanding balances to Medicaid Managed Care plans. In charge of cash receipts postings (NAMI, PVT, Medicaid Manage Care remits). Show less

• 

  The phoenix rehablitation & nursing center

  Oct 2016 - now

  Medicaid/financial coordinator

  Assist the families who in needs for health coverage with available Medicaid program Determine eligibility to secure the Medicaid funded services.Order all the documents and follow up with the financial institutions proactively to obtain the statements for the Medicaid application/conversion.Prepare and submit through EDITS the Medicaid new application, conversion, recertification.File for the Fair Hearing and attend if necessary to get the Medicaid approval.Educate the family and the residents about the financial obligation and collect the institutional payments(NAMI) as well as Private Pay.Work closely with the Medicaid MLTC plans to update the new enrollment information (code N1/N6).Participate in the testemonies in the Court Hearing to appoint the Guardian for the residents.Apply for the Medicare benefits for the residents to secure the Medicaid benefits. Show less