Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
Generic

Amancia Mieses

Bronx,NY

Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

22
22
years of professional experience
1
1
Certification

Work History

Denial Analyst

Acacia Network
10.2023 - Current
  • Developed awareness of and familiarity with denial reasons, services, and payers affecting Acacia Network finances and apply knowledge to evaluation, analysis, and interpretation of data
  • Maintained denial databases and conducting strategic analysis to include monthly, quarterly, annual and ad-hoc reports.
  • Preformed ADP Validate and input timesheets, hours worked, bonuses, and other compensation.
  • Identify and examine the root causes of denials, and work with other departments in Revenue Cycle and beyond to improve operations.
  • Organizes and supervises staff to work in accordance with operating protocols to achieve maximized efficiency.

Administrative Supervisor

Montefiore Medical Center
10.2022 - 03.2023
  • Supervised Medical Billers productivity which includes timely billing/rebilling, collections, filing reimbursement paperwork, liaising with insurance providers, correction and follow-up of claims
  • Reviewed A/R monthly and monitored high dollar accounts, underpaid and denied claims
  • Interacted with insurance carriers regarding commercial carrier issues
  • Processed payroll, weekly quality reviews and key performance in Kronos

Billing Coordinator

East Harlem Council for Human Services, Inc.
04.2021 - 10.2022
  • Reconciled all visits generated to billing and revenue reports, including visits by uninsured patients
  • Oversee the billing functions including timely submission, review denied billing, rebilling, posting payment
  • Prepare weekly and monthly billing and AR reports and analysis Patients AR to identify and collect on unpaid accounts.
  • Supervised employees in the Billing/Data Processing Department

Senior Billing Representative

NYU Langone Medical Center
09.2017 - 04.2021
  • Followed up /Payment Analysis with/for governmental and Third-Party carriers
  • Followed appeals carrier denial though reviews of coding, contracts and medical records
  • Performed daily task is assigned work-queues, entering account notes using EPIC formatting
  • Reviewed Report to identify revenue opportunity on unpaid claims and trends provider credentials issues
  • Reviewed the schedule for providers to identify out of network/self-pay patients and patients requiring referrals
  • Payment posting

Medical Biller

Urban Health Plan, Medical Center
11.2010 - 09.2017
  • Performed insurance verification, pre-certification, and pre-authorization
  • Performed a variety of tasks including pre claim submission, charge entry, assisting patients with billing issues for the Department of Radiology
  • Performed data analysis to identify root causes for denials, overpayments, underpayments in order to expedite cash flow, maximize reimbursement, efficiently lower A/R, and speed up the revenue cycle through claim submission software Emdeon, Claim Remedy.

Billing Housing Coordinator

Comunilife Inc. HIV Program
06.2008 - 11.2010
  • Assisted manager / supervisor and team with care coordination activities and tasks with the clients
  • Accounts Payable/Receivable in accordance with police and procedure
  • Made appropriate referrals to the Customer Care team to support benefit, billing / payment and eligibility of our members Outreach calls to our members / beneficiaries' post facility discharge Arranging post-discharge appointments, transportation, and transition of our members across the continuum of care
  • Supported the enrolled members / beneficiaries of our community partners.

Pre-School Administrative Coordinator

Cardenal McCloskey Family Day Care
01.2004 - 01.2008
  • Reviewed applications for completeness and accuracy with the care center.
  • Determined if applicants meet the eligibility requirements in the Day Care Center and payment processed.
  • Decided whether to admit, reject, or waitlist applicants for the Care center and ACS.
  • Prepared the file for the student.
  • Reviewed the provider license file and the determination to assign the instance. Communicating with the parent Reference Meet with prospective Child, Provide information about the admissions process and documentation.

Education

Degree in Accounting -

01.2003

Skills

  • Microsoft office
  • Analytical thinking
  • MS Excel
  • Time management

Certification

  • Evaluation Management Billing Medical
  • ICD-10-CM Certificate course for AAPC
  • Medical Assisting & Administrative
  • Clerk Certificate Medical Office Assistant Certificate Evaluation Management Billing Medical
  • Revenue Cycle Certificate
  • Leadership and Supervisor Certificate
  • Epic-RCO 203-Processing Denials Certificate.
  • Payment Variance Identification and resolution (Medicaid)Certificate
  • A/R Transactions and Explanation and Benefit Certificate
  • Business and Management and organization Certificate
  • Root Cause Analysis to Drive Improvement (Medicaid) Certificate
  • Epic, ECW, Nextgen CCI Edit, IDX, Webprice Billing System.
  • Payroll Kronos and EZ time Certificate
  • FMLA Training

Languages

English
Full Professional
Spanish
Native or Bilingual

Timeline

Denial Analyst

Acacia Network
10.2023 - Current

Administrative Supervisor

Montefiore Medical Center
10.2022 - 03.2023

Billing Coordinator

East Harlem Council for Human Services, Inc.
04.2021 - 10.2022

Senior Billing Representative

NYU Langone Medical Center
09.2017 - 04.2021

Medical Biller

Urban Health Plan, Medical Center
11.2010 - 09.2017

Billing Housing Coordinator

Comunilife Inc. HIV Program
06.2008 - 11.2010

Pre-School Administrative Coordinator

Cardenal McCloskey Family Day Care
01.2004 - 01.2008

Degree in Accounting -

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Amancia Mieses