ANDREINA PENA
Haines City
Summary
Professional with strong expertise in medical billing, bringing reliable and adaptable approach to navigating evolving needs. Proven track record in team collaboration and achieving results through effective communication and problem-solving. Skilled in coding, claims processing, and patient account management, with keen eye for accuracy and compliance. Known for dependability and focus on efficiency, ready to contribute to streamlined billing operations.
Overview
12
12
years of professional experience
Work History
Insurance and Financial Coordinator
Weill Cornell Imaging at NYP
09.2020 - Current
- Ensure that patient demographic, insurance information, verification and eligibility have been established.
- Authenticate and commence authorization for diagnostic services.
- Acquire retro-authorization for urgent cases that were performed.
- Accountable for obtaining financial clearance.
- Record and convey any insurance discrepancies to patient, clinical staff and administrators.
Medical Biller
NYP-Columbia University Irving Medical Center
06.2018 - 08.2020
- Managed insurance verification and prior-authorizations.
- Maintained work operations by following policies and procedures; reporting compliance issues.
- Resolve all billing inquiries patients have.
- Obtained all authorization for out-patient Biopsy procedures, and for any out of network services/office visits.
- Corrected registration errors on claims and complete registration process when necessary.
- Entered charges for all visits, reviewing the visit documentation and the encounter to ensure all charges are captured.
- Corrects hold bill edits and charge edits to ensure accurate and complete patient account information.
- Followed up on and located documentation and charges not checked off as being completed.
- Conducted an investigation of questionable charges. Made corrections or charge-backs as needed.
- Edit all charges prior to submitting to insurance company, appeal and modify any claims denied by the insurance company.
Insurance Coordinator
Gramercy Surgery Center
05.2016 - 06.2018
- Managed inquiries from patients, and verify commercial, Medicare, Medicaid, Worker's Comp, and no-fault insurance coverage efficiently and in a time-sensitive manner.
- Placed surgical supply orders, monitor inventory, and schedule/coordinate surgeries. Input all surgical procedures, and insurance verification into G-Time and AMKAI.
- Ensured all processes adhere to established policies and procedures.
- Verify insurance authorizations prior to surgeries, collaborating with billing department to ensure CPT and ICD-9/ICD-10 codes are billable, claims are submitted properly and patient invoices are paid in a timely manner.
- Liaise with the medical clearance department, to clear all patients prior to surgery.
Medical Secretary
NYP-Columbia University Irving Medical Center
07.2013 - 11.2015
- Oversaw all daily medical office functions to ensure efficiency and accuracy in all operations.
- Provided professional communication with patients, handling registrations and scheduling utilizing IDX, Crown, and EMR systems.
- Developed internal correspondence that facilitated effective communication with patients, and the transfer of information between offices and staff.
- Verified insurance payment options, and obtained prior authorizations for medical procedures, and any necessary prescriptions.
Education
High School Diploma -
Manhattan Hunter Science High School
06.2007
Skills
- Decision Making
- Critical thinking
- Problem Solving
- Adaptability
- Computer Skills
- Microsoft PowerPoint
- Effective Time Management
- Microsoft Excel
- Ability to Work Under Pressure
- Microsoft Office
- Customer Service
- Organizational Skills
- Communication
- Verbal and written communication
- Data entry
- Benefits explanation
- Invoice processing
- Payment collection
- Telephone etiquette
- Proficient in EPIC
- Financial planning
- Invoices and billing
- Financial document review
- Finance
DETAILS
- Haines City
- Florida
- 347-962-0558
- Andreina_pena16@yahoo.com
Languages
Spanish
Professional Working
Timeline
Insurance and Financial Coordinator
Weill Cornell Imaging at NYP
09.2020 - Current
Medical Biller
NYP-Columbia University Irving Medical Center
06.2018 - 08.2020
Insurance Coordinator
Gramercy Surgery Center
05.2016 - 06.2018
Medical Secretary
NYP-Columbia University Irving Medical Center
07.2013 - 11.2015
High School Diploma -
Manhattan Hunter Science High School
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