Danielle Yordan
Newburgh,NY
Overview
21
21
years of professional experience
Work History
Billing Specialist
EverCare
Newburgh, NY
03.2021 - Current
- I am the Billing Specialist for all 3 lines of business MLTC, CHAA and Adult Social Day Care.
- My work duties include but are not limited to billing and overseeing Multi Million Dollar Capitation claims for Orange, Dutchess and Rockland County for our MLTC.
- Managing and keeping track of all overpayment and compliance issues that require a refund to the state.
- Running aging reports, process and follow up on all denials as well as keep track and manage all retro enrollments and retro disenrollments.
- For the Adult Social Day Care I bill all claims for Orange And Dutchess County, create new patient accounts, attend weekly meetings, communicate on a regular basis with patient case workers, verify all authorizations are correct.
- In addition for our CHAA I participate in weekly meetings with our third party billing company to review aging reports and KPI reports for medicaid, medicare and commercial insurance carriers.
- I also took ownership of RCS Coordinator which requires communicating with our third party billing company and employees within our organization to ensure all requested information is obtained and forwarded to our billing company to ensure timely payment of claims.
Intake Coordinator & Medical Billing
Achievement Associates Center
Monroe, NY
04.2012 - 05.2019
- Remotely Managing and overseeing business operations for 4 satellite offices.
- Duties included but were not limited to: Create new client accounts, verify benefits and eligibility, obtain authorization for psycho therapy, schedule appointments, take messages for providers, oversee scheduling, blocking the schedule if a provider request off, reschedule appointments if a provider is out sick, communicate with the pharmacies and insurance carriers to ensure we obtain the proper prior authorization forms for medications, call in scripts, run eligibility reports weekly, update patient accounts if there is a new insurance, verify new insurance, if a patient has new insurance that the current provider is not inn network with inform their current provider and communicate with the patient to schedule an evaluation with a new inn network provider within the organization.
- Filing electronic ROI, progress notes and contacting pharmacies to confirm patients medications were approved by the insurance carrier.
Intake Coordinator & Medical Billing
Goshen, NY
04.2009 - 04.2012
- Duties include but are not limited to: answering heavy phone lines, new patient placement, obtain patient demographic information to create an account, verify benefits & eligibility and collate patient's physical chart; process all new patient denials & appeals.
- As a Medical Biller: charge entries, upload & submit electronic claims to clearing house, check submission report and correct all claims not successfully received & resubmit, post insurance payments, call on aging reports to ensure timely payments, address EOB's and appeals.
Business & Collections Administrator
Dolson Avenue Medical
Middletown, NY
11.2004 - 04.2009
- Duties include but are not limited to: review & analyze all incoming and outgoing medical insurance correspondence such as authorizations, scripts, pre-certifications and referrals.
- Oversee the reverification process of all new patients.
- Collect payments for the following provider organization: Middletown Physical Therapy & Pain Management, Childcare, Dolson Avenue Medical and Middletown Physical Therapy and Rehabilitation.
Timeline
Billing Specialist
EverCare
03.2021 - Current
Intake Coordinator & Medical Billing
Achievement Associates Center
04.2012 - 05.2019
Intake Coordinator & Medical Billing
04.2009 - 04.2012
Business & Collections Administrator
Dolson Avenue Medical
11.2004 - 04.2009