Debbie Navarro
Bergenfield,NJ
Summary
Versatile and results-oriented Assistant Director Revenue Cycle Management/Medical Billing Specialist with years of diverse experience, knowledgeable in all aspects of business functions, and with a solid background in the healthcare industry. Recognized for professionalism, positive mental attitude, commitment to excellence, and demonstrated ability to communicate and interact effectively with management and staff.
Overview
15
15
years of professional experience
Work History
ASSISTANT DIRECTOR OF REVENUE CYCLE MANAGEMENT
SPARK LABS
08.2022 - Current
- Submit claims to No-Fault and Worker's Compensation insurances.
- Appeal claims for non-payment, or low reimbursement.
- Send appeals to arbitration to 25 law offices.
- Prepare month-end closing journal entries, reports, and balance sheet account reconciliations.
- Produce accurate financial reports, financial statements, and project management details.
- Develop, implement, and oversee procedures for the review, appeal, and resubmission of all claim denials.
- Compile requested statistical, financial, billing or auditing reports.
CUSTOMER SERVICE REPRESENTATIVE
MOLINA HEALTHCARE
03.2021 - 08.2022
- Provided outstanding customer service, data entry.
- Diligently assisted members with medical supplies, transportation inquiries, home care services, and provider directory.
- Educated members with eligibility and benefits.
- Handled complex problems and work along with members to ensure all discrepancies were resolved, and escalated calls appropriately.
- Filed grievances and appeals.
- Identified issues with current process and notified management of potential concerns and potential solutions.
- Completed fax assignments in a timely manner.
- Participated in meetings related to the efficiency performance.
- Assisted providers with authorizations for device medical equipment and home care services.
MEDICAL BILLING & COLLECTION SPECIALIST/ AR
PROGRESSIVE SPINE & ORTHOPAEDICS, LLC
05.2018 - 09.2020
- Performed daily financial transactions such as verifying, classifying, computing, posting, and recording, accounts receivables's data.
- Reconciled the accounts receivable ledger to ensure that all payments were accounted for and properly posted.
- Data entry, preparing invoices, sending bill reminders to patients, filing paperwork, and contacting patients to discuss their outstanding balance.
- Analyzed patient's encounter forms to validate accuracy, completeness, and specificity of claims.
- Forwarded outstanding balances to the attorneys and collection agencies for further legal action.
- Completed and submitted appeals to Managed Care, No-Fault, and Worker's Compensation carriers.
PATIENT CARE COORDINATOR
ACES
07.2017 - 05.2018
- Answered high volume of calls.
- Registered patients and entered information including insurance, demographic, and health history into the system to ensure that all records were up to date.
- Verified insurance eligibility and benefits.
- Prepared prescription refill requests on behalf of the physicians and resolved any issues with patient medications.
FRONT DESK OFFICE MANAGER
CONTEMPORARY WOMEN'S HEALTH, PC
05.2014 - 11.2015
- Registered patients and verified insurance benefits.
- Obtained authorizations for office and hospital outpatient surgeries.
- Monitored budget and billing payments from patients and insurances.
- Assisted physician with office surgical procedures.
- Maintained membership in professional organizations.
- Renewed physician certifications and medical licenses.
SURGICAL COORDINATOR
SPINE CENTER AND ORTHOPEDIC REHABILITATION
06.2012 - 06.2013
- Submitted authorization requests for surgical procedures, ESI, and physical therapy.
- Appeals, peer to peer as necessary.
- Verified insurance eligibility and benefits.
- Responsible for surgery scheduling, facilities, and equipment.
- Assisted patients and addressed concerns before procedures.
MEDICAL BILLER/ PT ASSISTANT
PALISADES PHYSICAL THERAPY AND REHABILITATION
04.2009 - 10.2012
- Submitted claims to Medicare, Worker's Compensation and Managed Care.
- Posted payment to patient's accounts.
- Verified insurance benefits, obtained authorizations, and referrals.
- Resubmitted claims and appeals requested if needed.
- Patient Aging and Account Receivable Payroll and monthly billing reports.
- Guided patients in proper exercises, joint mobilization and electrical stimulation.
Education
MEDICAL BILLING & CODING -
LINCOLN TECHNICAL INSTITUTE
PARAMUS, NJ10.2008
Skills
- Bilingual (English/Spanish)
- ICD-10, CPT, & Medical Terminology
- Various Practice Management Software
- Claim Entry and Payment Posting
- Records Organization & Management
- Insurance and Patient Aging
- Online Claim Submission & ERA
- Communicative
- Multi-Tasker
- Detail Oriented
Timeline
ASSISTANT DIRECTOR OF REVENUE CYCLE MANAGEMENT
SPARK LABS
08.2022 - Current
CUSTOMER SERVICE REPRESENTATIVE
MOLINA HEALTHCARE
03.2021 - 08.2022
MEDICAL BILLING & COLLECTION SPECIALIST/ AR
PROGRESSIVE SPINE & ORTHOPAEDICS, LLC
05.2018 - 09.2020
PATIENT CARE COORDINATOR
ACES
07.2017 - 05.2018
FRONT DESK OFFICE MANAGER
CONTEMPORARY WOMEN'S HEALTH, PC
05.2014 - 11.2015
SURGICAL COORDINATOR
SPINE CENTER AND ORTHOPEDIC REHABILITATION
06.2012 - 06.2013
MEDICAL BILLER/ PT ASSISTANT
PALISADES PHYSICAL THERAPY AND REHABILITATION
04.2009 - 10.2012
MEDICAL BILLING & CODING -
LINCOLN TECHNICAL INSTITUTE
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