DENISE LAVIN

• Developed tracking systems for mandatory licensure renewals, maintaining 100% compliance among medical personnel.
• Managed sensitive information with discretion, ensuring the confidentiality of patient records and employee files.
• Managed the reappointment process for medical staff members, ensuring continuity of care for patients.

Established a successful Optometry/Ophthalmology Consulting business. I assisted many offices from Long Island to Rhode Island in various task, including Billing, Credentialing, Clearinghouse set-up and Training staff. Long term and Short term projects.

• Expert in Insurance credentialing, Medicare, Medicaid and commerical payers.
• Expert in Trizetto Clearinghouse with a working knowledge of others. Clear understanding of scrubbing claims and payer enrollments.
• Expert in claims submission and electronic payments.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Utilized auto post options with Practice Management systems for quicker posting.
• Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
• Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
• Developed and maintained courteous and effective working relationships.
• Demonstrated strong organizational and time management skills while managing multiple projects.
• Adaptable and proficient in learning new concepts quickly and efficiently.
• Proved successful working within tight deadlines and a fast-paced environment.
• Learned and adapted quickly to new technology and software applications.

• Reviewed billing problems, researched issues and resolved concerns
• Trained and mentored staff on procedures, compliance requirements and collections techniques
• Worked with customers to develop payment plans and bring accounts current
• Created new standard operating procedures improving billing accuracy and cash flow
• Disbursed petty cash by recording entries and verifying documentation
• Interacted with customers professionally by phone, email or in-person to provide information and directed to desired staff members
• Helped employees with day-to-day work and complex problems by applying motivational and analytical strategies
• Established and developed highly efficient and dependable administrative team by delivering ongoing coaching and motivation and fostering career advancement
• Reviewed charts and flagged incomplete or inaccurate information
• Communicated effectively with staff, patients and insurance companies by email and telephone
• Enrolled providers and Medicaid, Medicare and private insurance plans
• Maintained CAQH for all providers
• Direct contact with CBO for all insurance problems
• Weekly scanning of insurance checks to bank then sending to CBO for posting
• Weekly cash deposits to Bank of America

• Processed payment via telephone and in person with focus on accuracy and efficiency
• Executed billing tasks and recorded information in company databases
• Accepted payments for services and discussed remaining balances with customers to take accounts to zero
• Used classification manuals to gain additional knowledge of disease and diagnoses processes
• Participated in initiation visits and investigator meetings, implementing trials in accordance with study timelines and budgets
• Screened patient records, databases and physician referrals to identify prospective candidates for research studies
• Followed informed consent processes and maintained records

• Organized paperwork such as charts and reports for office and patient needs
• Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing
• Completed skilled administrative work to support all office staff and operational requirements
• Adhered to strict HIPAA guidelines at all times to protect patient privacy
• Coordinated patient scheduling, check-in, check-out and payments for billing
• Completed clerical duties and tasks for clinic administration
• Scheduled, rescheduled and handled cancelled appointments for patients
• Kept waiting room neat and organized at all times by stacking magazines, removing trash and overseeing Coffee Bar
• Checked patient data including insurance, demographic and health history to keep information current
• Promptly answered multi-line phone system and greeted callers enthusiastically
• Scheduled surgeries, managed pre-certifications and verified insurance coverage

• Provided instructional handouts, texts, audiovisual aids and other materials to facilitate learning
• Planned and documented programs of study meeting individual needs and abilities of students
• Instructed Adults students in Medical Assistant principles, concepts and in-depth subject matter
• Hands on training including EKG, Phlebotomy, Blood pressures

• Worked with healthcare employees to determine specific job qualifications
• Scheduled interviews with other healthcare professionals
• Completed human resource operational requirements by scheduling and assigning employees
• Maintained work structure by updating job requirements and job descriptions for all positions
• Source candidates from Monster.com
• Cold called into Hospitals & Healthcare offices for potential new business