DIANA GARCIA
Mount Sinai Health System
Bronx,N.Y.
1
Language
32
years of professional experience
Emergency Medicine Supervisor who leads team members to complete jobs on-time. Assigns tasks, trains employees, and implements company procedures. Excellent communication and listening skills. Provides leadership and vision, driving teams to meet goals. Extensive experience in Health Information management and billing.
Work History
Supervisor III Emergency Medicine Facility Billing
3 Years 6 Months- Ensure accurate charge capture, claim submission, payment processing, denial management, and reimbursement for emergency services provided to patients.
- Supervise daily billing activities for Emergency Department facility services.
- Review and correct edits on EPIC Workqueues for MSH, MSQ, MSB, South Nassau and Express Care locations.
- Communicate with Zotec coding company any coding errors/discrepancies and missing charges.
- Inform ED providers of missing provider documentation and update accounts on RFI.
- Evaluated staff performance, identifying improvement areas and developing tailored professional development plans.
- Established team priorities, maintained schedules and monitored performance.
- Facilitated team communication through regular meetings and promoted open dialogue, fostering a collaborative work environment.
- Collaborated with other departments to achieve organizational goals, fostering teamwork across various functions.
- Covered shifts for employees on paid time off, ensuring continuous service delivery.
- Oversaw payroll processing for employees in Timekeep, ensuring timely and accurate compensation.
Senior Billing Specialist
3 Years 5 Months- Review and process Emergency Department hospital accounts to ensure accurate billing for services provided by the facility.
- Prepare, validate and submit claims to Medicare, Medicaid, and commercial insurers within required filing deadlines.
- Investigated claim rejections, billing edits, missing information, charge discrepancies, and account errors to ensure prompt resolution.
- Send deficiencies in EPIC to ED providers to update charts with missing provider documentation.
- Monitored unpaid claims and reviewed aging reports to resolve outstanding accounts, enhancing collection efficiency.
- Informed coding company about coding errors and missing charges to facilitate corrections.
- Researched and resolved billing discrepancies to enable accurate billing.
- Resolved denied claims by reviewing coding, documentation, and payer requirements.
- Worked with multiple departments to check proper billing information.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
Senior Billing Coordinator
2 Years 10 Months- Conducted a thorough review of patient electronic medical records in the emergency room to ensure completeness.
- Notified medical providers of deficiencies in electronic medical record documentation to ensure compliance.
- Informed medical providers about deficiencies in electronic medical record documentation.
- Obtained the proper documentation for all procedures performed in the emergency room.
- Updated GoRecon weekly to maintain accurate records.
- E-mailed providers daily regarding deficiencies to expedite resolution and support timely billing processes.
- Updated Go Reco weekly to maintain system integrity.
- Communicated regularly with the Billing Manager regarding task progress and responsibilities.
Medical Records Representative
5 Years 7 Months- Assembled charts of discharged patients.
- Responsible for assembling charts of discharged patients.
- Assisted patients and authorized individuals with medical record requests to facilitate timely access to information.
- Welcomed visitors to the department with a friendly demeanor.
- Maintained a pleasant and helpful demeanor while assisting patients.
- Responded to telephone inquiries promptly and with courtesy.
- Collected specialized data for chart completion.
- Supported physicians and house staff with patient care activities.
- Answer telephone promptly and courteously.
- Maintained accurate log of medical information requests to support efficient tracking and retrieval.
Patient Account Representative
8 Years 6 Months- Followed up on inpatient and outpatient claims to ensure timely resolution.
- Follow up on Inpatient and Outpatient claims.
- Ensured timely adjudication of all claims, minimizing delays in payment.
- Prepare appeal requests for all denials received.
- Respond to patient and insurance inquiries in a timely manner.
- Prepared appeal requests for denied claims to facilitate reconsideration.
Administrative Service Associate
4 Years 9 Months- Managed various medical insurance plans (HMO's, PPO's, and Medicaid) to ensure optimal patient coverage.
- Performed ICD-9 coding, verified insurance eligibility, and filed medical claims to facilitate timely reimbursement.
- Collected insurance co-payments from patients at the front desk.
- Intake and discharging patients.
Unit Secretary
1 Year 4 Months- Facilitated patient intake for nursing unit, ensuring timely admission process.
- Organized medical charts for easy access by healthcare staff.
- Completed lab and x-ray requisition orders, supporting efficient diagnostic processes.
- Transcribing doctor's orders.
- Organize necessary documentation for patient discharge.
Education
Bachelor of Science - Nursing
- Minor study in Health Services Administration and Psychology
- Coursework included Information Management and Behavioral Science.
- Member of Student Union.
- Member of Spanish Club.
- Dean's List
- Honor Roll
Skills
Hospital billing knowledge
Software proficiency
Workflow management
Payroll processing
Multitasking
Training and mentoring
Time management
Attention to detail
Performance Management
Billing Compliance
Teamwork
Scheduling coordination
Work Planning and Prioritization
Work planning
Professional and courteous
LANGUAGES
Fluent in Spanish.
Timeline
Supervisor III Emergency Medicine Facility Billing
Mount Sinai Health System
04.2023 - CurrentRead More
Senior Billing Specialist
Mount Sinai Health System
11.2019 - 04.2023Read More
Senior Billing Coordinator
Mount Sinai Health System
01.2017 - 11.2019Read More
Medical Records Representative
Lenox Hill Hospital
05.2011 - 12.2016Read More
Patient Account Representative
Lenox Hill Hospital
11.2002 - 05.2011Read More
Administrative Service Associate
Lenox Hill Hospital Children's Center
02.1998 - 11.2002Read More
Unit Secretary
Our Lady of Mercy Medical Center
02.1995 - 06.1996Read More
Lehman College
Bachelor of Science from Nursing
Read More