DENISE E. Garcia
3114 78th Stl East Elmhurst,NY
Summary
Diligent Insurance Coordinator with robust background in insurance verification and coordination. Proven track record of streamlining verification processes and ensuring compliance with industry standards. Demonstrated expertise in problem-solving and effective communication.
Overview
26
26
years of professional experience
Work History
3rd Party Credit Collection Coordinator
Visiting Nurse Service of NY Homecare
08.2004 - Current
- Acts as primary liaison/contact between VNS Health and assigned insurance provider(s) to obtain payment, authorizations/verifications
- Obtains and compiles necessary information for insurance verification and authorization processing
- Researches and resolves issues such as missing information
- Confirms insurance verifications and eligibility of patient
- Escalates clinical questions/issues to appropriate clinician as necessary
- Follows established guidelines to communicate type and frequency of initial authorization request; submits authorization requests to payers and tracks benefit limits
- Request reconsideration from insurance provider on authorization visit reductions or authorization denials by using information from browser and clinical systems
- Escalates cases as needed
- Updates insurance setup within VNS Health Systems; validates and enters authorizations
- Documents activities and communications and enters information into payer systems
- Reviews unbilled/billed lists to identify and resolve issues which prevent services from billing
- Completed bi-weekly payroll for [Number] employees.
Bill Processor
Visiting Nurse Service of NY
06.1999 - Current
- Performs all functions necessary for the completion of computer-generated and manually prepared billing
- Sets up and maintains patient billing records
- Documents all billing activities and communications
- Prepare transmittals and cover letters to accompany billing
- Researches and processes denials, including insurance verification in a timely manner
- Performs timely follow up and resolves billing problems as necessary
- Reconciles data input with appropriate documents
- Prepares reports
- Completes, batches and forwards data entry documents
- Performs related duties as required
Education
Pre/Nursing and Liberal Arts -
Long Island University
Brooklyn, NY05.1998
Junior Accounting -
LaGuardia Community College
LIC, NY08.1994
Skills
- EPACES
- NGSCONNEX
- WAYSTAR
- INSTAMED
- EXCEL
- WORD
- Data entry proficiency
- Multitasking proficiency
- Continuous improvement
Timeline
3rd Party Credit Collection Coordinator
Visiting Nurse Service of NY Homecare
08.2004 - Current
Bill Processor
Visiting Nurse Service of NY
06.1999 - Current
Junior Accounting -
LaGuardia Community College
Pre/Nursing and Liberal Arts -
Long Island University
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