DONNA MARIE ENNIS ANDERSON
Brooklyn,NY
Summary
Excellent ,experienced and organizational financial coordinator with 14 years in dealing with detail's verifying insurance benefits, Authorizations, and coordinating financial plans for patients. Financial skills oriented and resourcefulness in completing projects; and multi-task skills which can be utilized effectively. Committed to superior customer service and patient relations. Known for taking on additional responsibilities with poise and grace. Confident and poised in interactions with individuals at all levels.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Financial Coordinator
Mount Sinai Hospital
01.2009 - Current
- Consult in questions over phone and in-person regarding billing, scheduling and treatment by counseling patients with limited coverage, potential out of pocket liability and provide necessary options to lower down financial stress.
- Monitor closely with all payers and representatives to ensure billing format is updated and claims are submitted in timely manner per protocols.
- Correspond with various carriers daily when claim has been denied and respond to CBO (Central Billing Office Team) about my findings on denial.
- Secure Outer Network Authorizations for non-par insurance carriers and negotiate with Hospital Finance Team on Single Case Agreements.
- Execute High Volume Prior Approvals and Partnered with Case Managers for Pre, and Post Kidney, Pre and Post Liver, Pediatric, Living Donor ,and Adult Liver Disease Programs, making sure Authorizations are approved for Surgeries, Ambulatory procedures and Radiology scans.
- Inform Clinical Team patient procedure or scan may be cancelled or rescheduled due to Financial issues.
- Explain correct CPT Codes and Diagnosis Codes are being used to avoid any claim delays, rejection or denials.
- Set Up and prepare 15 to 20 Peer to Peer, Appeals and Denials and managed all first level denials.
- Develop and track patient authorizations, informing clinical team of any expired dates.
- Fax clinical medical documentation to insurance carriers.
- Organize documents and data to give accurate presentations and forecasts to case management.
- Successful In verifying eligibility, benefits, referrals and scripts for upcoming appointments via web portals and phone.
- Prepare updated demographics and insurance policies in Epic and Cerner when patient coverage has lapsed.
- Implement New procedures to reduce denials for department.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager
- Motivate, Trained and Coach New Staff members.
Medical Administrative Assistant
Advanced Radiology Imaging
06.2001 - 12.2009
- Supported all front-office activities to optimize facility workflows and patient management and provide comprehensive administrative support to clinic and office managers, including appointment management, billing and collections, office administration, and customer service.
- Accurately scheduled 75 appointments daily for procedures such as X-rays, CT Scans, MRI, Mammography, Nuclear Medicine, and PET Scans.
- Improved patient satisfaction by ensuring efficient and timely check-in and check-out processes .
- Implemented new system for tracking patient appointments resulting in 15% decrease in patient no-shows.
- Greeted and Provided attention to patients in manner that fostered confidence, trust, respect and loyalty.
- Streamlined registration and insurance verification of incoming and outgoing patients, and collection of co-payments from patients for office visits and medical procedures.
- Explained insurance benefits, fees and procedures to patients and outer pocket expenses.
- Scheduled tests, procedures and lab appointments for patients.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Obtained Prior Approval for minor surgeries, procedures and specialty radiological scans for radiologists and physicians.
- Assisted with billing tasks and medical coding procedures to avoid any potential claim denials.
- Maintained and updated patient records for accurate, current medical histories
- Provided backup to front desk to step in to assist with various tasks whenever employee was absent or at lunch
- Trained new and existing front desk staff on office procedures and policies resulting decrease in errors.
Education
Communication Studies
York College of The City University of New York
Jamaica, NYSkills
- Telephone Etiquette
- Data Entry
- Verbal and Written Communication
- Benefits Explanations
- Knowledge of third party payer rules and regulations
- Diagnostic IC10 and CPT Codes
- Medical Terminology
- Coordinate Training
- Status Updates
- Microsoft Word/Excel
- Microsoft Outlook
- Epic
- Cerner and HDX
- Eagle
Certification
Mandl School of Allied Health (Medical Assistant)
Allan School of Allied Health (Nursing Assistant)
Healthcare Network (CPC Certificate= Pending) Fort Lee, New Jersey
Timeline
Financial Coordinator
Mount Sinai Hospital
01.2009 - Current
Medical Administrative Assistant
Advanced Radiology Imaging
06.2001 - 12.2009
Communication Studies
York College of The City University of New York
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