Herta Cherfils
North Miami Beach,FL
Summary
Motivated Social Worker with comprehensive knowledge of social justice issues and systems affecting marginalized communities. Passionate about developing and facilitating programs to support communities in need. Collaborative and analytical advocate builds strategic partnerships, advocate for clients and advance change for communities in need.
Overview
16
16
years of professional experience
Work History
Medical resolution & denial representative
Mount Sinai Medical Center
11.2022 - Current
- Conduct a thorough analysis of data pertaining to claims and denials to identify patterns and develop effective strategies for reducing future denials
- Investigate and resolve claim denials by insurance companies, working diligently to overturn the denial and secure proper reimbursement
- Generate comprehensive reports on claim denial trends, resolution outcomes, and reimbursement trends to identify areas for improvement
- Maintain accurate and organized records of claims, denials, appeals, and correspondence to ensure efficient and effective management of the claims process
- Document all actions taken to resolve claims and discrepancies, ensuring that all relevant information is recorded and easily accessible
- Contact insurance companies on a daily basis to follow up on claims resolutions and ensure that claims are processed in accordance with denial unit policies and procedures
- Provide all requested information to insurance companies in a timely manner and appeal all denied claims within the re-filing limit
- Review denied/rejected claims and re-bill as needed on a daily basis, ensuring that all requested corrections are made and sent to the insurance carrier
Clinical Social work intern
Active Community Health Center
02.2022 - 05.2023
- Population focus: Serve Children (Adolescents to teenagers) Individuals and families, disabled
- Managed caseloads of up to 6 families, providing weekly therapy services to adolescents and teenagers the age of 7 and 17, in a variety of settings (school/home/community/center) utilizing evidenced-based and research-informed therapeutic interventions to ensure the highest quality of care for my clients
- Deliver psycho-educational therapy with a specific emphasis on enhancing social-emotional and life skill development
- Incorporate the Transtheoretical model of change and Cultural-Relational theory, while taking into account any potential history of trauma and capitalizing on the individual's strengths
- Conducted risk assessments and managed any potential dangers with the utmost professionalism and discretion during times of crisis
- Provided clinical assessments, diagnosis and proposed treatment plans for students with emotional or behavioral needs
- Attended and participated in meetings, seminars and professional behavioral health trainings
- Facilitated conflict resolution groups and special topic groups among students identified as being in need of support such as social skills, anxiety, depression, substance use, anger management, grief/divorce, etc
- Maintained a variety of documentation, such as clinical notes, behavior/emotional progress, treatment goals progress reports
- Conducted assessments where an individualized treatment plan was developed specifically to address children’s trauma symptoms, improve their at-risk status, coping skills, and parent/child interactions.
Social work Intern
Evoke Wellness
01.2022 - 02.2022
- Population focus: Substance abuse/addictions
- Responsible for timely completion of assessments, development of treatment plans, signing of consent forms, and ongoing progress notes for clients
- Participated in team meetings with psychiatrists to decide on individualized plans for each client
- Facilitated substance abuse and mental health groups to help clients learn coping skills, manage emotions, and communicate effectively
- Acted as an advocate for clients regarding their clinical status and treatment options, helping them make informed decisions
- Provided support, encouragement, and accountability to residents in their daily activities to help them fulfill their plans
- Supervised residents, maintained order, and exercised appropriate judgment during meal times, on the residential floor, in common areas, during recreation, and during escorts
- Monitored assigned caseload participation in activities/groups by checking in with other counselors, reading group documentation notes, and checking in with assigned clients
- Maintained a variety of documentation, such as clinical notes, behavior/emotional progress, and treatment goals progress reports.
Case manager
Florida Resource Center of South Florida
12.2021 - 08.2022
- Population of focus: Serve Children (Infant, adolescents, teens) Individuals and families
- Manage caseloads of up to 11 families, ensuring safety, permanency, and wellbeing of children and youth on caseload
- Prepare judicial reviews, case plans, home studies, and other court reports to ensure compliance with agency policies and procedures
- Regularly contact each client and evaluate progress towards case goals, providing a wide range of case management and support services
- Supervise visits between parents and children, coordinating the services needed for children, family, foster parents, and other caregivers
- Attend and testify at court hearings, case reviews, and multidisciplinary staffing to provide updates on case progress
- Assess the safety and accessibility of individuals' homes, identifying potential hazards, and recommending modifications or resources to ensure a safe living environment
- Complete referrals to clinical departments to ensure children and/or parents have been linked with services
- Ensure timely completion of case notes, file documentation, and required paperwork per agency policy
- Assess when a child must be removed from a maltreating parent, non-maltreating parents in a separate household using parent home assessment
- Develop and manage safety plans for each case in response to present or impending danger, ensuring safety plans are in effect if a case remains open and parent(s)/legal guardian(s) do not have sufficient protective capacity to protect the child from out-of-control conditions in the home that would otherwise qualify as danger threats
- Monitor quality of care by conducting face-to-face home/residential visits of the child every 30 days
- Provide testimony in court and recommend service continuation or reunification of children in care
- Work closely with lawyers, child advocates, juvenile probation officers, and families to ensure continuum of services.
Medical Collections Representative
Mount Sinai Medical Center
09.2018 - 09.2021
- Exhibit a proactive approach in following up on outstanding insurance claims, working closely with insurance companies to resolve any discrepancies or denials in a timely and efficient manner
- Provide management with regular reports on the status of accounts receivable, outstanding balances, and collections efforts, reflecting the highest standards of accuracy and precision
- Maintain meticulous and up-to-date records of patient accounts, billing activities, and collections efforts, reflecting a commitment to excellence and professionalism
- Thoroughly document all communication and correspondence with patients, insurance companies, and other relevant parties, ensuring that every detail is captured with the utmost care and attention
- Exhibit a keen eye for detail in investigating and resolving billing discrepancies, denials, and other issues that may hinder timely payment, ensuring that every issue is addressed with the highest level of expertise and professionalism
- Provide exceptional customer service by addressing patient inquiries regarding their medical bills, providing clear and concise explanations and assistance as needed
- Collaborate seamlessly with other healthcare professionals, including billing and coding specialists, to ensure accurate billing and efficient collections processes, reflecting a commitment to teamwork and collaboration
- Continuously identify opportunities to improve billing and collections processes, streamline workflows, and enhance overall efficiency, reflecting a commitment to innovation and excellence.
Corporate collections specialist
HCA East Florida Ambulatory
06.2016 - 04.2018
- Generate and submit accurate claims for surgical procedures to insurance companies and other third-party payers
- Diligently document all communication and correspondence with esteemed patients, insurance companies, and other relevant parties, ensuring that every detail is captured with the utmost care and attention
- Ensure that all necessary billing information, including CPT and ICD codes, modifiers, and patient demographics, are correctly entered
- Monitor and track the status of submitted claims to identify any denials, rejections, or delays in payment
- Investigate and resolve claim discrepancies or issues, including resubmitting claims when necessary
- Prepare and submit appeals for denied or underpaid claims, providing necessary documentation and supporting information
- Interface with insurance companies to resolve disputes and discrepancies in reimbursement
- Generate and analyze reports related to revenue cycle performance, including aging reports and collections metrics.
Business Office Coordinator
Surgery Center of Aventura
12.2015 - 05.2016
- Responsible for oversight of medical record maintenance to ensure timely dispensation of completed charts, accuracy, completeness, and compliance with federal and state rules and regulations
- Resolve administrative issues, patient complaints, and operational challenges as they arise
- Address patient inquiries, concerns, and requests professionally and courteously
- Collaborate with healthcare providers, nurses, and other staff members to optimize the patient experience and office operations
- Oversees on-site business office personnel in the areas of insurance verification, compliance, scheduling of surgical procedures, and transcription of operative procedures in accordance with facility policies, procedures, philosophy, and objectives
- Communicate important information to patients, such as appointment reminders, follow-up instructions, and test results as directed by healthcare providers
- Patient access medical registrar
Aventura Medical Center
09.2007 - 11.2015
- Educate patients on financial responsibility and potential solutions
- Obtain, verify and update all patient demographic and regulatory data, utilizing a variety of tools, software and websites
- Schedule patient appointments to ensure smooth patient flow and business operations
- Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment
- Interview patients at workstation or at bedside to obtain all necessary account information
- Provide exemplary customer Service
- Understand/explain policies regarding services, pricing, insurance billing, and payment of account
- Provide patient and family centered care to patients, families, visitors and internal customers
- Communicate with physician's and their staff, nursing unit staff, and/or other appropriate personnel to exchange necessary information
- Coordinate patient transfers/admissions with admitting Nurses and appropriate physicians
- Collect all co-pays, deductibles and self-pay and provide receipts
Education
Masters of Social Work - Advance Trauma
Barry University
Miami Shores, FL05.2023
Bachelors of Science - Social Work
Florida International University
Doral, FL08.2021
Associate of Arts - Social Work
Broward College
Pembroke Pines, FL05.2018
Associate of Science - Medical Assisting
Brown Mackie College
Miami, FL08.2010
Skills
- Therapeutic Services
- Child Welfare and Protective Services
- Case Management
- Conflict Resolution
- Analytical Thinking
- Attention to Detail
- Patient-Centered Care
- Strengths-Based Solution-Focused Therapy
- Family Maintenance
- Confidential Case Documentation
- Client Coping Mechanisms
- Community Resource Development
- Relationship Issues Management
Languages
Haitian Creole
Native or Bilingual
English
Full Professional
Timeline
Medical resolution & denial representative
Mount Sinai Medical Center
11.2022 - Current
Clinical Social work intern
Active Community Health Center
02.2022 - 05.2023
Social work Intern
Evoke Wellness
01.2022 - 02.2022
Case manager
Florida Resource Center of South Florida
12.2021 - 08.2022
Medical Collections Representative
Mount Sinai Medical Center
09.2018 - 09.2021
Corporate collections specialist
HCA East Florida Ambulatory
06.2016 - 04.2018
Business Office Coordinator
Surgery Center of Aventura
12.2015 - 05.2016
Aventura Medical Center
09.2007 - 11.2015
Masters of Social Work - Advance Trauma
Barry University
Bachelors of Science - Social Work
Florida International University
Associate of Arts - Social Work
Broward College
Associate of Science - Medical Assisting
Brown Mackie College
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