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JESSICA MELENDEZ
Douglasville,GA
Work Preference
Summary
Detail-oriented Senior Patient Account Representative with expertise in medical billing and revenue cycle operations. Proficient in insurance verification, coding, and resolving claim issues, facilitating timely payments. Demonstrates a strong commitment to patient care through effective communication and adherence to compliance standards.
Overview
35
35
years of professional experience
Work History
Senior Patient Account Representative
Northwell Health
Lake Success, New York
01.2015 - Current
- Verify insurance eligibility benefits and obtain required authorizations prior to scheduling to prevent treatment delays and ensure accurate reimbursement.
- Research, analyze, and resolve denied or rejected claims, identifying root causes and implementing appropriate corrections to facilitate timely payment.
- Reviewed and validated provider charges for accurate dates of service, CPT/procedure codes, modifiers, location, diagnoses, and provider signature, minimizing billing rework and preventing errors.
- Collaborated with clinical, coding, scheduling, and accounting teams to investigate and resolve complex account issues, enhancing workflow and accelerating account resolution.
- Provided patient-centered customer service by responding to billing inquiries and clearly explaining insurance benefits, patient balances, and account activity.
- Maintain strict adherence to HIPPA privacy and confidentiality standards while handling sensitive patient, financial, and insurance information.
Buyer
Nycomed US
Melville, New York
04.1996 - 11.2010
- Negotiated and managed vendor contracts total approximately $5M, sourcing suppliers to meet production schedules and cost targets.
- Procured operating materials and managed purchase orders from creating through closeout; resolved invoice and billing discrepancies with accounting.
- Coordinated with Planning to ensure on-time material delivery and updated stakeholders on project status.
- Conducted supplier analysis, managed defective or surplus material disposition, and attended trade shows to identify and evaluate new products and suppliers.
- Supported Regulatory Affairs with FDA filing documentation and collaborated with IT to implement SAP improvements, enhancing procurement workflows.
Cashier/Customer Service/Bookkeeper
Pathmark Incorporated
Brentwood, New York
01.1992 - 01.2000
- Resolved daily customer service matters and addressed concerns to enhance customer satisfaction.
- Managed secure handling of cash and financial transactions while supporting financial recordkeeping and reporting.
- Assisted store staff and management with administrative tasks while maintaining accurate cash ledgers and transaction records.
Education
COMPLETED COURSE-WORK TOWARD MEDICAL BILLIING/ CODING -
Branford Hall
Bohemia, NY06-2012
COMPLETED COURSE-WORK TOWARD EXECUTIVE ASSITANTE CERTIFICATE -
Katherine Gibbs School of Business
Melville, NY07-1995
Skills
- ICD-9 and ICD-10 coding
- CPT coding
- DME and HCPCS coding
- Commercial and no-fault insurance
- NYS workers’ compensation
- HIPAA compliance
- Medical terminology expertise
- Patient data management
- Soarian and Epic systems
- EMR and GE Centricity Business knowledge
- Touchwork and Allscripts
- Athena software skills
Timeline
Senior Patient Account Representative
Northwell Health
01.2015 - Current
Buyer
Nycomed US
04.1996 - 11.2010
Cashier/Customer Service/Bookkeeper
Pathmark Incorporated
01.1992 - 01.2000
COMPLETED COURSE-WORK TOWARD MEDICAL BILLIING/ CODING -
Branford Hall
COMPLETED COURSE-WORK TOWARD EXECUTIVE ASSITANTE CERTIFICATE -
Katherine Gibbs School of Business