Joseline Nunez
Eatontown,NJ
Summary
A bilingual business professional with excellent written, verbal, and interpersonal skills. Detail-oriented and a self-motivator who takes initiative and gets the job done. An avid learner who possesses the ability to handle multiple tasks in a fast-paced environment. Dedicated to incorporating company values and expectations into practical daily operations.
Overview
11
11
years of professional experience
Work History
Billing Manager
Atlantic Eye Physicians,LLC
2024.01 - Current
- Responsible for overseeing the entire billing and collections process, including Credentialing of providers to ensure timeliness and accuracy of submission of claims
- Manage a team of billing specialists, providing necessary guidance and support
- Develop and implement billing policies and procedures to enhance efficiency and accuracy
- Monitor accounts receivable and coordinate with clients to resolve any payment issues
- Collaborate with other departments to ensure alignment of billing and collections success
- Prepare regular reports and analyze billing and collections performance
- Ensure compliance with all relevant laws, regulations, and industry best practices related to billing and collections
- Negotiating insurance contracts.
Surgical Coding Manager
Prism Vision Group
2020.10 - 2024.01
- Managed a team of 6 employees, 3 Surgical Coders & 3 Copay Assistance Staff members
- Monitored daily collections of eligible claims for reimbursement from applicable drug copay assistance program
- Team also observed enrollment status of patients to ensure constant revenue of Copay programs
- Worked alongside A/R team to ensure clean claim drop to ensure next cycle for copay reimbursement collection
- Conducted encounter, CPT, and diagnosis analysis, compared to current coding and payer guidelines, to achieve maximum reimbursement of billed charges, the decrease of denials through root cause analysis and provider education
- Analyzed patient medical records to identify and determine amount and nature of billable services; assigned and sequenced appropriate diagnostic/procedure billing codes in compliance with coding and billing requirements
- Interacted with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations to ensure receipt and analysis of all charges; obtained clarification of conflicting, ambiguous, or non-specific documentation; as well as with Department leaders regarding implementation of new codes and guidelines
- Attended coding workshops/webinars as available related to coding credentialing to receive updated coding information and changes in coding and/or regulations
- Assisted, notified, and maintained contact with clinical departments in order to communicate coding & payer trends that affect compensation, audit & education opportunities
- Performed miscellaneous job-related duties as requested/assigned.
Revenue Cycle Operations Analyst/Trainer
Regional Cancer Care Associates
2019.07 - 2020.10
- Comprehension of all departments and functions were imperative as a component of my role
- Ran reports from different databases to produce analysis of trends and issues, along with other daily and monthly reporting responsibilities
- Worked independently and with team members to understand database structure and provide resolution in task completion or system irregularities when needed by staff members
- Currently monitoring the transition of multiple databases to a single database and EMR system
- Provided manuals and SOP’s for new staff members and provided guidance during acquisition of role
- Traveled to several offices for front desk training and observation for improvement in workflow (pre-COVID-19)
- Provided support in departmental projects as needed.
Revenue Integrity Manager
Sovereign Medical Group
2019.01 - 2019.07
- Oversee incoming copay income for 1 large medical group and 11 Ambulatory Surgical centers
- Created and maintained spreadsheets to keep all posting accounted for and tracked
- Responsible for loading and tracking fee schedule for appropriate reimbursement
- Transitioned from existing legacy systems to Athena, I was part of the implementation team
- Managed a team of 5 including employees in Pakistan
- Ability to identify problem areas and redesign inefficient workflow or processes
- Strong ability to lead and motivate.
Practice Support Analyst
NJ Retina
2018.06 - 2019.01
- Composed policies and procedures (SOP)
- Visited several of our offices to observe and improve Front desk operations
- Assisted in composing reports for MIPS/MACRA for review and/or improvement
- Currently in training to run and oversee Helpdesk Department
- Excellent project management, prioritization, and organization skills
- Monitor practice management system (AthenaNet) for new updates
- Provide technical support and training for Front desk staff as new staff members.
Revenue Cycle Manager
BioReference Laboratories Inc.
2017.06 - 2018.04
- Planned, coordinated, and managed business operations to achieve corporate goals
- Developed and implemented business plan for profitability
- Developed strategies to improve overall quality and productivity
- Scheduled bi-weekly team meetings to discuss business updates, issues and recommendations/implementations
- Responded to employee concerns in timely manner
- Provided direction and guidance to employees in their assigned job duties
- Determined staffing requirements and ensured that office positions are filled promptly
- Assisted in employee recruitment, training, performance evaluation, promotion and termination
- Managed orientations and exit interviews for employees
- Ensured that employees followed company policies and procedures.
Financial Services Supervisor
Caduceus Incorporated
2013.12 - 2017.06
- Promoted from Payment Division Specialist to Financial Services Supervisor
- Composed “Proposal of Services provided” for potential clients
- Managed functions, as assigned, to provide high quality of customer service
- Prepared daily, weekly and monthly reports on a timely basis
- Multitasked among multiple clients while maintaining timely goals
- Trained and managed a staff of four employees
- Directed the team to ensure that policies and directives were met through coaching and guidance
- Reviewed, recognized, and implemented processes to address issues and facilitate smooth workflow.
Revenue Cycle Team Lead
Gotham City Orthopedics, LLC
2013.05 - 2013.12
- Hired as a Medical Biller and then promoted to Team Lead for 2 teams, Physical Therapy & Sports Medicine
- Responsible for ensuring Accounts Receivable was reviewed & collected apon accordingly
- Managed and supervised the billing functions of my teams
- Executed collection activities and trained new hires for the demands of the daily processing functions
- Completed special projects assigned by management
- Served as the project manager for the implementation of the new system Centricity.
Education
CPC Certification – Certified Professional Coder -
AAPC
11.2018
Diploma - Vascular Sonography Program - undefined
Eastwick College, Nutley, NJ
12.2009
Associate Degree - Business Administration - undefined
Berkeley College, New York, NY
12.1994
Skills
- Microsoft Office
- Lotus 1-2-3
- Eagle
- WebCis
- IDX (Hospital Software)
- Advanced Data Systems (ADS)
- SequelMed
- Centricity
- Athena
- Xifin
Languages
Spanish
Native or Bilingual
Timeline
Billing Manager
Atlantic Eye Physicians,LLC
2024.01 - Current
Surgical Coding Manager
Prism Vision Group
2020.10 - 2024.01
Revenue Cycle Operations Analyst/Trainer
Regional Cancer Care Associates
2019.07 - 2020.10
Revenue Integrity Manager
Sovereign Medical Group
2019.01 - 2019.07
Practice Support Analyst
NJ Retina
2018.06 - 2019.01
Revenue Cycle Manager
BioReference Laboratories Inc.
2017.06 - 2018.04
Financial Services Supervisor
Caduceus Incorporated
2013.12 - 2017.06
Revenue Cycle Team Lead
Gotham City Orthopedics, LLC
2013.05 - 2013.12
CPC Certification – Certified Professional Coder -
AAPC
Diploma - Vascular Sonography Program - undefined
Eastwick College, Nutley, NJ
Associate Degree - Business Administration - undefined
Berkeley College, New York, NY
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