Kanita Carlos
Bronx,NY
Summary
Detail-oriented worker able to adapt to a constantly changing health care environment. Seeking to leverage my expertise and contribute to the success of a healthcare organization that can best utilize and enhance my capabilities.
Overview
16
16
years of professional experience
Work History
Insurance Coordinator Rev Cycle Dept
VNS HEALTH
New York, NY
09.2015 - Current
- Managed the end-to-end insurance authorization process for home care services, ensuring timely & accurate approval updates and verification of patient services.
- Handled high volume case load of authorization requests, consistently meeting stringent deadlines while maintaining a high attention to detail.
- Serves as the primary point on contact for clinical staff regarding insurance related matters, including prior authorization approval, coverage details and claim inquiries.
- Handle all escalated inquires timely to avoid delay in services. Reviewed unbilled/non-billed report to prevent issues for billing services.
- Collaborated with other departments on special projects to resolve claim denials, rejections or discrepancies to maximize reimbursement opportunities.
- Utilized internal and external systems to verify eligibility. Including navigating multiple system applications at once.
- Train junior/new staff as requires enabling strategies to expedite approval processes and overall efficiency.
Insurance Processor Homecare
Visiting Nurse Services of New York
New York, NY
06.2008 - 08.2015
- Processed incoming authorization requests and updated customer accounts accordingly.
- Managed workflow processes for authorization requests, including routing documents and tracking progress.
- Reviewed and approved authorization requests according to established criteria.
- Researched information as necessary to resolve customer inquiries or issues with authorizations.
- Researched and compiled information for unbilled reports.
- Developed training materials for new Authorization Coordinators and staff members.
- Performed administrative duties such as filing, copying, scanning, faxing.
Intake Coordinator
R&G Brenner Tax Consultants
Spring Valley, NY
01.2008 - 04.2008
- Coordinated the intake process for new clients, including scheduling initial assessments and providing necessary paperwork.
- Maintained accurate records of client intakes in electronic database system.
- Collaborated with accountants to analyze financial statements prior to filing taxes.
- Processed payments from clients for services rendered related to income tax preparation or filing fees.
- Performed quality control reviews on completed returns before they were submitted to government agencies.
- Reconciled or entered report discrepancies found in financial records.
- Collated taxes, data-entry, answered/routed all incoming calls.
Education
Associate of Applied Science - Health Information Technology
TCI COLLEGE OF TECHNOLOGY
New York, NY06.2007
Skills
- Highly organized; strong attention to detail, fast learner
- Possess good analytical and problem-solving skills
- Interpersonal skill, team player, adaptive to mentoring and continual learning
- Excellent written and verbal communication skills, Data-entry
- MS Word, Excel, power Point, Medical Software
- Eligibility reviews
- Medical Insurance industry experience
References
References available upon request.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
You will recognize your own path when you come upon it because you will suddenly have all the energy and imagination you will ever need.
Sara Teasdale
Timeline
Insurance Coordinator Rev Cycle Dept
VNS HEALTH
09.2015 - Current
Insurance Processor Homecare
Visiting Nurse Services of New York
06.2008 - 08.2015
Intake Coordinator
R&G Brenner Tax Consultants
01.2008 - 04.2008
Associate of Applied Science - Health Information Technology
TCI COLLEGE OF TECHNOLOGY