Karen Ann Gurrieri
Totowa,NJ
Summary
Detail-oriented professional with excellent communication, interpersonal skills. Aiming to leverage my abilities to successfully fill the vacancy at your company. Frequently praised as hardworking by my peers, I can be relied upon to help your company achieve its goals.
Overview
29
29
years of professional experience
1
1
Certification
Work History
DIRECTOR OF BILLING/PRACTICE ADMINISTRATOR
Hamptons Vein & Vascular
Rutherford
06.2014 - Current
- Conducted recruitment, hiring and training of personnel
- Supervised and evaluated work activities of medical, technical, clerical, personnel
- Handled all medical billing, inclusive, but not limited to charge entry, payment posting, denials, out-of-network negotiations, appeals
- Established objectives and evaluative and operational criteria for units managed
- Maintained communication between medical staff and employees
- Maintained awareness of advances in data processing technology, health insurance changes and financing options
- Established work schedules and assignments for staff
- Developed and implemented organizational policies and procedures for practice
- Maintained and developed office policies and procedures
- Benefit Verifications
- Handled all aspects of day-to-day operations of medical practice.
- Negotiated agreements with external partners such as contractors or consultants.
- Guided and motivated staff to drive maximum performance.
- Developed strategies to reduce denials, improve accounts receivable, and enhance revenue cycle performance.
- Oversaw complete lifecycle of revenue operations.
PRIOR AUTHORIZATION TEAM LEAD
NYC Surgical Associates
West Caldwell
04.2013 - 11.2016
- Precertified all procedures for the practice, implemented predetermiantion processes to facilitate an efficient claim processing
- Performed detailed benefit verifications and discussed benefits with patients and patient obligations
- Lead the preauthorization team as well as the billing department team with daily tasks and assignments
- Conducted employee interviews and was an integral part of the hiring process
- Credentialed all physicians with the insurance carriers
- Insured the insurance referrals were received for in-network providers
- Coordinated with the surgical coordinator for scheduling upon receiving authorization status
- Handled all incoming claim negotiations from vendors for out-of-network billing
- Recommended employees for promotions and notified individuals of career progression opportunities
- Recommended changes in working conditions to increase team efficiency
- Administered and created training and awareness presentations or materials
- Delegated tasks to team members according employee strengths
- Liason between Medical Doctors and Staff
- Trained and review with Medical Doctors payor guidelines for procedures performed
- Trained Medical Doctors on payor guidelines for charting.
- Interpreted complex policy language from insurance providers to determine benefits coverage.
- Assisted customers in understanding their benefits package and how it relates to their individual needs.
- Monitored changes in regulations related to healthcare benefits verification processes and procedures.
- Reviewed and verified health insurance benefits for patients prior to their scheduled appointments.
Supervisor
Mario Capio, MD
Pompton Plains, NJ
10.2012 - 04.2013
- Maintained confidentiality of personal and financial information, protecting patient rights and complying with HIPAA regulations
- Recorded patient and insurance payments, maintaining accurate financial records
- Scheduled patients for exams and screenings
- Collected co-payments and co-insurance and issued appropriate receipts during check-in
- Scanned and documented new patient information in electronic health records for registration purposes
- Typed reports and correspondence
- Evaluated daily schedules accommodating patient flow
- Greeted patients immediately upon arrival, providing excellent customer service
- Completed insurance or other claim forms
- Transmitted correspondence and medical records by mail, e-mail and fax
- Credits and collections, preparing and sending financial statements and bills and keeping financial records
- Completed documents, case histories and forms, such as intake and insurance forms
- Scheduled and confirmed patient diagnostic appointments and medical consultations
- Performed various clerical and administrative functions
- Answered telephones and directed calls to appropriate staff.
- Directed and supervised team of 15 employees in daily operations.
MEDICAL OFFICE MANAGER
Paul A Ostergaard, MD
Pompton Plains
01.1995 - 12.2012
- Day-to-day operations of a Family Practice
- Managed a team of 12 - medical staff professionals and non-professionals
- Referrals & PreCertifications of procedures ordered by physicians
- Schedule appointments
- Credential all MD's with payors
- Implemented EHR
- Trained employees
- Created work-flow processes
- All aspects of medical billing.
Education
Certification - Court Reporting
StenoTech Career Institute - Piscataway
Fairfield05-1990
Skills
- Electronic Health Records
- Records Management Systems
- Managing Practice Operations
- Supply Ordering
- Payroll Administration
- Electronic Document Management System
- Managing Files And Records
- Best Practices And Standards
- Staff Meetings
- Referral Management
- Managing Medical Practices
- Family Medicine
- Policy And Procedure Development
- Confidential Records Management
- Insurance Referral Facilitation
- Clerical Support
- Coaching And Mentoring
- Schedule Management
- Prescription Refills
- Biweekly Payroll Processing
- Reminder Calls
- Deductible Collection
- Leadership Development
- Employee Performance Reviews
- Practice Management
- Administrative Staff Supervision
- Staff Development
- Staff Management
- Contract Management
- Contract Negotiation
- Team Management
- Hiring and Retention
- Organizational Development
- Charismatic Leader
- People Management
- Contract and Vendor Management
- Negotiation
- Issues Resolution
- Verbal and written communication
Personal Information
Title: Billing Director/Practice Administrator
References
- DINA CLARK, NYC Surgical Associates, Preauthorization Specialist, Co-worker, (201) 247-4014, dm-c411@optonline.net
- CARRIE TURELLI, Universal Furniture, District Manager, Friend, (973) 809-9070, carrieturelli@gmail.com
- MARIA CAPIO, Mario Capio, MD, Office Manager, Former Boss, (201) 575-6917, mariacapio1956@gmail.com
Certification
- Notary Public of the State of New Jersey
Timeline
DIRECTOR OF BILLING/PRACTICE ADMINISTRATOR
Hamptons Vein & Vascular
06.2014 - Current
PRIOR AUTHORIZATION TEAM LEAD
NYC Surgical Associates
04.2013 - 11.2016
Supervisor
Mario Capio, MD
10.2012 - 04.2013
MEDICAL OFFICE MANAGER
Paul A Ostergaard, MD
01.1995 - 12.2012
Certification - Court Reporting
StenoTech Career Institute - Piscataway
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