Kenia Lara
New York
Summary
Thorough and accurate Revenue Cycle Analyst with 5 years of experience in the Health Care Industry. Proven strengths in account planning and management, tracking variances between anticipated and actual revenues and recommending course corrections. Eager to contribute in senior-level role.
Overview
17
17
years of professional experience
Work History
Revenue Cycle Analyst
Mount Sinai Hospital
03.2017 - Current
- Provided Statical data on payment discrepancies, which enables management to accurately monitor accounts receivable on activities on an ongoing basis
- Data provided was forwarded to information technology for contract correction and/or updates may also result in payer escalation
- Assisted with development and implementation of strategies and procedures that will reduce denials, maximize reimbursement, and promote faster payment
- Performed analytical Reviewed of denial and payment variances
- Determined the reason for denials and made recommendations to prevent future denials and payments variances
- Researched claims processing guidelines, provider contracts fee schedules and system configuration to determine root cause of payment error
- Monitored reports and assigned work queues, ensuring coding charge submission and accounts receivable
- Performed reimbursement management, analyze payer reimbursement to ensure proper claim adjudication and reports on high volume payment discrepancies
- Prepared trending reports of all high-volume denials and payment variances
- Meet with various department communicate findings and recommendation to improve revenue management
- Performed accounts Receivable and financial review for the revenue department, communicate revenue impact to management.
Senior Financial Services Associate
NYU Langone Medical Center
05.2015 - 03.2017
- Reviewed accounts with outstanding balances to determine whether account should be cancelled and re-billed, billed secondary carrier/patient or refunded
- Reviewed billing edits and provided insurance provider with corrected information
- Provided tenacious follow-up to ensure proper payments were fully collected
- Submitted clear and accurate claims to third party carriers on a timely basis, utilized electronic follow up system to perform billing activities
- Investigated problem accounts utilizing EPIC Work Queues, analyzed all applicable information to make the most accurate decision such as adjustments, write-offs and account referral to external agency for collection
- Transferred secondary balances to appropriate financial class and provided documentation for processing the claims
- Resolved credit balances by reviewing accounts thoroughly; pursues refund or adjustment as appropriate
- Responded to patient and third-party inquiries; researched and resolved problems; corrected errors and referred most complex issues to supervisor
- Identify reason for denials or delay payments, pursue payers or corrective action to resolve claim.
Financial Coordinator
Lincoln Medical and Mental Health Center (HHC)
11.2011 - 05.2015
- Reviewed Medical charts to obtain pertinent information for accurately coding and completing third party billing forms indicating treatment given
- Informed patient of hospital rates; performed in-depth interviews with patients and family to determine ability to pay hospital charges
- Verified insurance benefits for patients, determined patient liability and coordinated payment of uncovered medical expenses
- Monitored patient accounts for payments by insurance companies, co-payments and self pays
- Collaborated with front end staff to coordinate error resolution and provided information on appropriate registration and charging practice
- Contacted Insurance to obtain authorization and pre-certification for inpatient and outpatient services
- Responded to complex inquiries from patient and third-party payers and resolves disputes concerning bills submitted for payment
- Reviewed outstanding accounts, processed fees scales for services provided.
Project Manager
Habitat for Humanity
06.2006 - 11.2011
- Managed homebuyer selection process, including supervising review of applications and mortgage underwriting
- Evaluated credit reports, financial statements, recurring income to pre-approve affordable housing units
- Determined loan pricing based on ability to pay and current debt load by utilizing debt-to-income ratio
- Developed and implemented home marketing strategy, including media campaigns, community outreach, organizing public information sessions and open houses
- Oversaw the management of homeowner orientations and other support and educational programs
- Managed relationships with Habitat-NYC condominium associations, including the establishment of condominium board
- Prepared reports and spreadsheets that provided key information and analysis of clients to government grantors, senior management, and mortgage bank(s)
- Assisted real state team in producing underwriting policies and producers which improved efficiency by 35%.
Education
MBA in Finance -
New York Institute Of technology
New York, NY01.2011
Bachelor of Science in Business Management -
New York Institute Of technology
New York, NY01.2001
Associate of Business Administration/ Accounting -
Suny Morrisville
Morrisville, NY01.1998
Certified Medical Coding -
LEHMAN COLLEGE
BRONX, NYCertified Professional Coding -
MOUNT SINAI CODING PROGRAM & AAPC
01.2022
Skills
- Proficient with AR Aging Reports
- Certified Professional Coder
- Proficient with EPIC/Eagle/Microsoft Office
- Experienced with Claim Edits (CPT-4, ICD-10 CM)
- Process Invoices/Account Reconciliation
- Bilingual Spanish Speaking
Languages
Spanish
Native or Bilingual
Timeline
Revenue Cycle Analyst
Mount Sinai Hospital
03.2017 - Current
Senior Financial Services Associate
NYU Langone Medical Center
05.2015 - 03.2017
Financial Coordinator
Lincoln Medical and Mental Health Center (HHC)
11.2011 - 05.2015
Project Manager
Habitat for Humanity
06.2006 - 11.2011
MBA in Finance -
New York Institute Of technology
Bachelor of Science in Business Management -
New York Institute Of technology
Associate of Business Administration/ Accounting -
Suny Morrisville
Certified Medical Coding -
LEHMAN COLLEGE
Certified Professional Coding -
MOUNT SINAI CODING PROGRAM & AAPC
Similar Profiles
Cynthia John-OgamCynthia John-Ogam
Registered Nurse- Operating Room at Mount Sinai Health System: The Mount Sinai HospitalRegistered Nurse- Operating Room at Mount Sinai Health System: The Mount Sinai Hospital
Robert ReillyRobert Reilly
Emergency Staff Nurse at Sinai Health, Mount Sinai HospitalEmergency Staff Nurse at Sinai Health, Mount Sinai Hospital
Osvaldo MezaOsvaldo Meza
Revenue Cycle Reimbursement Analyst at Sinai Health System, Mount Sinai HospitalRevenue Cycle Reimbursement Analyst at Sinai Health System, Mount Sinai Hospital
Janaria BaniquedJanaria Baniqued
Clinical Nurse Coordinator at Sinai Health System, Mount Sinai HospitalClinical Nurse Coordinator at Sinai Health System, Mount Sinai Hospital
Alexandra HortonAlexandra Horton
Live-Out Nanny at The Saperstein FamilyLive-Out Nanny at The Saperstein Family