Leyani Garabito
Miami,FL
Summary
Highly analytical and driven professional combining more than 15 years of work experience in the healthcare industry with proficiency in Financial Management. Proven ability to effectively communicate, lead teams, be flexible and partner with all levels of the organization. Skilled at communicating, organizing and solving problems to raise the stature and rankings of the company.
Overview
18
18
years of professional experience
Work History
Front Desk Office Manager
The Institute Miami
01.2023 - Current
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Developed and maintained successful relationships with vendors, suppliers and contractors.
- Controlled finances to lower costs and keep business operating within budget. Increased sales by 10%.
- Managed compliance to keep organization operating within legal and regulatory guidelines.
- Provided proper scheduling of patients, ensuring timely, and effective allocation of resources and calendars.
- Accomplished multiple tasks within established timeframes.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Provided prompt, polite and professional in-person and telephone customer service.
- Updated patient information and insurance details for accurate electronic medical records.
- Prepared patient charts by gathering and organizing medical records ahead of appointments.
- Used Aesthetic Record to schedule appointments for doctor visits and procedures.
- Restocked each medical room with adequate supply of medications and supplies in preparation for patients.
- Received, recorded and filed medical payments by check, cash, and credit card.
- Received and routed laboratory results to doctors for review.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
AP/AR Account Clerk
Miami-Dade County Fire Rescue Department
08.2017 - 12.2022
- Performed data entry of permit payments made via checks, cash and credit card transactions.
- Collected payments on a daily basis and posted them to their respective accounts.
- Utilized accounting software programs to perform daily duties and responsibilities.
- Communicated with customers via mail regarding payment discrepancies.
- Opened and properly distributed incoming mail.
- Scanned and validated journal entries daily and as needed.
- Reconciled vendor invoices and handled payment discrepancies.
- Ensured unpaid invoice payments were made in a timely manner.
- Submitted information to the appropriate personnel for approval, if rejected researched thoroughly.
- Researched vendor statements and reviewed invoices for appropriate documentation and approval, prior to payment.
- Communicated with upper management and Procurement in order to resolve purchase order issues and get approval for invoices.
- Communicated with vendors/customers to resolve payment issues via phone and email.
- Reviewed purchase orders and the language in order to match to the corresponding invoice for accurate payment.
- Maintained a database of invoices and their payment status.
- Assisted with various projects as needed.
Provider Network Business Analyst II
Molina Healthcare of Florida, Inc
07.2013 - 02.2017
- Administered benefits and provider contracts on a QNXT system or a comparable system accurately analyzing configuration needs for processing claims.
- Acted as subject matter expert for business analysis of contracts, benefits, fee schedules, service groups and reference tables in coordination with Corporate Configuration team.
- Coordinated with Corporate Configuration to ensure contracts, benefits and/or reference tables are configured to accurately reflect health plans business needs.
- Reviewed and documented testing results to ensure that system implementation will meet required documented goals.
- Identified opportunities for improvement, developed solutions and documented processes requiring change, or where new processes needed to be developed.
- Provided recommendations for implementation.
- Applied previous experience and knowledge to research and resolve claim/encounter issues, pended claims and updated system(s) as necessary.
- Sent e-mails, fax transmissions and schedule meetings as needed, etc.
- Maintained thorough and concise documentation for tracking of all provider, contract, benefit or reference table configuration change request forms for quality audit purposes.
Administrative Assistant III
Baptist Health South Florida, Inc
01.2013 - 07.2013
- Maintained a clean reception area, including lounge and associated areas.
- Scheduled and coordinated meetings, interviews, events and other assigned projects.
- Ordered and distributed office supplies while adhering to a fixed office budget.
- Planned and coordinated logistics and materials for board meetings, committee meetings and staff events.
- Directed guests and routed deliveries and courier services.
- Screened applicant resumes and coordinated both phone and in-person interviews.
- Data entry using Midas medical software.
- Prepared Midas Software reports on a weekly basis for review.
- Answered and managed incoming and outgoing calls accordingly.
- Created monthly PowerPoint Presentations.
- Greeted numerous visitors, including VIPs, vendors and interview candidates.
- Opened and properly distributed incoming mail throughout the department.
- Prepared meeting minutes and notes.
- Maintained and updated the communication board for the department.
- Assisted supervisor with special projects as needed.
- Implemented Compliance and patient confidentiality standards.
Financial Counselor
Baptist Health South Florida, Inc
05.2010 - 01.2013
- Contacted insurance companies and collected payments accordingly.
- Researched and resolved accounts payable discrepancies.
- Utilized weekly Accounts Receivable reports and spreadsheets to collect insurance payments.
- Reviewed and analyzed Managed Care contracts for updates and corrections.
- Utilized all available systems to obtain claim status such as WEB MD, Availity, etc.
- Identified various CPT, ICD-9, HCPCS, DRG, revenue codes in order to ensure proper reimbursement.
- Complied and adhered to HIPAA guidelines and regulations.
- Requested and assessed medical records from HIM Department for insurance companies.
- Communicated and assisted patients with Coordination of Benefits to acquire account resolution and/or payment.
- Reviewed Explanation of Benefits from insurance companies on a daily basis.
- Reviewed credit accounts to ensure correct adjustment and/or refunds were applied.
- Transferred unresolved accounts to upper management for resolution.
- Documented detailed information of all action taken on patient accounts.
Medical Billing and Collections Specialist
J and A Medical Billing, Inc
08.2006 - 05.2010
- Utilized Accounts Receivable reports to identify past due accounts and increase revenue and decrease cost.
- Responsible for maintenance of patient's documents including information such as addresses, medical records, etc.
- Maintained patient's insurance information, reports, and claims up to date.
- Posted insurance payments to appropriate patient's accounts by utilizing and understanding the Remittance/Explanation of Benefits.
- Monitored payments due from patients and other sources to promptly contact the ones with past due payments.
- Comprehended insurance Explanation of Benefits including Medicare, Medicaid, managed care & auto carriers.
- Applied the Correct Coding Initiative (CCI) to ensure proper handling & processing of claims.
- Prepared formal appeals for insurance companies.
- Approved, batched and transmitted electronic claims using the McKesson medical software.
- Contacted insurance companies and responded to them in a timely manner by phone and/or email.
- Responsible for staff training and ordering office supplies.
- Filed and organized posted charges and payments.
Education
High School Diploma -
Miami Coral Park Senior High School
Miami, FL06.2002
Skills
- Best Practice Implementation
- Medical Terminology
- Patient Registration
- Work Planning and Prioritization
- Patient Scheduling
- Budgeting and Resource Management
- Professional Networking
- Customer Service Management
- Autonomous and Self-Directed
- Budget Planning
- Insurance Verification
- Discretion and Confidentiality
- Administration and Operations
- Research and Analysis
- Proficient in MS Programs
- Highly detail-oriented
Languages
Fluent in English and Spanish
References
References available upon request.
Timeline
Front Desk Office Manager
The Institute Miami
01.2023 - Current
AP/AR Account Clerk
Miami-Dade County Fire Rescue Department
08.2017 - 12.2022
Provider Network Business Analyst II
Molina Healthcare of Florida, Inc
07.2013 - 02.2017
Administrative Assistant III
Baptist Health South Florida, Inc
01.2013 - 07.2013
Financial Counselor
Baptist Health South Florida, Inc
05.2010 - 01.2013
Medical Billing and Collections Specialist
J and A Medical Billing, Inc
08.2006 - 05.2010
High School Diploma -
Miami Coral Park Senior High School
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