Lisbeth Ruiz-Hernandez
Jersey City,NJ
Summary
Adaptable Manager offers 25 years of experience coordinating operations to achieve organizational goals. Communicative team leader with expertise in strategic planning and inventory management. Committed to driving improvements through innovation and leadership. Hardworking and motivated Manger of ARS with 25 years of experience and record of success in administrated industry. Solid history balancing team performance, customer service targets and business objectives. Dedicated to working closely with employees to maximize productivity and optimize procedures. Decisive leader with good planning and organizational skills.
Overview
14
14
years of professional experience
Work History
Manager of ARS
RWJ Barnabas
South Plainfield, NJ
10.2016 - Current
- Leading and developing a team of representatives responsible for managing, investigating, appealing claims, and finding resolutions on all open claims
- Obtain authorizations for specialty drugs for Oncology patients, Heart Transplant patients, etc
- Ability to analyze data, and report trends, barriers, and financials at a high-level overview
- Handle all the credentialing for our Specialty Pharmacy and hospital services
- Responsible for the yearly budget
- Experience managing teams in a collaborative, team-oriented environment: experience with employee developments
- Knowledge of billing and retrieval functions/Utilize v-loop, filtering, and sorting functions
- Provide excellent customer service and handle and report any patient complaints
- Responsible for finding funding for our patients and ensuring the patients are happy and satisfied with our services
- Creating and improving workflow processes
- Ensuring high quality of work and productivity of staff
- Having a daily meeting with staff to improve workflow
- Weekly 1:1 meeting with staff about workflow accountability of projects
- Completed data analysis reports by payers to keep track of work volume and billing errors
- Submit employee information into All IG Database to see if they have previously committed fraud
- In charge of Month End closing and giving reports to our Account Receivables Department
- Supervise 14 employees and in charge of managing them and their productivity, double checking their work, and assisting in the transition to be remote during the current Pandemic.
Reimbursement Manager/Patient Accountant Manager
10.2016 - 06.2018
- Interviewed, cross-trained, and managed a staff of 15 employees
- Manage all inpatient and outpatient hospital claims, including commercial, Medicare HMO, and Medicaid products
- Reported staff productivity and managed payroll
- Responsible for billing for Infusion Medication
- Transferred accounts to collections
- Tracked census for infusion
- Created all contracts with insurance and negotiated rates
- Ability to work well independently and as part of a collaborative team
- Insurance verification for all patient encounters
- Create follow for all accounts over 10,000.00
- Follow up on A/R denials and incorrectly paid claims utilizing daily, weekly, and monthly reports
- Mentored staff and advised of solutions to billing questions while guiding them through the appropriate tasks to perform within each billing cycle.
Reimbursement Coordinator/Admission
Radiology Center
Lyndhurst, NJ
05.2012 - 10.2016
- Interviewed, cross-trained, and managed a staff of 15 employees
- Reported staff productivity and managed payroll
- Contact and follow up with contracted insurance plans to reconcile delinquent client accounts
- Responsible for billing and tracking census for Infusion Medications
- Transferred accounts to collections
- Created all contracts with insurance and negotiated rates
- Experience and proficiency in the navigation an electronic health records.
Clinic Administrator
Therapro
North Bergen, NJ
11.2009 - 05.2012
- Interviewed, cross-trained, and managed a staff of 15 employees
- Reported staff productivity and managed payroll
- Responsible for billing for Infusion Medication
- Transferred accounts to collections
- Tracked census for infusion
- Created all contracts with insurance and negotiated rates.
Education
Bachelor’s Degree in Business Administration -
Ashford University
01.2024
Certified Electrocardiogram Technician -
Allen Schwartz Institute
High School Diploma -
Emerson High School
Skills
- Bi-lingual in English and Spanish (Fluent)
- Microsoft Office Suite (Word, Excel, PowerPoint, and Outlook)
- EPIC and Wellsky
- Medicare Electronic Billing Coding/ Appeals
- Medicaid NJ /NY billing/precertification/appeals
- Private Insurance/HMO/PIP Workers Comp NJ & NY
- Monthly report Generator AR-A/L and Collections
- Familiar with the complete process of billing from the first patient contact to data entry to billing
- Contract Management
- Business Development
- Financial Management
- Business Administration
- Strategic Planning
- Expense Tracking
- Workforce Management
- Policy Implementation
- Schedule Preparation
- Team Leadership
- Business Planning
- Time Management
- Budget Control
- Verbal and Written Communication
- Negotiation
- Complex Problem-Solving
Languages
Spanish
Native/ Bilingual
Timeline
Manager of ARS
RWJ Barnabas
10.2016 - Current
Reimbursement Manager/Patient Accountant Manager
10.2016 - 06.2018
Reimbursement Coordinator/Admission
Radiology Center
05.2012 - 10.2016
Clinic Administrator
Therapro
11.2009 - 05.2012
Bachelor’s Degree in Business Administration -
Ashford University
Certified Electrocardiogram Technician -
Allen Schwartz Institute
High School Diploma -
Emerson High School
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