Lucinda Reid
Brooklyn,NY
Summary
Medical Billing Collector with 25 years of experience in efficiently handling complex assignments. Proven track record in reconciling insurance and patient payments, resolving denials, managing difficult billing confidentiality. Highly skilled with proactive management software and committed to maintain patient confidentiality. Excellent communicator with strong organizational skills and a solid work ethic. I am committed to adapting to changes that drive better outcomes for our department’s objectives. By actively sharing relevant information, I help streamline follow-up processes, ensuring faster resolution of case issues and improving overall efficiency.
Overview
23
23
years of professional experience
Work History
Senior Hospital Care Investigator
Woodhull NYCHHC
03.2022 - Current
- Supervise and mentor team ensuring successful completion of task and adherence to deadlines.
- Monitor teams progress and escalate unresolved issues to senior leadership, ensuring swift and effective solutions.
- Handle email-related insurance provider issues, improving communication and collaboration.
- Report insurance concerns in weekly meetings, ensuring proactive problem – solving.
- Present root cause analysis of claim denials, utilizing statistical methods and data-driven approaches to identify underlying issues and propose solutions.
- Manage the Cost outlier and Medicaid work queue in its entirety, ensuring all processes were streamlined and efficient.
- Serve as a liaison between patient accounts and Utilization Management to ensure prompt resolution of medical necessity denials and management of appeals.
- Evaluate and respond to DRG audits promptly and accurately, ensuring compliance and timely resolution.
- Facilitate Bi- weekly team meetings to enhance communication and collaboration, driving improvements in overall team productivity and fostering a more cohesive work environment.
Hospital Care Investigator
Woodhull NYCHHC
01.2003 - 03.2022
- Coordinate and follow-up with insurance companies for claim status and payment.
- Disputed and resolved denials with insurance, third party and patient.
- Review every account on receivable report and take appropriate action with insurance according to departmental procedures.
- Verified Insurance information for eligibility for billing.
- Transfers secondary balances to appropriate financial class and provides documentation for processing claims.
- Ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner.
- Coordinate with Utilization management to ensure not medically necessary appeals and roll backs are submitted timely.
- Ensure DRG reassignment are reviewed by HM and rebilled timely.
- Submit inactive third-party coverage information via payer portal reconsideration to update patient COB.
Education
Bachelor of Business Administration - Health Services Management
Berkeley College
New York, NY01-2012
Skills
- Proficient in Microsoft Office suite (Word, Excel, Power Point, Outlook)
- Experienced with EPIC, Siemens-Unity, Quadramed, and Soarian Enterprise healthcare systems
- Knowledge of Medicare Omni Pro, EDM, NGS Connex platforms
- Skilled on OnBase document management and ICD 9/10 coding systems
- Familiar with HCPCS coding standards
Timeline
Senior Hospital Care Investigator
Woodhull NYCHHC
03.2022 - Current
Hospital Care Investigator
Woodhull NYCHHC
01.2003 - 03.2022
Bachelor of Business Administration - Health Services Management
Berkeley College