Maria Mero
Roosevelt,NY
Summary
To secure a challenging position that utilizes my years of experience, while allowing me the opportunity to grow professionally.
Overview
13
13
years of professional experience
Work History
Revenue Cycle Analyst
NYU Langone Health
New York, NY
01.2023 - Current
- Perform complex data analysis using tools like Tableau and Excel to create detailed, sophisticated reports
- Develop and maintain programs, methodologies, and files for analyzing and presenting data, ensuring well-organized, well-documented, and consistently maintained
- Maintain databases and conduct strategic analysis for monthly, quarterly, annual, and ad-hoc requests
- Develop and maintain hospital reporting, including daily reports, dashboards, and other ad hoc requests
- Execute data mining and in-depth insurance clearance WQ analysis, maintaining data integrity throughout
- Monitor and report on Key Performance Indicator (KPI) goals for Revenue Cycle Operations (RCO) Insurance Clearance (IC) teams
- Identify trends and patterns through the analysis of IP and OP denial data related to eligibility and benefits information, medical necessity and coordination of benefits
- Collaborate with multidisciplinary teams to reduce future denials and patient estimate disputes and explore other revenue opportunities
- Collect and analyze data related to IC Work queues, focusing on aging days in queues and days scheduled to date of service
- Track and report on Self-Pay Combined estimate compliance, estimate accuracy rates, and analyze data related to estimate queries
- Analyze workflows and data to provide analytical support to the management team, ensuring timely and accurate insurance verification and optimal customer service
- Work closely with Revenue Cycle Operations (RCO) management and various departments to identify issues, trends, and opportunities for improvement
- Serve as a liaison with internal departments, external business partners, and contracted payers to improve revenue cycle operations
- Coordinate audit activities and ensure timely submission of deliverables, including analyses and summaries for meetings
- Support ongoing staff training to enhance customer service skills, emphasizing a patient-centric approach
- Ensure compliance with all relevant policies, including 100% compliance with HIPAA requirements and other hospital-mandated activities
- Stay current on industry trends and best practices related to revenue cycle operations
- Proactively work to implement operational best practices and solutions to address issues related to eligibility, authorization, estimate, billing, and claims processing
Supervisor, Patient Access Services - Revenue Cycle Front End
Northwell Health
Valley Stream, NY
06.2023 - 01.2025
- Supervises union team members responsible for the daily operations as they relate to Hospital access services departments/programs
- Coordinates efforts among clinical personnel, case managers, administrative and support staff as needed
- Promotes Patient Access Services department goals by selecting, motivating, and training capable team members
- Leads the activities of assigned Patient Access team members by communicating and providing guidance toward achieving department objectives
- Supervises the department's day-to-day operations as they relate to Hospital billing, registration, admitting, and office management, hires, trains, disciplines, and evaluates the performance of staff; ensures performance appraisals are completed in a timely manner
- Analyzes, recommends, implements, and monitors approved work-flow changes; processes payroll maintaining employee records and work schedules while always ensuring adequate coverage
- Ensures compliance with regulations as they pertain to completion and filing of death certificates and termination certificates
- Maintains daily workflow to expedite processing while ensuring quality, accuracy, and customer service
- Monitors the inpatient and outpatient registrations for quality assurance
- Responds to concerns of patients, families, physicians, and staff
- Recommends procedural and system changes to improve operational quality and efficiency; actively participates in process improvement projects
Lead Access Service Representative- All Northwell Health sites
Northwell health
New Hyde Park, NY
03.2019 - 06.2023
- Review and keep triage list up to date
- Leads activities of assigned Patient Access team members by communicating and providing guidance toward achieving department objectives
- Verify patient insurance through an invision eligibility system, Emdeon or Mede and insurance portals to possibly secure patients' inpatient admission
- Internal communication with hospital workers to collect patient responsibilities like deductibles, co-pay, and coinsurance obligations
- Contacts insurance carrier(s) to obtain all information necessary for the successful billing of third-party payers in certain departments (coordination of benefits, benefit coverage/limits, co-pay/deductible amounts, authorization, pre-certification, and referral requirements)
- Re-verifies insurance of recurring patients' admission
- Performs financial assessments and Sliding Fee Scale Assessments of patients who are uninsured and/or are unable to meet their financial obligation to the hospital
- Work on maternity admit and delivery accounts
- Work along hospitals' financial counselors to provide any additional information for Medicaid applications
- Follow up with insurance carriers to verify and request pre-certification for maternity admission and neonatal intensive care unit babies
- Keep track of babies' neonatal admission for pending pre-certification after mom discharges
- Assist coworkers and management with any questions and aged cases
- Communicate with management with any discrepancy with accounts
- Assist and perform tasks on excel spreadsheet for improvement purposes
- Help coworkers improve our work ethic for the success of our department and the success of Northwell Health System
- Provide excellent customer services skills to our patients
Senior Account Receivable Clerk- Huntington Hospital
United Health Group /Optum 360
Melville, NY
06.2018 - 03.2019
- Working on posting insurance payment, patient payments and verifying billing daily
- Entering patient information and other types of data in the computer system to avoid any denials
- Post transactions and adjustment into the Patient Accounting Systems
- Assists in the preparation of 3rd party bills for recovery of reimbursements
- Performing word and excel tasks and various other clerical duties for department needs
- Keep track of insurance missed payments
- Performing follow-up calls to underpaid accounts to obtain the expected contractual reimbursement
- Entering and retrieves patient, financial, and administrative information
- Keeping billing files organized, maintains copies of payment recovery vouchers and spreadsheets for reporting
- Retrieve electronic remits, explanation of benefits to document patient accounts
- Compiling, printing and / or disseminating medical records to be sent to appropriate destination
- Perform other tasks as assigned
- Works on simple tasks using established procedures
- Assist co-workers with any need, like investigate and post missing payments for billing purposes on a regular basis
Senior Customer Service Representative
United Health Group /Optum 360
Melville, NY
10.2016 - 12.2018
- Answer incoming calls and perform outbound calls daily
- Notate patient hospital accounts of patient communication and call resolution on a daily day basis
- Constantly meeting and establishing productivity, schedule adherence, and qualities standards with the insurance department
- Collects on patient co-pays and deductibles and coinsurance
- Resolve customer service inquiries which could include billing and payment issues, patient itemized bill requests, and processes requests for financial assistance, and set patients on payment arrangements
- Process requests in a timely manner to meet the goals and demands of the department
- Performing word and excel tasks and various other clerical duties for department assigned
- Assists in the preparation of 3rd party bills for recovery of reimbursements
- Data entry and Insurance verification to fulfill necessary information to assist the proper channels for the patient
- Help my coworkers with any question or concern regarding patient accounts
- Assist management with reports and any other tasks assigned on a timely fashion such as: Infertility department, invalid insurance, and supervisor review reports
Medical Records Retriever
RES Servicing Corp
Kew Gardens, NY
01.2013 - 10.2016
- Receiving invoices and processing payments over the phone to medical facilities and copy service companies for the release of patient's medical records
- Process HIPAA compliant forms
- Answering incoming phone calls and updating cases daily
- Maintaining a busy schedule up to date
- Provide excellent customer service over the phone
Office Assistant
Wendy's Blue Limousine
Queens, NY
01.2012 - 01.2013
- Arranging and scheduling pickups and drop offs; keeping a busy agenda up to a date; phone answering; creative invoices; performed light bookkeeping and accounting; statements; accounts; payables & receivables
- Responsible for the purchase and or lease of all supplies
- Solely responsible for the procurement of supplies and equipment necessary for every operation
- Maintain database of vendors and contractors used to purchase goods and services
- Developed and maintained schedules and confidentiality for celebrity pickups and drop offs
Education
Bachelor's Degree in Health Science -
York college
Jamaica, New York06.2023
High School Diploma -
Unidad Educativa Montecristi
Manta, Ecuador02.2013
Skills
- Bilingual (Spanish)
- EPIC Proficent
- Northwell Health Systems
- Connex & Epaces
- Commercial insurance Website
- Denial management
- Patient access
- Workflow optimization
- Problem-solving
- Team leadership
- Data analysis
- Insurance verification
- Revenue cycle management
- KPI monitoring
- Patient Registration
- Process improvement
- Goal oriented
- Customer support
- Time management
- Verbal and written communication
- Training experience
- Typing 80 wpm
- Call center customer service
- Performance improvement
- Claims management
- Billing management
- Payment posting
- Healthcare Compliance
- Collections experience
- Data Analytics
- Billing cycle performance
- Revenue metrics analysis
- Team management
- Project management
- Microsoft Office
- Revenue performance
- Union Employee Supervision
- Communication skills
- Multitasking and organization
- Insurance coverage verification
- Financial counseling
Accomplishments
- Employee of month- Revenue Cycle Melville
- Employee of 2017- Revenue Cycle Melville
- Employee of the month 2019 - Huntington Hospital
- Promotion to Lead Access Service Rep 2021 - CBO New Hyde Park
References
Maria Mero, maria_mero93@hotmail.com, (347) 260-7911, 600 Brookside Ave, Roosevelt, NY, 11575, Excellent references upon request
Volunteer Experience
Red Cross Certification, Present, Participate in events provided by the local church., Feed the homeless., Beauty and esthetics class for local women in the nearby community., Help administer the Rett syndrome Walk sponsored by the FDNY.
Timeline
Supervisor, Patient Access Services - Revenue Cycle Front End
Northwell Health
06.2023 - 01.2025
Revenue Cycle Analyst
NYU Langone Health
01.2023 - Current
Lead Access Service Representative- All Northwell Health sites
Northwell health
03.2019 - 06.2023
Senior Account Receivable Clerk- Huntington Hospital
United Health Group /Optum 360
06.2018 - 03.2019
Senior Customer Service Representative
United Health Group /Optum 360
10.2016 - 12.2018
Medical Records Retriever
RES Servicing Corp
01.2013 - 10.2016
Office Assistant
Wendy's Blue Limousine
01.2012 - 01.2013
Bachelor's Degree in Health Science -
York college
High School Diploma -
Unidad Educativa Montecristi
Similar Profiles
Estefania GallegoEstefania Gallego
Research Laboratory Supervisor at NYU Center for Biospecimen Research and Development, NYU Langone HealthResearch Laboratory Supervisor at NYU Center for Biospecimen Research and Development, NYU Langone Health
Claire Cooper, MSPHClaire Cooper, MSPH
Senior Project Coordinator at NYU Langone Health - Department of Population HealthSenior Project Coordinator at NYU Langone Health - Department of Population Health
Kowssar SafaKowssar Safa
Intern at Family Health Center – NYU Langone HealthIntern at Family Health Center – NYU Langone Health
Benita MohabirBenita Mohabir
Medical Assistant at NYU Langone Health-Center For Women's HealthMedical Assistant at NYU Langone Health-Center For Women's Health
Brittany BroomfieldBrittany Broomfield
Unit Clerk – Heart Failure Unit at Mount Sinai South NassauUnit Clerk – Heart Failure Unit at Mount Sinai South Nassau