MARY DONALD
Amityville,NY
Summary
Revenue cycle expert with over 12 years at Northwell Health, specializing in pediatric specialty billing operations. Led billing teams to optimize receivables and third-party reimbursements, achieving a 98% prior authorization approval rate. Epic Wave 1 certified with strong data systems and regulatory compliance knowledge.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Revenue Cycle Specialist, Pediatric Cardiology Division
Northwell Health
, USA
07.2013 - Current
- Achieved 98% prior authorization approval rate through proactive communication with payers.
- Coordinated with providers and insurers to improve reimbursement outcomes while maintaining HIPAA compliance.
- Resolved complex billing issues, focusing on escalated denials and specialty cases.
- Managed billing operations, focusing on third-party reimbursements and data entry accuracy within Epic systems.
- Led practice billing associates in receivable management and revenue cycle functions to enhance overall billing efficiency.
Accounts Receivable Representative - Recovery Audit Program
North Shore-LIJ Health System
, USA
11.2011 - 05.2013
- Coordinated Medicare audit responses and prepared appeals, ensuring timely revenue recovery.
- Managed data tracking and reporting in GNYHA recovery audit system, facilitating accurate financial oversight.
Patient Accounts Representative & Receptionist
North Shore-LIJ Health System
, USA
12.2010 - 10.2011
- Resolved payment denials and processed outstanding claims to enhance accounts receivable.
- Reduced claim rejections by conducting eligibility verifications and precertifications.
Education
Bachelor of Business Administration -
Strayer University
12.2026
Skills
- EPIC Health Connect
- Care Tract Manager
- CITRIX
- TouchWorks
- E-Carenext
- Soarian Financials
- Siemens Invision
- Athena
- GNYHA Tracker
- Microsoft Office (Advanced Excel)
Certification
EPIC Wave 1 Certified
Timeline
Revenue Cycle Specialist, Pediatric Cardiology Division
Northwell Health
07.2013 - Current
Accounts Receivable Representative - Recovery Audit Program
North Shore-LIJ Health System
11.2011 - 05.2013
Patient Accounts Representative & Receptionist
North Shore-LIJ Health System
12.2010 - 10.2011
Bachelor of Business Administration -
Strayer University