Melisa Pineda
Brentwood,USA
Summary
Skilled professional ready to excel in leadership role with focus on results-driven performance. Proven ability to streamline operations and foster team collaboration to achieve organizational goals. Known for reliability and adaptability in meeting changing demands while maintaining high standards.
Overview
8
8
years of professional experience
Work History
Supervisor, Patient Account Services
Northwell labs Billing
06.2023 - Current
- Promotes Patient Account Services department goals by selecting, motivating, and training capable team members.
- Leads the activities of assigned Patient Account Services team members by communicating and providing guidance toward achieving department objectives.
- Supervises, 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.
- Assists in the recommendation, implementation, and evaluation of approved operating budget; maintains records, reports on performance, and recommends corrective action or justifies variances.
- Prepares statistical and budgetary reports; reviews physicians’ charges against hospital account index; manages write-offs, adjust downs, bad debts and other delinquent accounts.
- Coordinates clinical documentation requests to business office to ensure timely appeals.
- Develops and implements policies and procedures to facilitate billing and maximize case collections.
- Reviews and recommends improvements for financial management of each billing area.
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
Lead Financial Counselor
SouthShore University Hospital
04.2020 - 05.2023
- Collaborated with Patient Access Supervisors to identify performance gaps & implemented protocols to facilitate workflow processing improvements of 13% avg. monthly.
- Interviews patients to obtain necessary financial and insurance information.
- Verifies patients insurance and collects additional insurance such as No Fault and Workers Compensation.
- Developed & presented customized training solutions for staff on insurance regulations & patient financial/billing processes, improving by deceasing denials 10%
- Performs financial assessment of patients.
- Refers potential Medicaid cases to Medicaid Investigator
- Gathers documentation and assists in the completion of the Financial Assistance Program (FAU) application process.
- Assist patients and/or families in resolving hospital bills.
- Partnered with director team to develop process best practices for optimizing revenue capture and bad debt payment plans for $2M+ worth of outstanding debt.
- Advises and counsels patients of their payment responsibility due to the hospital.
- Establishes patients’ pro-rated financial obligations and sets-up payment arrangements/contracts.
- Follows up on scheduled payments via mail and telephone.
- Processes applications for Section 1011, where applicable.
- Maintains daily work log of payments collected.
Patient Access Service Representative
Long Island Community Hospital
07.2018 - 04.2020
- Keys information into registration system.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Optimized patient access operations by streamlining processes & workflows for 8 clinical departments, leading to 50% quicker turnarounds for outpatient registration services with 95% satisfaction rate.
- Conducts interviews to obtain demographics and insurance information.
- Verifies financial and insurance information. Obtains appropriate signatures on medical, legal and financial forms.
- Secured $1M+ reimbursement funds annually; verified coverage & collected 700+ co-payments daily & associated paperwork within 24hrs turnaround time.
- Admits patients and provides information
regarding hospital rules and regulations. - Improved patient satisfaction by efficiently registering patients and verifying insurance information.
Paratransit Reservationist
Suffolk Bus Corp
02.2017 - 07.2018
- Utilized reservation software proficiently, ensuring quick response times during high call volumes.
- Monitored 450+ rides daily to ensure timely arrival of vehicles & prevent over-booking, resulting in a 30% reduction in customer wait times.
- Enhanced customer satisfaction by efficiently managing reservations and promptly addressing inquiries.
- Proactively established positive communication with dispatch to accurately forecast and evaluate route information, leading to increased customer satisfaction rate of 30%.
- Provided driver assistance regarding mobility device usage, resulting in a 10% reduction of operational costs.
- Handled challenging situations or dissatisfied customers professionally, resolving issues and retaining business when possible.
Education
Bachelor of Science - Healthcare Administration, HR Management
Ashford University
San Diego, CA05.2020
Associate of Arts - Liberal Arts
Suffolk County Community College
Brentwood01-2017
High School Diploma -
Brentwood High School
Brentwood, NY06-2011
Skills
- Bilingual
- HDX/Invision Software
- Mede Analytics
- Sunrise EHR
- Xifin
- Front Runner
- (Office, Excel, PowerPoint, Word)
- Training and mentoring
- Staff management
- Team building
- Workflow management
Timeline
Supervisor, Patient Account Services
Northwell labs Billing
06.2023 - Current
Lead Financial Counselor
SouthShore University Hospital
04.2020 - 05.2023
Patient Access Service Representative
Long Island Community Hospital
07.2018 - 04.2020
Paratransit Reservationist
Suffolk Bus Corp
02.2017 - 07.2018
Bachelor of Science - Healthcare Administration, HR Management
Ashford University
Associate of Arts - Liberal Arts
Suffolk County Community College
High School Diploma -
Brentwood High School
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