Michael Medina
Summary
Ambitious and compassionate healthcare professional, with financial experience both inside and outside the medical field. Quick-thinking Supervisor recognized for success in guiding teams and boosting performance. Practical problem-solver with excellent issue and conflict resolution skills to drive team and organizational success. Highly effective and knowledgeable in process improvement and inventory control. Accountable and responsible with a strong focus on teamwork. Quick learner willing to take on new responsibilities. Adept in completing tasks for upper management in a prompt and efficient matter.
Overview
10
10
years of professional experience
Work History
Supervisor
Northwell Health - Patient Access Services
11.2019 - Current
- Responsible for managing representatives
- Assists, coaches, and develops representatives
- Uses Kronos in order to track employees' shifts and monitor payroll
- Interviews prospective new candidates for the department
- Prepares and organizes
- Trains new employees
- Generate Spreadsheet for each Team Members Individually to work (Daily) - Distribute to Team Members (Tableau - DPX Referrals) - Approximately 15 to 20 Spreadsheets a day, sometimes more when assisted by other teams
- Generate Team Members Daily Summary(Daily Reporting) ( Summary of work Completed each day & Distribute to each Team Member & CC Leadership)
- Run Report for Warm & Cold Transfer (Daily Reporting) - Check Soarian for appointments scheduled - Disposition in List app Face to Face Appointment made(Credit for Dept) On Average there are approximately 300 Patient to Review
- Run Report for Left Message, Patient will call back & No Answer(Monday's) - Check Soarian for appointments scheduled - Disposition in List app Face to Face Appointment made(Credit for Dept) Approximately 318 Patient to Review
- Concorde Providers - Report sent biweekly with appointment Facilitated by our RM Team members which result in Appointments Scheduled, These appointment need to be dispositioned in List app in order for our team to get credit
- WHM Providers (Westchester Health Medical) - Report sent biweekly with appointment Facilitated by our RM Team members which result in Appointments Scheduled, these appointments need to be dispositioned in List app in order for our team to get credit
- Go thru DPX 1st Attempts(Daily) - Check Soarian for appointments scheduled and disposition appointments scheduled credit (Approximately 150 Referral)
- Go thru DPX 2nd Attempts(Daily) - Check Soarian for appointments scheduled and disposition appointments scheduled credit (Approximately 200 Referral)
- Answer Calls when Queuing
- Manage team - Answer Questions, Available Time & ACW - Huddles & 1:1
- Create Monthly Performance Reviews - Meet with each Team Members for Review
- Maintain Spreadsheets - for Current initiatives
- Upload Referrals to List app (Daily) - Health Solutions - Advised 20 for the month - and received 46 Referral in one day
- Upload Referrals to List app ( Daily) - Wellbridge
- Upload Referrals to List app (Daily) - NETS - Approximately 20 a week
- Chaim Medical Resource - I Personally work - Assist in getting sooner appts for patient(Urgent Issues)
- Maintain Team Members Anecdotal
- Review & Maintain Go health( List App) - Referrals POM doesn't reach out to.
Supervisor
Northwell Health - Account Management - CBO
06.2016 - 11.2019
- Responsible for managing 15 representatives, including two senior representatives
- Assists, coaches, and develops representatives
- Completes projects assigned by the assistant director that are either carrier or physician based
- Experience using DBMS queries to highlight trends related to different specialties
- Uses Kronos in order to track employees' shifts and monitor payroll
- Assists in completing the Matrix weekly in order to monitor department activity
- Interviews prospective new candidates for the department
- Prepares and organizes overtime for representatives
- Trains new employees in a classroom setting.
Sr. CPP Representative
Northwell Health - CBO
01.2015 - 01.2016
- AR follow-up for Medicare and all commercial carries for both high dollar and high volume claims
- Review invoices for accuracy according to Clinical Practice Plan (CPP) policies and procedures utilizing QOPI and appendix
- Vet escalations from representatives before submitting to supervisor
- Assist Management with various projects; Mail box request, carrier based projects, QUIC projects, reporting any issue and trends for improvements
- Assist with new hire onboarding & Training of new hires
- Perform charge edits, charge corrections, write off, invoice adjustments and fixing payment posting errors
- Document results of insurance verification; respond to insurance carrier inquiries (W-9, license, Medical record, and referral authorization) onto Stockamp systems & GECB
- Assist representatives and fellow senior representatives with questions regarding AR follow up/or policies, procedures and reeducation
- Assist Supervisor in Team meetings, Look over team of representative when Supervisor is unavailable
- Handles multiple situations simultaneously and exercise sound judgment
- Demonstrates outstanding written and verbal communication skills and the ability to articulate department policies and procedures.
CPP Representative
Northwell Health - CBO
01.2014 - 01.2015
- Works well in a team based setting, organizing work in an efficient and effective manner
- Selected for 'Carve Out' team to handle high profile neurosurgery, plastic surgery, otolaryngology, In-vitro fertilization and intrauterine insemination cases
- Expert knowledge of IDX, Stockamp, and Invision systems
- Proficient in GECB and Soarian.
Education
Business Administration -
Nassau Community College
Skills
- Patient
- Fast and efficient learner
- Self-disciplined
- Team and relationship orientated
- Organized
- Conflict resolution and problem Solver
- Time management
- Computer and technology astute
- Innovative
- Training and mentoring
- Goal-Oriented
Accomplishments
- Press Ganey - Maintain top tier for 3 consecutive years, Tier 1
- Awarded Supervisor of the Quarter - Second Quarter 2018
References
Available Upon Request
Timeline
Supervisor
Northwell Health - Patient Access Services
11.2019 - Current
Supervisor
Northwell Health - Account Management - CBO
06.2016 - 11.2019
Sr. CPP Representative
Northwell Health - CBO
01.2015 - 01.2016
CPP Representative
Northwell Health - CBO
01.2014 - 01.2015
Business Administration -
Nassau Community College
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