Resourceful Manager offering history of success coordinating and monitoring operations across various departments. Effective leader and problem solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Strong leader and problem solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision making skills and sound judgment to positively impact company success. Over ten years of experience in healthcare administration. In-depth knowledge of patient accounting financial clearance and healthcare insurances. Hands on experience in verifying the accurateness of insurance and demographic data, managing denials and rejected bills accordingly.
Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
Oversee 30 staff members.
Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
Successfully managed budgets and allocated resources to maximize productivity and profitability.
Improved staffing during busy periods by creating employee schedules and monitoring callouts.
Identified and communicated customer needs to supply chain capacity and quality teams.
Leveraged data and analytics to make informed decisions and drive business improvements.
Championed diversity initiatives within workplace by fostering inclusive environment and ensuring equal opportunities for all staff members.
Facilitated resolution of complex issues by employing critical thinking skills and engaging in collaborative problem-solving with team members.
Developed robust reporting systems that provided real-time insights into project statuses, supporting data-driven decision-making processes.
Managed cross-functional teams for successful project completion, ensuring timely delivery and high-quality results.
Evaluated employee performance regularly to identify areas of improvement and provide targeted support for professional development opportunities.
Collaborated with various departments for seamless integration of projects, ensuring smooth transitions between stages and reducing bottlenecks.
Reduced operating costs by identifying inefficiencies and implementing cost-saving measures within department processes.
Safeguarded compliance with industry regulations by staying current on updates and disseminating relevant information to team members accordingly.
Promoted culture of continuous improvement by encouraging open communication channels among team members for sharing ideas and best practices.
Increased overall customer satisfaction with regular follow-ups, addressing concerns promptly, and providing tailored solutions.
Standardized departmental procedures through creation of detailed guidelines, promoting consistency across all team functions.
Enhanced team productivity by providing guidance, mentorship, and constructive feedback to staff members.
Bellevue Medical Center- HCI-Billing Inquiry Supervisor
New York City Health + Health | Bellevue Hospital
08.2018 - 05.2022
Enter appropriate account notes in Epic billing system to clarify actions taken to reconcile claims.
Submit insurance claims to clearing house or individual insurance companies electronically or via paper UBO4 form
Resolve claim edits via claim edit work queues and/or external billing software
Verify eligibility for coverage via multiple payor websites.
Monitor accounts such as Receivable Edge, Optum & Pay span for accurate and appropriate payments posted along with denials
Follow-up with payments, adjust accounts in EPIC to contracted rate or non-contracted rate if required
Reviewed claim denials and payer requirements for corrective action and prevention in future
Research and resolve incorrect payments, EOB rejections, EOB denials, outstanding appeals and deposition payments.
Review and send medical records to Insurances companies when requested for payment or reimbursement.
Researched and replied in timely manner to insurance, patient, and internal customer inquiries.
Interview patients, families and other hospital personnel to obtain patient insurance information.
Investigate system review by Epaces, Connex, Unity and Insurance Websites
Analyze unpaid claims and denials and investigate reasons for nonpayment
Verify claim information for accuracy and completeness for paper and electronic claims
Managing status of accounts and balances and identifying inconsistencies
Write thorough reports on billing activity with clear and reliable data.
Finding financial solutions for patients or customers who may need payment assistance
Correct errors and discrepancies on customer billing as necessary
Provide basic training or guidance to entry-level customer service reps
Apply payments and adjustments to patient accounts
Assess and update patient and insurance demographics
Explain methods and principles used for billing to customers and resolve their doubts.
Handled on average 50-75 calls per day in call center environment.
Answered customer questions and solved problems according to Bellevue standardized procedures
Recorded details of customer interactions such as inquiries, complaints, comments, or actions taken
Referred unresolved customer grievances to designated departments for further investigation
Trained, coached, and motivated employees in performing at optimal levels.
Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
Senior Medical Secretary
Weill Cornell Medical
03.2017 - 06.2018
Responsibilities include screening incoming telephone calls; recording and transmitting messages; scheduling, receiving, and announcing scheduled patients and visitors; screening unscheduled patients and visitors; arranging referrals to other health care providers; scheduling appointments for consultations, lab tests and PCP care.
Maintain patient confidence and protect operations by keeping information confidential.
Accurately document patient information, referral information, verifies eligibility and any additional information as needed for appointment
Fulfills patient care responsibilities by accurately relaying pertinent information and instructions to patients, family members and caregivers, based on each physician’s practice protocols.
Identifies, triages, and escalates priority calls and WCC messages.
In addition, redirects and transfers calls to most appropriate person/department
Fulfills clerical responsibilities, as assigned, which may include entering referral and other pertinent data/information, managing charting process to ensure information is complete and filed accurately utilizing Epic Practice Manager
Obtain pre-authorization, referral numbers when required and ensure that information is properly entered in system.
Use Managed Care websites to do insurance verifications.
Managed approximately 30 incoming calls, emails and faxes per day from customers.
Acted as advocate for patients seeking assistance with navigating complex health insurance requirements or obtaining medication prior authorizations.
Assisted clinicians in development of effective care plans by gathering relevant patient history information upon intake.
Enhanced patient education efforts by developing informative brochures and handouts on various medical conditions or treatment options.
Enhanced patient satisfaction by efficiently managing appointment scheduling and follow-up procedures.
Streamlined office operations for increased efficiency, organizing medical records and maintaining patient confidentiality.
Contributed to positive workplace culture by fostering teamwork among administrative staff and proactively addressing any conflicts that arose.
Improved interdepartmental communication by serving as liaison between physicians, nurses, and other healthcare professionals. Contributed to overall success of practice by consistently exceeding performance expectations in terms of productivity, accuracy, and professionalism.
Maintained high levels of patient satisfaction through exceptional customer service skills during phone interactions or face-to-face encounters.
Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Kept information confidential and followed HIPAA guidelines to maintain patient trust.
Prioritized calls through screening process and transferred calls and recorded messages for appropriate personnel.
Organized paperwork such as charts and reports for office and patient needs.
Registered new patients in electronic medical records prior to appointment scheduling.
Documented patient medical information, case histories, and insurance details to facilitate smooth appointments and payment processing.
Enhanced office productivity by handling high volume of callers per day.
Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.
Used knowledge of medical terminology to transcribe patient information from written copy, electronic equipment, or verbal direction.
Customer Service Liaison II
Montefiore Hospital
09.2013 - 01.2017
.Experience with public contact as customer service liaison in health care / managed care setting.
Integral and key member of Primary Care Contact Center Team, operating as remote extension of institution’s ambulatory clinic administrative services; specializing in patient appointment scheduling and customer service
Maintained accurate, up to date, comprehensive, and confidential files and records
Oversaw team of ten agents dealing with special projects
Proficient use of Carecast, IDX, and Centricity Electronic Medical Records
Interacted with internal and external customers of all levels including management level, patient origin, ethnic background and education levels
Collaborated with site administrators to design efficient guidelines and protocols for contact center customer service liaisons to follow while engaged with patients
Interacted directly with patient population providing professional and courteous assistance with navigating Montefiore Health System
Electronically coordinate, route and manage messages between patients and their physician/physician’s office through use of Centricity Electronic Medical Record (CEMR) and transitioning to Epic
Direct interaction with patient population providing professional and courteous assistance with navigating Montefiore Health System
Responsible for accurate scheduling of patient appointments on behalf of their primary care physician’s office
Epic Super User during transition of Epic.
Education
Associate of Arts - Liberal Arts And General Studies
Borough of Manhattan Community College
New York, NY
05.2017
BBA - Health Administration
Empire State University
Saratoga Springs, NY
05.2025
Skills
Experienced in database and data entry
Fast and accurate typist: 55 words minute
Proficient in Microsoft Word, One Note, Outlook, Office and QuickBooks
Proficient in IDX, Care Cast, and EMR, EPIC, OAM, Unity
Possess knowledge of HIPAA rules and regulation
EPIC Super User Qualified
Cisco Phone System
Ability to work effectively, respectfully and responsibility in collaborative manner with multiple demands and short timelines