Nelfi Nunez
Selden,NY
Summary
Meticulous Senior Billing Analyst offering 14 years of comprehensive experience in healthcare and environmental consulting. Comfortable working independently or as part of supportive team. Extensive familiarity with EHR and ERP systems. I have a master's degree in Healthcare Administration and skills sets that include, 10 years of Athena IDX & Soarian project experience, years of Excel project experience budgeting, forecasting & tracking performance. Working knowledge of SAP ERP Proficient in MS project, Word, PowerPoint Pivot table experience CRM experience Knowledge of HIPPA and GAAP.
Overview
15
15
years of professional experience
Work History
Senior Billing Analyst
Roux Environmental Consulting & Management
Islandia, NY
11.2022 - Current
- Created a financial manual for use by an accounting team
- Implemented an invoicing manual
- Checked and balanced work in progress, compiled and provided clients accurate invoices
- Resolved billing issues, responded to billing-related inquiries and complaints
- Implemented validation procedures, streamlined billing processes
- Analyzed billing data with Excel, made recommendations for improvements, established billing accounts, resolved invoice or client-related complaints or questions
- Analyzed complex billing data, managed the process of reviewing, approving, and processing employee expense reports, provided budget reports, verified job phases, tasks, and billing codes, performed various calculations
- Prepared monthly, quarterly and yearly reports on billing activities
- Maintained up-to-date records of all billing information in the system
- Provided technical support for internal users regarding billing software applications
- Monitored accounts receivable balances and ensured timely payments from customers
- Tracked changes in pricing structure, payment terms, discounts
- Resolved billing issues by applying knowledge and completing in-depth research
- Answered customer questions to maintain high satisfaction levels
- Processed invoice payments and recorded information in account database
- Trained new team members on company policies and accounting systems to keep team operations productive and efficient
- Executed account updates and noted account information in company data systems
- Generated and distributed month-end statements for customers and resolved related concerns
- Maintained accounting ledgers by verifying and posting account transactions
- Developed strong professional rapport with vendors and clients
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries
- Reconciled financial accounts using Deltek software
- Generated invoices based on customer orders using ERP systems
- Reconciled accounts receivable transactions against general ledger entries
- Reviewed timesheets for accuracy and completeness prior to processing payroll
- Reviewed and analyzed expense reports for accuracy, completeness, and compliance with company policy
- Monitored budget performance to ensure expenses were within allocated limits
- Reconciled discrepancies between actual costs and budget estimates
- Maintained detailed files and records relating to all transactions processed
- Processed vendor invoices for payment according to established terms
- Maintained accurate records of all markdown activity
- Ensured compliance with company policies and procedures related to markdowns
- Prepared monthly reports on the status of all subcontracts in progress or completed
- Created and implemented processes to ensure successful completion of projects.
Revenue Cycle Data Analyst
Northwell Health
New Hyde Park, NY
09.2014 - 10.2022
- Implemented new software systems for the submission of electronic claims
- Developed billing training manuals, supported external audits, processed and compiled patient paperwork
- Answered incoming phone calls, scheduled patient appointments, prepared patient itinerary and correspondence
- Identified and tracked recurring operational problems
- Processed electronic and paper claims, assigned ICD-10 and CPT codes
- Researched and resolved incorrect payments and EOB rejections
- Posted and reconciled insurance and patient payments
- Sent secondary claims
- Processed patient statements, answered and resolved patient billing inquiries
- Followed up on insurance and patient aging reports
- Resubmitted insurance claims
- Reviewed credit balance reports, performed reconciliation of refund accounts
- Transferred balance credit to correct invoices
- Resolved billing discrepancies with other departments or insurance companies
- Assisted patients in understanding their medical bills, benefits, and coverage
- Analyzed patient accounts to determine appropriate payment plans
- Generated reports on outstanding claims and payments received
- Maintained up-to-date knowledge of healthcare regulations and laws
- Managed multiple databases of patient records for efficient retrieval of data
- Reconciled daily cash postings against system generated reports
- Applied HIPAA privacy and security regulations while handling patient information
- Communicated with insurance representatives to complete claims processing or resolve problem claims
- Coordinated communications between patients, billing personnel and insurance carriers
- Handled billing, waivers and claims for private and commercial clients
- Organized information for past-due accounts and transferred to collection agency
- Leveraged EMR software to post payments received for medical services
- Maintained billing software by updating rate change, cash spreadsheets and current collection reports
- Created reports to track progress of billing activities
- Analyzed data from customer accounts to identify discrepancies
- Assisted in the preparation of monthly financial statements
- Processed credit card payments for customers
- Prepared weekly, monthly, quarterly, and annual reports on billing activity
- Performed daily audits of customer accounts to ensure accuracy of information
- Checked claims coding for accuracy with ICD-10 standards
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices
- Input statement information, reconciled accounts and resolved discrepancies
- Trained new team members on company policies and accounting systems to keep team operations productive and efficient
- Assessed billing statements for correct diagnostic codes and identified problems with coding
- Generated and distributed month-end statements for customers and resolved related concerns
- Maintained accounting ledgers by verifying and posting account transactions
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
Go Live Consultant
Divurgent
Virginia Beach, VA
07.2011 - 08.2014
- Performed data flow and processing mapping, strategic technology planning, data, business and systems analysis
- Implemented new EMR and EHR software
- Resolved billing issues, reviewed claim denials and payer requirements
- Researched and replied to insurance, patient, and internal client inquiries, kept accurate records, greeted, registered, and scheduled patients
- Processed correspondences, attached HIPAA/Medicare documents, checked-in patients
- Identified appropriate account for patient visit, presented and educated patients on required forms, imprinted patient-specific chart documents, copied, filed, and distributed insurance cards
- Scheduled tests and procedures, determined amount of cash to be collected
- Checked-out patients, answered telephone and delivered messages
- Reported obtained medical information accurately, prepared patients' charts
- Created dashboards, reports, and visualizations to monitor trends in patient outcomes
- Developed and implemented data models to analyze healthcare data
- Conducted regular audits of patient records to ensure accuracy of data entry
- Developed methods for automating the process of analyzing large amounts of complex data
- Maintained databases of patient histories, medications, laboratory results, insurance claims
- Collaborated with stakeholders across multiple departments to develop strategies that leverage existing healthcare analytics resources
- Utilized natural language processing techniques to extract relevant information from unstructured text documents such as doctor's notes or discharge summaries
- Reviewed coding conventions used by physicians when entering diagnoses into EHRs
- Protected medical information against unauthorized access, loss or corruption by consistently following security protocols
- Met needs of physicians and other treating team members with timely retrievals of patient medical records
- Enhanced electronic records management systems to meet new needs and forecasted demands
- Developed in-service educational materials
- Conducted comprehensive testing of all applications prior to Go-Live date
- Provided technical support during the post-Go-Live phase
- Generated reports related to Go-Live activities and system performance
- Created detailed plans outlining tasks, resources, timelines, and milestones needed for successful project completion
- Resolved conflicts between teams concerning implementation timelines, budgets, and scope creep
- Facilitated meetings with stakeholders to discuss project progress and identify areas needing improvement
- Consulted via telephone to understand user problems, run through testing scripts and ask probing questions to locate root causes
- Assisted in developing training materials for end users on new systems.
Home Health Aide
Americare Inc
Brooklyn, NY
06.2009 - 07.2010
- Provided routine personal care and basic housekeeping
- Evaluated patients' level of functioning, knowledge of maintaining proper infection control measures
- Self-directed with the capability to work with little or no direct supervision
- Comprehensive knowledge of taking proper measures for patient safety and comfort
- Provided detailed and accurate written reports to agency
- Collected information about conditions and treatment plans from caregivers, nurses, and doctors
- Administered medications as instructed by physician or nurse practitioner
- Answered patient calls promptly, providing assistance or referring them to appropriate personnel when needed
- Reported any changes in the client's physical or emotional condition to supervisor immediately
- Recorded daily notes about client conditions, treatments provided and progress made
- Participated in developing individualized care plans based on medical orders and assessments.
Education
Master of Science in Health Care Administration -
Monroe College
01.2023
Health Information Technology Course -
Suffolk County Community College
01.2016
Bachelor of Arts in Psychology -
Touro College
01.2012
Associates of Arts in Psychology -
Touro College
01.2011
Skills
- Payment Processing
- Invoice Processing
- Data Management
- Accounts Receivable
- Discrepancy Resolution
- Invoice Generation
- Administrative Support
- Cost accounting
- Customer Account Management
- Database Management
- Customer Service
- Hour Tracking
- Expense Tracking
- Account Reconciliation
- Data Analysis
- Accounting Support
- Job Billing
- Cost Tracking
- Account updating
- Word Processing
- Payment Transactions
- Time management abilities
- Accounts Receivable (AR)
- Financial Analysis
- Accounting
- Invoicing
- Employee Timesheet
- Problem-solving aptitude
- Generally Accepted Accounting Principles (GAAP)
- Statement preparation
- Interpersonal Skills
- Reconciling charges
- Decision-Making
- Year-end reporting
- Adaptability and Flexibility
- Continuous Improvement
- Adaptability
- Billing
- Signature Verification
- Customer Contact
- Self-Motivation
- General Ledger Entries
- Interpersonal Communication
- Charges and Rates Documentation
- Organizational Skills
- Problem-Solving
- Written Communication
- Analytical Skills
- Bilingual (Spanish)
- Accounts Payable (AP)
- Operations
- Administrative Assistance
- Financial Services
- Healthcare: Outpatient
- Inpatient
- Hospital
- Environmental
- Billing Systems
- Collections Management
- Inquiry Handling
- Financial Reporting
- Cost Reporting
- Billing Document Creation
- Discrepancy Reconciliation
Systems Experience
- Athena IDX & Soarian
- Excel
- Deltek (ERP)
- VantagePoint
- SAP
- Crystal Reports
- EcareNext
- Fluent in Spanish
- Irvine
- EleVia Electronic Invoicing
- ICD-10
- CPN
- Allscripts
- Collaborati
- Nokia
- Legal Tracker
- Patient Keeper
- Siemens Soarian
- AS-OBGYN
- Senior Leadership
- Google Sheet
- Word
- Microsoft
Timeline
Senior Billing Analyst
Roux Environmental Consulting & Management
11.2022 - Current
Revenue Cycle Data Analyst
Northwell Health
09.2014 - 10.2022
Go Live Consultant
Divurgent
07.2011 - 08.2014
Home Health Aide
Americare Inc
06.2009 - 07.2010
Master of Science in Health Care Administration -
Monroe College
Health Information Technology Course -
Suffolk County Community College
Bachelor of Arts in Psychology -
Touro College
Associates of Arts in Psychology -
Touro College
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