Nicole Perlingiero-Lapointe
Johnston,RI
Summary
To secure a position with in the Providence VA Medical Center
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
18
18
years of professional experience
Work History
Third Party Audit Coordinator
Lifespan
07.2016 - 11.2024
- Company Overview: Brown University Health
- Coordinate all non-government and government health plan audits for Lifespan and its affiliates
- Review all third-party audit requests to ensure there are no contracting concerns
- Works independently and assumes day to day leadership for routine third party payer audits relating to denials and underpayments
- Maintains database for third party audits which includes: Inputting all third-party audit and complex review letters, tracking deliverables from various departments, and updating payer findings
- Provides continuous communication to HIM Department to ensure responses to third party audits are responded within the contracted timeframe
- Works closely with payers and outside audit companies challenging complex decisions and ensure audit determinations are received within specified timeframes
- Communicates with Manager and Director of Contracting regularly to express concerns and recommend resolutions to problems encountered
Public Assistance Coordinator
Landmark Medical Center
07.2006 - 07.2016
- Supervised Customer Service Department
- Managed Self Pay Receivables which included providing estimates to patients and collecting deposits on elective procedures screening patients for COBRA, State Programs, and Disability
- Worked closely with patients ensuring accuracy with the charity applications process, created and maintained Excel database for charity applications providing statistics to Senior Management
- Certified with the State of Rhode Island to complete Medicaid applications communicating and collaborating with Physicians, Utilization Management, Social Workers and the Department of Health and Human Services
- Escorted patients to SSA and the Department of Health and Human Services to ensure compliancy
- Active member of the Hospital Association of Rhode Island for the Affordable Care Act and maintain Financial Resource Counseling certification for the submission of Rite Care Applications
- Familiar with JACHO and EMTALA requirements
- Supervised 1 full time employee
Emergency Room Registration Specialist
Lifespan
11.2014 - 04.2015
- Company Overview: The Miriam Hospital
- Register patients with various third-party insurances utilizing Epic Lifechart
- Collect all demographic information for patients presenting to the ED
- Provides access to payer websites on behalf of the enterprise
- Verify and validate all insurance information
- Collect all pertinent billing forms and required documents for Medicare Billing
- Complete admission checklist to ensure accuracy prior to patients leaving ED
- Verify and collect copayments for patient visits
- Interact with various departments including medical records and Patient Financial Services
Education
Cosmetology School -
01.1993
Liberal Arts -
09-1990
High School -
01.1990
Skills
- Patient Oriented
- Motivated self-starter
- Excelled customer service skills
- Time management
- Problem-solving abilities
- Attention to detail
- Organizational skills
- Prioritization
- Telephone etiquette
- Electronic communication
- Computer skills-Epic, McKesson Billing System, Word, and Excel
- Medical terminology
- Teamwork and collaboration
- Reliability
- Excellent communication
- Process improvement recommendations
Activities
Special Olympics Volunteer
Timeline
Third Party Audit Coordinator - Lifespan
07.2016 - 11.2024
Emergency Room Registration Specialist - Lifespan
11.2014 - 04.2015
Public Assistance Coordinator - Landmark Medical Center
07.2006 - 07.2016
North Providence High School - High School,
Loretta's School of Cosmetology - Cosmetology School,
CCRI - Liberal Arts,
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