ROSEANN HOSTOS

Work History

TRINITY HEALTH

12.2022 - Current

Reviewed insurance claims for accuracy and completeness.
Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
Maintained compliance with Medicare regulations and standards by staying current on relevant laws, policies, and best practices for handling insurance claims.
Managed a high volume of claims simultaneously, prioritizing cases based on complexity and urgency to optimize workflow efficiency.
Assisted providers with appeals processes when warranted, advocating for fair reimbursement determinations based on clinical documentation and policy guidelines.
Expedited payment turnaround times by promptly resolving discrepancies in claims submissions.

BayCare Medical Group

09.2021 - 12.2022

Handled insurance verification and provided assistance with forms and documentation.
Enhanced patient satisfaction by efficiently managing appointment scheduling and check-in procedures.
Coordinated referrals to specialists, ensuring patients received the appropriate care in a timely manner.
Effectively managed high-stress situations while maintaining professionalism under pressure, ensuring a positive experience for both patients and staff.

NYC Health and Hospitals

09.2018 - 08.2021

Developed strong relationships with insurance companies through effective communication and negotiation skills, enhancing payment turnaround times.
Enhanced revenue cycle management by overseeing timely and accurate claims submission.
Served as an expert resource on complex patient account issues or high-dollar claims requiring specialized handling, ultimately resolving outstanding balances in an efficient manner.
Monitored compliance with industry regulations to mitigate risks associated with audits and penalties.
Achieved key performance metrics goals by setting expectations for the team''s output quality standards while monitoring progress toward objectives closely throughout each reporting period.
Trained team members on best practices in medical billing, ensuring consistent high-quality work across the department.

NYC Health and Hospitals

01.2006 - 09.2018

Developed strong working relationships with hospital departments and staff members, facilitating efficient information gathering during investigations.
Protected patient rights by overseeing employee HIPAA education program.
Worked with customers to develop payment plans and bring accounts current.
Reviewed billing problems, researched issues, and resolved concerns.
Posted and adjusted payments from insurance companies.
Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.