SEAN THOMAS
New Hyde Park,NY
Summary
Detail-oriented healthcare revenue cycle management professional with extensive expertise in claims processing and insurance reimbursement. Demonstrated proficiency in ICD-10, CPT, and HCPCS coding, specializing in prior authorizations and denial resolution to enhance revenue and minimize billing errors. Adept at utilizing EHR and billing software to analyze accounts, identify discrepancies, and implement strategic solutions that improve cash flow while maintaining exceptional service standards for patients and providers. Committed to continuous learning and professional development within the healthcare sector.
Overview
7
7
years of professional experience
Work History
Supervisor - Clinical Appeals
Jzanus
Franklin Square, NY
01.2024 - Current
- Staff Training & Development - Train and mentor billing staff on payer requirements, billing software, coding standards, and changes in insurance regulations.
- Ensure the team stays updated on billing procedures, and regulatory workflow changes
- Management Reporting - Prepared and analyzed billing reports, tracking claim statuses, outstanding balances, denial rates, and payment trends.
- Collaborated with the finance department to reconcile payments, identify unpaid claims
- Ensured claims were submitted accurately with proper coding (ICD-10, CPT, HCPCS) and medical documentation to prevent delays or denials.
- Managed high-volume billing processes and addressed any discrepancies in patient billing.
- Oversee Billing Operations - Supervise a team of medical billers, ensuring timely and accurate submission of appeals for claim denials
- Ensure that appeals and claims are submitted in accordance with payer requirements, including correct coding, proper documentation, authorization and adherence to insurance guidelines.
- Team Management - Monitored daily workflow, delegated tasks, and ensured the team met billing deadlines and accuracy goals.
- Conducted performance evaluations, provided coaching, and managed staffing needs.
Authorization Unit
Northwell Health
New York, NY
09.2022 - 04.2023
- Coordination with Healthcare Providers - Worked closely with physicians, nurses, and administrative staff to secure necessary approvals for scheduled procedures and services.
- Communicate with insurance companies to resolve authorization issues and expedite approvals.
- Claims & Denial Management - Investigated and resolved authorization denials by coordinating appeals and resubmitting necessary documentation.
- Secured prior authorizations for imaging procedures such as MRIs, CT scans, ultrasounds, and X-rays by coordinating with insurance providers.
- Assigned accurate ICD-10, CPT, and HCPCS codes for radiology procedures, inpatient/outpatient services, and diagnostic tests.
- Radiology Appointment Scheduling - Scheduled and coordinated imaging procedures, including MRIs, CT scans, X-rays, ultrasounds, and mammograms, ensuring efficient patient flow.
Registrar Associate
Northwell Health
New Hyde Park, New York
01.2020 - 09.2022
- Patient Registration & Intake - Registered patients efficiently by collecting and verifying personal, medical, and insurance information in compliance with HIPAA regulations.
- Insurance Verification & Billing Support - Verified insurance eligibility and benefits, processed authorizations, and informed patients of co-pays and financial obligations.
- Collaborated with billing departments to ensure proper coding and accurate claims submission.
- Understanding Authorization denials and proper ICD-10 coding
- Electronic Health Records (EHR) Management - Entered and updated patient demographics, medical history, and insurance details in EHR systems to maintain accurate and accessible records.
- Customer Service & Patient Assistance - Provided exceptional customer service by addressing patient inquiries, guiding them through the registration process, and resolving concerns professionally.
- Assisted in scheduling patient appointments, tests, and follow-ups to streamline healthcare services.
DIC Support Associate
Northwell Health
New Hyde Park, NY
07.2018 - 01.2020
- Facility & Equipment Management – Ensured medical equipment, supplies, and patient areas were clean, stocked, and properly maintained
- Patient Support & Assistance Lead – Managed patient check-in, transportation, and inquiries, ensuring a seamless hospital experience while coordinating with medical staff to optimize patient flow and care efficiency.
- Collaboration with Medical Staff – Worked closely with nurses, doctors, and Radiology Techs to support patient care and operational needs.
- Insurance & Billing Support – Assisted with verifying insurance information, processing payments, and explaining billing procedures to patients.
- Records Retrieval & Filing – Organized and retrieved patient files for medical staff, ensuring efficient record-keeping in both digital and paper formats
Cashier Team Lead
Sears
Garden City
11.2017 - 06.2018
- Performance Monitoring and Coaching – Provided ongoing feedback, conducted performance evaluations, and motivated team members to meet and exceed sales targets.
- Supervised and trained staff – Led a team of sales associates, provided coaching, and ensured employees met performance goals and company standards.
- Scheduling and Workforce Management – Created employee schedules, assigned tasks, and managed shift coverage to maintain smooth store operations.
- Conflict Resolution and Problem-Solving – Addressed customer complaints, resolved employee conflicts, and implemented solutions to improve team dynamics.
Education
BBA - Economic
Cuny Baruch College
New York, NY05-2025
Associate of Science - Accounting and Business Administration
Nassau Community College
Garden City, NY05.2022
Skills
- Problem-Solving & Critical Thinking
- Leadership & Team Collaboration
- Documentation & Accuracy
- Staff management
- Inventory control
- Analytical thinking
- Dispute resolution
- Assertiveness
- Leadership Management
- Strong Time Management
- Knowledge in Epic, Eagle, Meditech, Careport, and other hospital systems
- Knowledge of EHR Portals
- Strong knowledge of Microsoft applications
- Data analysis
Volunteer Experience
- Parker Jewish Institution for Healthcare and Rehab, New Hyde Park, NY, Occupational Therapy Assistance,
- St Johns Mar Thomas Church, Queens, NY, Organized Fellowships, Retreats and Biblical Activities, Meal On Wheels And Bake Sales
- Lending-A-Hand Organization, Queens, NY, Parish Representative, Volunteered at the Ronald Mc Donald House
Timeline
Supervisor - Clinical Appeals
Jzanus
01.2024 - Current
Authorization Unit
Northwell Health
09.2022 - 04.2023
Registrar Associate
Northwell Health
01.2020 - 09.2022
DIC Support Associate
Northwell Health
07.2018 - 01.2020
Cashier Team Lead
Sears
11.2017 - 06.2018
BBA - Economic
Cuny Baruch College
Associate of Science - Accounting and Business Administration
Nassau Community College
Similar Profiles
Guy JulesGuy Jules
Revenue Cycle Representative at JzanusRevenue Cycle Representative at Jzanus
Felicity VidalFelicity Vidal
Billing Specialist at Jzanus Home Care Inc.Billing Specialist at Jzanus Home Care Inc.
Bibi H Khan KhalilBibi H Khan Khalil
Clerk at Jzanus Ltd.Clerk at Jzanus Ltd.