Serena Morales
Edison,NJ
Summary
Experienced with data analysis, statistical modeling, and business intelligence tools. Utilizes analytical skills to identify trends and provide actionable insights that support business decisions. Knowledge of data visualization techniques and effective communication ensures clear presentation of complex information to stakeholders.
Overview
16
16
years of professional experience
Work History
Patient Access Analyst
Hackensack Meridian Health JFK Medical Center
Edison, NJ
09.2021 - Current
- Analyzed healthcare data to identify trends and support decision-making processes.
- Implements the Medical Center's pre-registration, pre-certification, referral procurement and insurance verification policies and procedures for the assigned outpatient point of service
- Adheres to patient identification policy and ensures an accurate patient search is performed in order to prevent duplicate medical record numbers
- initiate real time eligibility query on all eligible insurances. Must review real time eligibility response to ensure correct plan code assignment and correct coordination of benefits to facilitate timely reimbursement
- Ensure accurate completion of Medicare Secondary Payer Questionnaire
- Where appropriate, pursues upfront cash collections to assist patients in understanding their financial responsibilities and minimize overall bad debt
- Informs patients of their out of pocket responsibility taking payment via credit card or in person and explaining financial resources including financial assistance, payment plans or payment on date of service
- Verifies benefits to ensure the procedure is a covered service under the patients plan prior to receiving services
- Verifies pre-authorization requirements and follows up with both the referring physician and payer to ensure authorizations are on file for the scheduled procedure prior to date of service
- Ensures diagnosis data that is entered on registration is accurate and meets medical necessity criteria
- Answers a high volume number of phone calls and responds in an appropriate/professional manner. Address and resolve any issues quickly/accurately
- Able to access and navigate various payer websites (e.g. Availity) to confirm patients' insurance coverage and policy benefits
- Works with patients to financially clear their account per policy at least 7 days prior to procedure. Resolves any issues with coverage and escalates any complications to manager. Makes referrals to Financial Counselors if appropriate
- Very knowledgeable with Epic
- Checks email daily to maintain timely updates on any process/task changes/updates
- Meet departmental daily productivity and process standards
- other duties and/or projects as assigned
- Completes assigned work queue accounts in a timely and efficient manner
Patient Account Analyst
Hackensack Meridian Health JFK Medical Center
Edison, NJ
01.2019 - 09.2021
- Analyzed patient accounts for billing discrepancies and ensured accurate resolutions.
- Collaborated with healthcare providers to optimize claims processing and reimbursement cycles.
- Monitored account status and followed up on outstanding balances to enhance revenue recovery.
- Developed and implemented process improvements to streamline account reconciliation workflows.
Materials Management Distribution Technician
Hackensack Meridian Health JFK Medical Center
Edison, NJ
11.2009 - 01.2019
- Managed inventory levels to ensure timely replenishment and minimize stockouts.
- Oversaw order fulfillment processes, ensuring accuracy in picking and packing operations.
- Implemented best practices for materials handling to enhance safety and efficiency in distribution.
- Trained new team members on operational procedures and safety protocols.
Education
High School Diploma -
Certificate - Medical Billing And Codien
Medical Billing And Coding For Professional LLC
Linden04-2018
High School Diploma -
Piscataway High School
Piscataway, NJ06-1994
Skills
- Time management
- Analytical Thinking
Timeline
Patient Access Analyst
Hackensack Meridian Health JFK Medical Center
09.2021 - Current
Patient Account Analyst
Hackensack Meridian Health JFK Medical Center
01.2019 - 09.2021
Materials Management Distribution Technician
Hackensack Meridian Health JFK Medical Center
11.2009 - 01.2019
High School Diploma -
Certificate - Medical Billing And Codien
Medical Billing And Coding For Professional LLC
High School Diploma -
Piscataway High School