Summary
Overview
Work History
Education
Skills
Timeline
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SHANA MARIE RUSSO

Matawan,NJ

Summary

Healthcare professional with comprehensive experience in medical administrative tasks and patient interaction. Known for effective office management, ensuring smooth operations and seamless patient flow. Skilled in medical terminology, electronic health records, benefits, pre authorizations and patient office /surgical scheduling. Fluent in Spanish and Portuguese languages.

Overview

25
25
years of professional experience

Work History

Medical Office Assistant-Pre Authorization/Patient Coordinator

ALLIED DIGESTIVE HEALTH - GASTROENTEROLOGY
05.2022 - 11.2023
  • Verify patients' benefits, eligibility and submit pre-authorization documentation and referrals as required for medical procedures
  • Schedule patients for office visits, medical records requests, collect co pays/coinsurance, patient billing, and claims resolution for collections.

Pediatric Office Insurance & Billing/Front Desk assistant

SENSORY PLAYGROUND THERAPY
05.2021 - 12.2021
  • Processed insurance pre authorizations for pediatric OT/PT therapies; managed collections; set up payment plans
  • Submitted patient evaluations and progress notes; processed medical billing claims in Web PT portal
  • Scheduled appointments, created, and maintained files; processed claims, verified insurance benefits and eligibility using Availity, Navinet, Aim Specialty, NIA, Meritain, UHC, Optum and Horizon, collected and reconciled accounts.

Pediatric Office Insurance & Billing/Front Desk assistant

SENSORY PLAYGROUND THERAPY
05.2021 - 12.2021
  • Processed insurance pre authorizations for pediatric OT/PT therapies; managed collections; set up payment plans
  • Submitted patient evaluations and progress notes; processed medical billing claims in Web PT portal
  • Scheduled appointments, created, and maintained files; processed claims, verified insurance benefits and eligibility using Availity, Navinet, Aim Specialty, NIA, Meritain, UHC, Optum and Horizon, collected and reconciled accounts.

Human Resources/ Benefits Manager

GENESIS HEALTHCARE CENTER
06.2010 - 04.2017
  • Recruited new hires and conducted onboarding functions beginning to end, improved employee retention rates, supported organization development, implemented HR policies and employee recognition programs
  • Administrated health benefits, disability, workers' compensation, leaves of absence, pension, and retirement plans
  • Conducted employee investigations, including conflict resolution, and properly documenting all incidents
  • With management, advised and counseled administrative staff of proposed organization changes.

Human Resources/ Benefits Manager

GENESIS HEALTHCARE CENTER
06.2010 - 04.2017
  • Recruited new hires and conducted onboarding functions beginning to end, improved employee retention rates, supported organization development, implemented HR policies and employee recognition programs
  • Administrated health benefits, disability, workers' compensation, leaves of absence, pension, and retirement plans
  • Conducted employee investigations, including conflict resolution, and properly documenting all incidents
  • With management, advised and counseled administrative staff of proposed organization changes.

Benefits & Leave of Absence Specialist

INVENTIV HEALTH INC.
03.2008 - 10.2009
  • Administered benefits for corporate sales force nationwide/internationally; conducted benefits orientations
  • Counseled on eligibility and ensured legal compliance for leaves of absence and workers' compensation
  • Processed disability, workers' compensation, and FMLA for NJ, PA, CT, CA, RI, and HI
  • Counseled employees on compliance and eligibility for NJFLA, NJ Paid Family Leave/NJ Bonding.

Benefits & Leave of Absence Specialist

INVENTIV HEALTH INC.
03.2008 - 10.2009
  • Administered benefits for corporate sales force nationwide/internationally; conducted benefits orientations
  • Counseled on eligibility and ensured legal compliance for leaves of absence and workers' compensation
  • Processed disability, workers' compensation, and FMLA for NJ, PA, CT, CA, RI, and HI
  • Counseled employees on compliance and eligibility for NJFLA, NJ Paid Family Leave/NJ Bonding.

Benefits Counselor

RARITAN BAY MEDICAL CENTER
03.2006 - 03.2008
  • Company Overview: HOSPITAL & HEALTH CARE
  • Assisted in administration and communication of employee benefit plans; conducted new hire benefits enrollments/orientations
  • Conducted annual benefits open enrollments for all employees
  • FMLA, COBRA, disability, health benefits, workers' compensation, and retirement/pension plans.
  • HOSPITAL & HEALTH CARE

Benefits Counselor

RARITAN BAY MEDICAL CENTER
03.2006 - 03.2008
  • Company Overview: HOSPITAL & HEALTH CARE
  • Assisted in administration and communication of employee benefit plans; conducted new hire benefits enrollments/orientations
  • Conducted annual benefits open enrollments for all employees
  • FMLA, COBRA, disability, health benefits, workers' compensation, and retirement/pension plans.
  • HOSPITAL & HEALTH CARE

Human Resources Assistant

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
06.2002 - 12.2005
  • Administered benefits, retirements and leaves of absence programs, new hire orientations, employee relations and performance issues
  • Managed job fairs, payroll issues and maintained legally compliant personnel files.

Human Resources Assistant

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
06.2002 - 12.2005
  • Administered benefits, retirements and leaves of absence programs, new hire orientations, employee relations and performance issues
  • Managed job fairs, payroll issues and maintained legally compliant personnel files.

Human Resources Coordinator

SANOFI-AVENTIS PHARMACEUTICALS
06.2002 - 12.2005
  • Maintained data integrity; generated audit reports and provided basic report support in SAP/Glorhia
  • Processed promotions, transfers, leaves, hires, and terminations for domestic and international hires in US/Puerto Rico
  • As primary contact for HR Services, participated in enhancement and redesign of onboarding process.

Human Resources Coordinator

SANOFI-AVENTIS PHARMACEUTICALS
06.2002 - 12.2005
  • Maintained data integrity; generated audit reports and provided basic report support in SAP/Glorhia
  • Processed promotions, transfers, leaves, hires, and terminations for domestic and international hires in US/Puerto Rico
  • As primary contact for HR Services, participated in enhancement and redesign of onboarding process.

Customer Service Benefits Representative

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
04.1999 - 12.2001
  • Handled complex client base; provided customer service to policyholders, providers, and brokers
  • Quoted eligibility and claims status, processed claims for payment or adjustment.

Customer Service Benefits Representative

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
04.1999 - 12.2001
  • Handled complex client base; provided customer service to policyholders, providers, and brokers
  • Quoted eligibility and claims status, processed claims for payment or adjustment.

Education

Bachelor of Science - Business Administration

Centenary University
Parsippany, NJ
01-2018

Associate Degree in Applied Science - Business Administration

Gibbs College
Montclair, NJ

Certificate - Executive Assistant Program

Katherine Gibbs School
Piscataway, NJ
01-1996

Skills

  • MS Office
  • HRIS
  • EMR
  • ADP
  • Athena
  • Practice Fusion
  • Availity/Navinet
  • Web PT
  • Knowledge of Medical Terminology
  • HIPAA regulations

Timeline

Medical Office Assistant-Pre Authorization/Patient Coordinator

ALLIED DIGESTIVE HEALTH - GASTROENTEROLOGY
05.2022 - 11.2023

Pediatric Office Insurance & Billing/Front Desk assistant

SENSORY PLAYGROUND THERAPY
05.2021 - 12.2021

Pediatric Office Insurance & Billing/Front Desk assistant

SENSORY PLAYGROUND THERAPY
05.2021 - 12.2021

Human Resources/ Benefits Manager

GENESIS HEALTHCARE CENTER
06.2010 - 04.2017

Human Resources/ Benefits Manager

GENESIS HEALTHCARE CENTER
06.2010 - 04.2017

Benefits & Leave of Absence Specialist

INVENTIV HEALTH INC.
03.2008 - 10.2009

Benefits & Leave of Absence Specialist

INVENTIV HEALTH INC.
03.2008 - 10.2009

Benefits Counselor

RARITAN BAY MEDICAL CENTER
03.2006 - 03.2008

Benefits Counselor

RARITAN BAY MEDICAL CENTER
03.2006 - 03.2008

Human Resources Assistant

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
06.2002 - 12.2005

Human Resources Assistant

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
06.2002 - 12.2005

Human Resources Coordinator

SANOFI-AVENTIS PHARMACEUTICALS
06.2002 - 12.2005

Human Resources Coordinator

SANOFI-AVENTIS PHARMACEUTICALS
06.2002 - 12.2005

Customer Service Benefits Representative

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
04.1999 - 12.2001

Customer Service Benefits Representative

GREAT WEST LIFE & ANNUITIES INSURANCE CO.
04.1999 - 12.2001

Bachelor of Science - Business Administration

Centenary University

Associate Degree in Applied Science - Business Administration

Gibbs College

Certificate - Executive Assistant Program

Katherine Gibbs School
SHANA MARIE RUSSO