Summary
Overview
Work History
Languages
Timeline
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Vanessa Brenes

Bay Shore,NY

Summary

Results-oriented achiever with a track record of consistently surpassing targets. Possessing a blend of strategic thinking and hands-on experience, able to deliver impactful solutions that enhance organizational performance. Committed to continuous improvement and dedicated to making a significant impact in any role undertaken.

Overview

9
9
years of professional experience

Work History

Revenue Cycle Quality & Performance Management Analyst (Analytics Team)

Northwell Health
01.2022 - Current
  • Identify, review, and analyze large data sets for denials, systemic trends, and payer behaviors
  • Present data and summary of analysis to Revenue Managers/Directors for appeal to payers
  • Demonstrates expertise in the use of GECB and DBMS to obtain information from the IDX system to prepare reports for analysis
  • Provide Ad Hoc reporting as requested
  • Research payer policies that affect reimbursement and other areas of Revenue Cycle
  • Review and analyze weekly/monthly dashboards
  • Utilize analytical skills and excel to manage special projects based on CBO needs and requests from CBO and other teams across the health system
  • Works as a team with management, physician practices and other administrative personnel

Revenue Cycle Quality & Performance Management Analyst (Provider Enrollment)

Northwell Health
01.2019 - 03.2021
  • Performs management reporting and financial analysis for physician practices for thousands of providers across all specialties, departments, locations, insurance carriers, and AR volumes
  • Prepares financial and clinical reports using data extracted from the IDX system and other financial databases
  • Identifies and proposes solutions to enrollment delays for providers
  • Assists leadership in planning and implementing policies and procedures resulting from changes in enrollment, reimbursement and/or bad debt
  • Manually reviews high-dollar and high-volume reports informing accruable, risk and bad debt revenue when necessary to ensure reliable data for management, physician practices and administrative personnel
  • Follows-up on outstanding inquiries with third party vendors as needed for provider updates
  • Provides guidance and training to support staff on current and new procedures
  • Creates and maintains job aids, workflows, and other supplemental work material to increase efficiency and consistency of work in the department
  • Demonstrates expertise in accounts receivables applications for assisting support staff and management with routine query writing, reporting, and auditing
  • Demonstrates expertise in training and performing quality reviews for staff

Senior Clinical Practice Plan Representative

Northwell Health
01.2016 - 12.2018
  • Accurately document researched information while doing claim follow up with insurance carriers to obtain payment
  • (AR Follow up, PPD/SWP, Crime Victims, SPNI International.)
  • Reviews medical records and claims for completeness for claim submission (Documentation Edits.)
  • Assists with creation/Re-editing of workflows
  • Works with mailbox requests for external locations (CPP Mailbox.)
  • Works alongside management on various projects and meets deadlines within a timely manner
  • Train new hires and seasoned employees as well reviewing representatives’ work for accuracy and efficiency

Languages

Spanish

Timeline

Revenue Cycle Quality & Performance Management Analyst (Analytics Team)

Northwell Health
01.2022 - Current

Revenue Cycle Quality & Performance Management Analyst (Provider Enrollment)

Northwell Health
01.2019 - 03.2021

Senior Clinical Practice Plan Representative

Northwell Health
01.2016 - 12.2018

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Vanessa Brenes