Waheeda Hussain
Richmond,TX
Summary
Determined Reimbursement Manager thinking outside-of-the-box and overseeing cost reporting processes. Offering more than 3 years of observing data confidentiality requirements, keeping accurate records and assessing data. Experienced in working closely with team members, upper management and other key stakeholders.
Overview
17
17
years of professional experience
Work History
Field Reimbursement Manager
AmerisourceBergen Xcenda
10.2021 - Current
- Manage daily activities that support appropriate patients access to Client’s products in various provider sites of service as well worked as liaison to offer patient assistance and patient services offered by Hub
- Provided support for coding, reimbursement and addressed authorization, appeals and denials
- Reviewed patient insurance benefit options and validated prior authorization requirements
- Identifying alternate funding/financial assistance programs
- Reviewed patient-specific information in cases where site has specifically requested assistance and patient health information is available in resolving any issues or coverage challenges
- Coordinated with client’s to offer patient support services programs Collaborated with ISGS, KAM, KAS and ABS to identify client needs one team one dream
- Supported clients with access barriers and affordability related issues
- Face to face meetings with clients assisted with Hub/portal enrollment
- Direct interaction with Nurse Navigator on weekly and or daily to resolve any access related situations
- Informed clients on payor updates which included Medicare SAD list.
- Increased efficiency in reimbursement process by implementing streamlined procedures and guidelines.
- Maintained strong knowledge of medical terminology and procedures.
- Monitored industry trends and regulatory changes to stay current on best practices for reimbursement management.
- Streamlined communication between departments involved in reimbursement process, fostering collaboration and accuracy
- Observed strict data confidentiality procedures to protect patients' information
- Helped minimize escalations by reaching out to clients in advance of expected problems
- Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results
Patient Access
Houston Methodist Hospital
08.2014 - 12.2015
- Register patients in high volume Emergency Room
- Verify insurance
- Collect patient demographics, received co-pays and/or deductibles, and adjusted patient accounts with payments
- Create new profiles for patients and updated patient information into hospital database
- Accomplish projects on timely manner
- Post payments and generate receipts
- Assist patient with bill related problems, direct callers with appropriate information and personnel. Maintained compliance with HIPAA regulations, safeguarding sensitive patient information throughout all stages of registration process.
- Promoted positive work environment by fostering teamwork among Patient Access Clerk staff members.
- Reduced patient wait times by effectively prioritizing tasks and delegating responsibilities among team members.
Patient Access
The Brooklyn Hospital Center
11.2013 - 08.2014
- Register patients for chemotherapy, special treatment infusions and office visits
- Verify insurance, schedule/confirm appointments and greet patients
- Manage patient records, answer multi-phone line, fax progress notes, and retrieve medical records
- Collect patient demographics, received co-pays, and adjusted patient accounts with payments
- Create new profiles for patients and updated patient information into hospital database
- Retrieve voicemail messages, call all no-show patients-send letters for missed appointments, sort and distribute mail
- Accomplish projects on timely manner
- Post payments and generate receipts
- Create letters for patients as dictated by doctors, collaborated with senior management to created positive workflow
- Assist patient with bill related problems, direct callers with appropriate information and personnel
- Managed and trained volunteers.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information throughout all stages of registration process.
- Identified opportunities for process improvement within Patient Access department, resulting in tangible enhancements to overall operational efficiency levels.
ROI Specialist
HealthPort The Brooklyn Hospital
01.2013 - 11.2013
- Assisted with management of associates in area of release of information and trained new hires
- Worked closely with area and district manage to insure that charts were handled in secure manner
- Met Daily demands of records delivery to requester
- Answered multi-line phone system, transferred calls, open and sorted mail
- Transacted over 75 chart request daily customers and made records available virtually to clients in need
- Provided customers with highest quality product and customer service
- Demonstrated working knowledge of E-Smartlog, Smart-link, rep online and other work tools and software
- Generated reports from E-Smartlog, rep online and other tools and software
- Submitted weekly reports as directed by Area and/or District Manager
- Validate requests and authorizations for release of medical information according to established procedures and HIPAA guidelines.
- Improved efficiency of ROI analysis by streamlining data collection and reporting processes.
- Developed strong relationships with third-party payers, facilitating prompt resolution of claims issues and ensuring accurate reimbursements.
- Provided comprehensive reports on key performance indicators to senior management for informed decision-making purposes.
Administrator/Coordinator
Dr. Paul Bader & Dr. Nasir Gondal: Hematology/Oncology
11.2006 - 01.2013
- Managed medical front desk
- Schedule appointments, prepare charts for medical chart reviews, verify insurance, obtain referrals for patients, and daily interaction with all major health insurance carriers
- Gathered up-to-date contact information for physicians
- Managed credentialing process
- Verified legitimacy of practitioner information with universities, licensing agencies, and certification group
- Distributed mail to physician’s and office manager, order and process office supplies, register new patient, created new patient charts, answer phones, filing, faxing, and photocopying
- Obtained medical transcriptions from medical practices/hospitals
- Also responsible for collecting patient co-payments end of business day
- Developed tracking system for scans and authorizations
- Coordinated daily pharmaceutical related matters to verify and expedite high volume of prescription orders
- Inform patients of abnormal lab results and adjust Coumadin dosage
- Initiated and acquired authorizations - schedule all radiology exams for patients
- Manage office staff schedule
- Research patient medical history and entered patient information into database
- Generated KRAS, EGFR/ALK studies and CT Guided biopsy clearance for patients.
- Completed bi-weekly payroll for 6 employees.
- Implemented efficient filing system that improved document retrieval times significantly
- Streamlined office processes by implementing new administrative procedures and tools.
- Maintained strict confidentiality while handling sensitive information pertaining to company operations or personnel matters.
Education
Bachelor of Professional Studies in Business Administration - Health Information Management
DeVry College of New York
New York, NY06.2012
Skills
- Microsoft Office
- Credentialing and Multi-Tasking-Abilities
- Knowledge of CPT/ICD-9 Codes
- EPIC
- Centricity
- Emdeon E-cashiering and Clearwave
- Paffa
- Whiz
- Salesforce
- HCPCS Coding
- HIPAA Compliance
- Insurance Verification
- Medicare knowledge
- Provider Relations
- Revenue Cycle Management
- Reimbursement Strategies
- Medicaid knowledge
- Copay Collection
- Eligibility Verification
- Benefits Administration
Timeline
Field Reimbursement Manager
AmerisourceBergen Xcenda
10.2021 - Current
Patient Access
Houston Methodist Hospital
08.2014 - 12.2015
Patient Access
The Brooklyn Hospital Center
11.2013 - 08.2014
ROI Specialist
HealthPort The Brooklyn Hospital
01.2013 - 11.2013
Administrator/Coordinator
Dr. Paul Bader & Dr. Nasir Gondal: Hematology/Oncology
11.2006 - 01.2013
Bachelor of Professional Studies in Business Administration - Health Information Management
DeVry College of New York
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