Experience

D & A Medical Billing & Consulting Inc
• United States
• Medical Practices
• 1 - 100 Employee
• CEO/Founder

  • Nov 2015 - Present


GeneDx

• United States
• Biotechnology Research
• 700 & Above Employee

• Senior Manager

  • Nov 2015 - Mar 2019

  Managing a staff of 23 representatives responsibilities lie in Prior Authorization totaling over 5000 case per month, and Responsible for posting $15M/month gross revenue. Understands and applies payor prior-authorization requirements, and stays current with payor changes. Provides excellent customer service by adhering to quality standards and case management/confidentiality policy and procedures. Maintains/documents accurate record of insurance/pre-auth company information. Communicates barriers or process improvement opportunities to management. Training new personnel or in implementing new procedures. Adheres to the company Compliance Program and policies. Monitor staff productivity. Create team SOP. Generate monthly trend reports. Assist with hiring, disciplinary, and performance evaluations. Having hiring/firing authority and/or significant impact on hiring/firing decisions. Oversee the process of providing coverage for employee vacation and sick calls. Provide back-up for scheduling as needed. Provide department orientation for all direct reports and coordinates training per job description. Liaison with other managers/supervisors to promote ongoing communication and ensure accuracy. Responsible for departments reaching goals. Attends appropriate business meetings, and assists manager with implementation of new policies, goals and objectives that relate to business functions. Act as an escalated level of response for patient concerns and complaints; assists staff with enforcing policy. Keep staff informed regarding new and changing policies and procedures. Promote a positive working environment through role modeling, team development, respect, and being fair and consistent.



BioReference Laboratories

• United States
• Biotechnology Research
• 100 - 200 Employee

• Billing Representative, Account Receivable

  • Feb 2012 - Nov 2015

  Correcting all kind of denials and resubmit claims to insurance Coding medical records with ICD-9, CPT-4. Calling doctor office to obtain missing information Submitting all kind of appeals to insurance (late filing, out of network) Printing all management report (aged claims) for all insurance Calling patients to obtain missing information and collect unpaid bills Coding Cytopathology reports with ICD-9, CPT-4 Correcting all kind of denials and resubmit claims to insurance Coding medical records with ICD-9, CPT-4. Calling doctor office to obtain missing information Submitting all kind of appeals to insurance (late filing, out of network) Printing all management report (aged claims) for all insurance Calling patients to obtain missing information and collect unpaid bills Coding Cytopathology reports with ICD-9, CPT-4