Experience

ClaimCare

• Hospitals and Health Care
• 1 - 100 Employee

• Insurance Follow Up

  • May 2019 - Present



Oak Orchard Community Health Center

• Hospitals and Health Care
• 1 - 100 Employee

• Patient Advocate

  • Aug 2016 - May 2019

  Medical billing specialist, Medicaid Medical billing specialist, Medicaid



Rochester Regional Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Patient Account Specialist

  • Aug 2014 - Aug 2016

  • Bill Medicaid Primary and secondary claim’s using the e-Paces system on e-MedNY to generate timely payment of claims. • Work various reports to process appeals for Medicaid denials. • Research and solve unpaid A/R to bring over 90 day A/R down as much as possible • Work Medicaid Eligibility Reports to be sure patients are being billed correctly • Receive, research, resolve, and bill ACM Lab charges for Medicaid patients • Use various websites to determine patient’s insurance eligibility, bill or send to correct biller accordingly • Post payments received from various insurance companies as needed • Research and post “Bad Debt” accounts weekly • Newsletter Committee "Reidman Reader" - writing column “For Your Health”, monthly • Rochester Regional – Regional Actions Committee – Activity committee to promote interaction of merged Rochester General and Unity Hospital/Clinic employees and to promote common ground through community service and charity fundraising. Plan activities for employees to promote a sense of unity. Show less



Penfield Place Skilled Nursing Facility

• Penfield, NY

• Office Manager

  • Jun 2013 - May 2014

  * Perform pre-employment background checks, and criminal background checks * Set up and maintain employee files, coordinate fingerprinting of new employees * Employee Orientation * Confirm certification and recertification’s of all professional licenses for Dr’s, nurses, Social Workers, and Therapists. * Obtain and maintain all Certificates of Insurance for all Vendors * Handle all Resident Admissions, insurance pre-authorizations, financials and POA paperwork. * Assist Residents in obtaining Medicaid if needed * Maintain Census Reports * Maintain all records as needed and required for NYS DOH Show less



ClaimCare

• Hospitals and Health Care
• 1 - 100 Employee

• Medical Billing and Followup Specialist

  • Jun 2008 - May 2012

  Medical Insurance Follow-up Specialist: * Oversaw two medical practices with a total of 10 Dr’s to f/u on claims that were rejected, denied or never paid by insurance. * Filed appeals, correct and repost claims with corrected DX’s and/or modifiers * Heavy phone contacts with insurance companies, doctors offices, and patients to problem solve to get the claims paid. * Brought the 120 day + A/R balance from 10.84% on my combined accounts to 3.63% * Practices worked were: Orthopedic/Physical Therapy and Cardiac, with some helping out in Dermatology and Family Medicine when needed. Medical Billing Specialist: * Enter Demographics and verify insurance for various practices in preparation for charge entering * Enter charges and post payments for various practices and doctors, adhering to Medicare/Billing standard, with the goal of getting the claims out “clean.” * Responsible for three Orthopedic practices and 2 Dermatology practices, to see that they are entered cleanly, timely, end close by end-of-month. Show less