Lauren Castillo

Seeking a personal assistant position

Senior Financial Clearance Analyst at NYU LANGONE Health (2024-08 – Present)

• Performs medical necessity review for applicable services to ensure diagnosis is covered under insurance carrier clinical bulletin policy for outpatient appointments as scheduled
• Determines patients' benefit level based on in-network or out-of-network benefits
• Identifies non-par plan status and follows appropriate out of network workflow based on service and payer type, calculates and communicates patients' estimated out of pocket hospital financial responsibility pre-service for scheduled or prospective services utilizing the Epic Estimator tool or International Calculator
• Understands performance measures and is accountable for meeting monthly target goals as determined based on service and payer
• provide coding, financial and/or operational reports, and provide feedback to providers to improve documentation to maximize revenue and reduce denials
• Review and train practices on local and national coding and reimbursement policies including payer coding guidelines
• Monitor reports and assigned work queues, ensuring coding, charge submission and accounts receivable follow-up is occurring on a timely basis
• Perform charge reconciliation to validate all revenue is captured
• Review unbilled charge reports and follow up with physicians and/or practice management for unbilled services
• Works collaboratively with and acts as a liaison with a variety of internal departments within NYULH, external business partners, external departments, and NYULH's contracted payers
• Works independently, takes initiative, and escalates to leadership appropriately

Medical Billing and Coding Specialist at NYU LANGONE FGP Ophthalmology (2021-07 – 2024-08)

• Accurately assigned CPT, ICD-10, and HCPCS codes to medical procedures and diagnoses, ensuring precise documentation for billing purposes
• Processed insurance claims and resolved billing discrepancies to maximize reimbursement
• Reviewed patient medical records for accuracy and compliance with payer and regulatory guidelines
• Managed accounts receivable, including payment posting and follow-up on denied or unpaid claims
• Maintained adherence to HIPAA and patient confidentiality regulations
• Reviewing and extracting appropriate CPT, ICD-10CM, and/or HCPCS based off of documentation
• Responsible for pre authorizations, approvals and denial claims for all surgical procedures
• Determine reasoning for denied claims, resubmit documents, verify insurances utilizing insurance portals
• Monitors intake work queue for timely intake completion
• Assist patients with payment assistance programs for surgical procedures that are not covered by insurance
• Diagnostic and procedural inpatient coding for all ophthalmic procedures
• Review, analyze, abstract, code, or index patients' medical records
• Order specialty medications for in office procedures, create and track all medication logs on excel sheet
• Apply knowledge to identify diagnoses and procedures documented in the medical record
• Apply knowledge of the ICD-10-CM and CPT-4 coding system to translate identified diagnoses and procedures to codes for accurate reimbursement and data
• Ensures that appropriate procedure and diagnosis coding is utilized in the pre-certification and verification process and questions physicians, if appropriate, to ensure accuracy and completeness of information
• Performs other related duties as needed by providers and supervisors
• Maintains cooperative and professional relationships with physicians, nurses and office and clinical staff
• Types routine material such as forms and letters, envelopes, etc. Types materials neatly, accurately and according to instructions
• Works independently, takes initiative, meets all deadlines and demonstrates leadership
• Trains less senior staff

Medical Secretary II at NYU LANGONE FGP Ophthalmology (2019-04 – 2021-07)

• Greet and check in patients
• Responsible for all Insurance verifications prior to patients appointments and authorization approvals
• Scan all necessary documents (insurance cards, lab requisitions, etc.) into the intake system
• Assist patients with kiosk and questionnaire
• Represents physicians by screening incoming practice calls; triages calls and handles calls efficiently and accurately
• Epic Registration
• Update physicians schedules
• Arrange referrals to other health care providers; scheduling appointments for consultations
• Confirm authorizations and insurances for patients
• Handled co-payments

Front Desk Supervisor at Union Square Eye Care (2017-08 – 2019-04)

• Oversea less senior staff/train new hires
• Greet and check in patients
• Represents physicians by screening incoming telephone calls; recording and transmitting messages
• IFA data entry software, Athena Scheduling
• Arranged referrals to other health care providers; scheduling appointments for consultations, x-rays, lab tests, MRI's, CT scans, Medical records, etc
• Confirm authorizations and insurances for patients
• Handled co-payments, claims and insurance clearances

Front Desk Manager/Auditor at Bio Fitness Center (2016-05 – 2017-06)

• Acknowledged and greeted guest upon arrival
• Open/closed facility
• Registered clients and trainers on data entry
• Oversee maintenance of the reception and waiting area
• Bookkeeper, coordinated customer payments, cash wrap, night auditing
• Provided information regarding facility and payment options
• Generate operational and managerial report

Medical Administrative Assistant at East Side Diagnostic Clinic (2013-03 – 2016-06)

• Check in Patients, schedule appointments, answer phone calls
• Organize and track files, fax and printed documents
• Assisted with physical therapy
• Prepare room for physician
• Medical billing and filing
• Confirm authorizations and insurances for patients
• Handled co-payments

Associates Degree in Health Care Administration/Medical Assistant – Mildred Elley College (2017-11 – 2017-11)

High School Diploma – Renaissance Charter High School for Innovation (2010-01 – 2014-12)