FGP Reimbursement Analyst – MCO at NYU LANGONE (2023-12 – Present)
Perform data analytics to identify and recover underpayments caused by Managed Care contract misinterpretation and invalid denials to maximize reimbursement, efficiently lower A/R, and expedite the revenue cycle process.
- Perform duties as assigned.
- Learn appropriate new software systems to help analyze and evaluate claims data
- Work collaboratively with a variety of departments within NYU School of Medicine and externally with commercial managed care payers via Tracker call directly.
- Develop a comprehensive understanding of all managed care contractual terms and reimbursement methodologies between NYU School of Medicine and external commercial payers as well as navigating through payer's portal.
- Maintain data integrity when manipulating excel data files for purposes of pivot analysis to ensure data does not become corrupted through conscientious use of tools and a system of checks and balances.
- Execute data mining and in-depth analysis to support managed care contracting initiatives.
- Collect and analyze data to determine denial and underpayment trends across the Faculty Group Practice for review and distribution.
FGP Billing Coordinator – ACWS at NYU LANGONE (2022-04 – 2023-12)
Ensure ICD-10-CM, CPT and HCPCS coding is submitted properly based on documentation review (Medical Coding Review) as well as charge submission and accounts receivable follow-up on a timely manner in EPIC system.
- Perform billing tasks assigned by management which may include data entry, claim review, charge review, accounts receivable follow-up, or other related responsibilities.
- Perform daily tasks in assigned work queues and according to manager assignments.
- Follow workflows provided in training classes and request additional training as needed.
- Communicate with providers or other responsible person to ensure that claims are correctly processed by third party payers.
- Review and resolve denial issues by reviewing documentation and payer specific policies.
- Participate in reviews of office procedures as they relate to charge submission and denial management; recommend suggestions, ideas and solutions to improve processes. Collaborate with the practice and administration to implement changes to practice operations where necessary
- Review resources including (but not limited to): CPT and ICD-10-CM manuals, payer policy and procedure manuals and updates and CMS publications to ensure practices are in compliant with documentation, current policies and procedures.
- Attend all required training classes. Escalate issues to management as needed. Coordinate functions and work cooperatively with others. Explain processes and procedures to others; perform other related duties as required.
- Perform Ad hoc duties as assigned.
Revenue Cycle Coding Support – Radiology (Fully Remote) at RADNET, INC (2021-09 – 2022-04)
- Research the various RIS systems for medical necessity, drugs, orders, ABN's and other information as needed.
- Contact imaging centers and/or hospitals when addendums or information is needed to accurately code an exam.
- Research to resolve reports in the Transcription and Need Report queues.
- Email Charge Corrections spreadsheets weekly.
- Email PET contact questions from the coders.
- Report issues, trends and/or problems to the Supervisor in a timely manner.
- Perform Ad hoc duties as assigned.
Contact Tracer (Temporary Assignment) at NEW YORK STATE HEALTH DEPARTMENT (2020-10 – 2021-02)
- Work in collaboration with the Case Investigator from the local health department (LHD).
- Call contacts of newly diagnosed cases.
- Communicate with contacts in a professional and empathetic manner maintaining emotional and cultural awareness.
- Collect and record information on symptoms and needs into the CRM with accuracy.
- Provide contacts with approved information about NYS isolation and quarantine procedures, and if appropriate, refer them to testing according to protocol and/or to a COVID-19 Community Support Specialist for social resources.
- Follow a set script to inform contacts about the importance of isolation or quarantine and what to do if symptoms are present or develop.
- Maintain daily contact with Team Supervisor via Microsoft Team.
Medical Front Desk Internship at LAWRENCE NESHIWAT, MD P.C. (Endocrinologist) (2019-09 – 2020-09)
- Process referrals and schedule client appointments
- Document referral in practice management system.
- Verify insurance benefits via system tools (EHR), and Insurance Payer Portal/Phone.
- Responsible for obtaining accurate and timely pre-authorizations for professional services.
- Prior authorizations may include, but are not limited to surgical procedures, outpatient treatments, medications and diagnostic testing (i.e. ultrasounds, labs, radiology, IV therapy, referrals).
- Collect all monies due from patient at time of service and input charges and payments to computerized system.
- Enter new patient data, processing forms, complete faxing/scanning tasks and answer phone calls
- Assist Administrative team, Cardiologist team and Sonogram team as required.
- Provide medical records as directed to legal, insurance, and other providers.
- Conform to all applicable HIPAA, Billing Compliance and safety policies and guidelines.
Treasurer (Board Member Volunteer) at THE NEW YORK FLUTE CLUB (2020-06 – 2024-05)
- Responsible for weekly, monthly, and quarterly bank reconciliation
- Prepare financial reports for board of directors meeting.
- Responsible for issuing payments to artists, space rental, and any administrative expenses along with making deposits.
- Process 1099, ASCAP, and BMI in addition to following-up on Char500 and Form 990 tax return.
- Participate in the flute fair and assist on sales and collection.
Tax Preparer Assistant (Temporary Assignment) at KUN LEE, CPA, PC (2019-01 – 2021-04)
Responsible for the accurate preparation of income tax season for individual and corporate clients.
- Specific duties include interviewing and consulting with clients, preparing and filing all documents (manual and electronic), maintaining detailed financial records with financial review, and providing quality customer service.
- Process annual, quarterly, monthly and/or weekly payroll and payroll/sales taxes.
- Prepare W2, W3, 940, 941, and NYS45.
- Assist in preparation of Form 990, 1120, and 1065.
Senior Credit Officer – Credit Middle & Training / Corporate & Specialized Financing at SUMITOMO MITSUBISHI BANKING CORPORATION (2007-04 – 2018-10)
Responsible for performing credit and transaction analysis of new and existing clients of investment grade and non-investment grade in various industries, including real estate, consumer products, automotive, general corporate, aircraft financing, leasing, and project finance.
- Oversaw the underwriting and due diligence process along with the closing activities.
- Reviewed credit risk grades to counterparties and applications for renewal of credit lines.
- Monitored and verified new and existing transactions for compliance with credit limits and conditions along with other credit administration, reporting and analysis related tasks as assigned.
- Reviewed and analyzed risk elements of existing and new clients covered by pre-approved list.
- Trained junior credit analyst on risk control and transactional review on grading and self-assessment.
- Attended Credit Committee meeting and performed ad hoc projects as required.
Investment Officer (Closely-Held Company Analyst) at CITIGROUP TRUST – Global Wealth Management (2000-08 – 2007-04)
Responsible for internal pricing of private companies. Prepared valuation report on private companies by analyzing financial statements, interviewing management, performing cash flow analysis, and utilizing comparable company analysis.
