Ramona Mahilall

I obtained a B.A in Public Administration from the City College of NY. For over 30 years, I worked in the medical billing and coding field. I have worked for a wide variety of medical specialties and have reviewed documentation for coding appropriateness for billing and reimbursement including: Evaluation and Management, Surgery Coding, Outpatient Professional, Inpatient Professional, ED, and Homecare Billing.

I have an extensive knowledge from the front-end of billing and coding to maximizing reimbursement; charge reviews, Accounts Receivables follow up including Insurance appeals, and payment posting. I became a Certified Professional Coder in March 2005, and I am a member of the AAPC (American Academy of Professional Coders).

Education and Certifications:

• Bachelor of Arts, Public Administration, The City College of New York/CWE
• American Academy of Professional Coders (AAPC) – CPC

• Member, AAPC

• Reviews and performs billing, Collection and Coding activities for Brady Urological Associates & Pediatrics.
• Responsible for reviewing medical records for appropriateness of Documentation, procedure, diagnosis, and Evaluation & Management Coding. 
• Performs Accounts Receivables management activities that involves follow-up and includes writing appeal letters.
• Conducts pre-billing documentation reviews in accordance with institutional guidelines.
• Maintains current knowledge of applicable billing and reimbursement laws and regulations and serves a resource to the faculty. 
• Identifies problems with denied claims – reviews system edits for third party payers and makes appropriate corrections and resubmit claims for payment.
• Reviews EOBs to ensure payments are made in accordance with Cornell’s contracted fee schedule.
• Identifies errors and provides requested information to Insurance carriers.
• Determines and process refunds to insurance companies as necessary.
• Contacts insurance carriers and patients by phone or written correspondence to discuss problems and resolve discrepancies.
• Handles inquiries from third party payers and/or patients regarding claims and/or bills respectively.
• Track delinquent claims and perform in-house collection activities; composes correspondence and contacts insurance companies for follow-up.
• Back-up coverage for Urology – acted as the revenue cycle and billing compliance administrator while this role was vacant on two occasions within two years. Took on an added elevated scope of work to ensure all aspects of the departmental revenue cycle and billing program were covered. Effectively multitasking on a plethora of complex scenarios specific to coding, revenue cycle, and compliance. Served as a backup for Interventional Radiology Coding within Urology.

The City College of New York 2015

• Bachelor of Arts: Public Administration

• CPT Coding/Clinical Documentation: Outpatient & Ambulatory Surgery Coding/Billing
• Queens College, NY 1995
• Certificate in Hospital & Physician Billing

• American Association of Professional Coders (AAPC) 2006 – Present
• Manhattan Local Chapter 2006 - Present