S V

To secure a challenging position in a reputable organization for expansion of personal skills, knowledge and experience. Demonstrated to solve problems independently and perform at an optimal level.

Authorization and Billing Specialist - GenCare Resources Home Health Services

(2025-06)

Certified Professional Biller with over 13 years Experience. Expert in securing prior Authorization for PDN. PCA and Adults. Focusing on accuracy in verifying insurance and securing timely approvals.

• Managed all claim submission and follow up. Achieving a 95%r clean claim rate and reduced turnaround time for authorization and revenue cycle.

DME Authorization Specialist - ROMTECH - Brookfield, Connecticut

(2023-03 - 2025-06)

• Attain authorization for all Insurance payor and VACCN veterans.
• Verify Insurance and ensure coverage are accurate and copay’s, co ins and deductibles are calculated and collected before device is delivered.
• communication with providers/insurers and meticulous documentation to reduce denials and streamline processes for efficient patient care and financial outcomes

Authorization/ Insurance AND Billing Specialist - New Life Heart Care - Orlando, Florida

(2022-07 - 2025-03)

With proficient knowledge of ICD-10 and CPT codes of procedures and diagnosis, insurance guidelines and medical terminology has proved patient and physician satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.

• Calculate copy, co insurance and deductible for all visits and diagnostic testing.
• Processed eligibility and benefits verification, referrals and authorization requests.
• Tracked pending authorizations to resolve discrepancies and avoid revenue loss.

Prior Authorization and Insurance Specialist - Magruder Eye Ins - Orlando, FL

(2021-09 - 2022-05)

• Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests for surgery.
• Reduced processing times by effectively managing 50 to 60 authorizations and referrals daily.
• Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during authorization process.
• Increased accuracy by diligently reviewing and benefit verification patient eligibility, coverage, and benefits
• Analyzed medical records and other documents to determine approval of requests for authorization.
• Input all patient data regarding claims and prior authorizations into system accurately.
• Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.

Medical Biller & Authorization Specialist - NYU Langone-CVA - Bayside, NY

(2013-09 - 2021-09)

• Scrub, Submit and communicated with insurance providers to resolve denied claims and resubmitted.
• Verified and update insurance over 20 patients insurance eligibility daily.
• Collected payments and post EOB and insurance payment to patients account
• Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
• Accurately entered and update patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
• Reviewed patient diagnosis codes to verify accuracy and completeness to obtain cardiac authorization for all diagnostic and radiology procedures and surgery to be done in office, hospital and ambulatory center.

Practice Billing Associate - NSLIJ-CVA - Bayside, NY

(2012-09 - 2013-08)

• Streamlined invoicing process for increased efficiency, utilizing automated billing software and systems.
• Maintained updated records of customer account information to ensure accurate and timely billing processes for 50 -70 daily schedule patients
• Enhanced client satisfaction by promptly addressing and resolving billing inquiries, discrepancies, or disputes.
• Ensured compliance with company policies and industry regulations while managing sensitive financial data securely .

GED Diploma - NYC Brooklyn GED School