Medical Biller/ Collections/ Accounts Receivable



69-01 21st Avenue, Brooklyn,
NY 11204  (H)718-232-4684
(C)718-908-8007  carolvicens@yahoo.com



 



                                                                Carol Vicens


_________________________________________________________________________________________

Experience



 



 



                      Abacus Staffing LLC/Executive Physician System Inc.  (TEMP)



2012 -2012



Follow –up on receivable and posting on IDX




  • Posted rejections

  • Followed –up on Physician billing

  • Assignment completed Sept.29



_______________________________________________________________________



2010 - 2011                                         
Health
Business Solutions (Daytop)



Client Account Specialist




  • Register clients upon admission

  • Complete applications, recertification’s, Face to Face for HRA

  • Complete Out of County Applications and Re-certs for benefits

  • Ensure continuity of benefits/entitlements/ food stamps

  • Complete overrides, exemptions, restrictions for Medicaid and
         follow up             

  • Change payee and Social Security Benefits Transferred. All Social
         Security issues

  • Update files enter all issues in computer

  • Do Rotations for clients going Upstate with transfer letter and chart

  • Make sure clients obtain ID

  • Enter billing sheets

  • Reconcile Status Report.

  • Verify Insurance benefits and obtain authorization.

  • Check EPACES monthly for continuity of benefits

  • Help with PNA Balances and disputes thru Counselor

  • Work with Saams, Stars and Relay Health





                         




___________________________________________________________________________________________

2008-2009                                                     Village Care of New York
Care of New York



Senior Medical Biller




  • Responsible for all aspects of Medicaid Billing

  • Review aging for Medicaid and other accounts receivable

  • Update and maintain budgets for patient funds

  • Follow up on all denials and pending claims

  • Responsible for daily, weekly and month end reports reconciling
         all patient billing, overpayments

  • Perform all necessary steps to refund overpayment

  • Maintained daily census



_______________________________________________________________________________________



1984-2008                                                            Victory Memorial Hospital



 



1994-2008



Patient Account and SNF Supervisor




  • Assist billers with problem accounts until resolved

  • Delegate and schedule daily employee work assignments

  • Perform evaluation and disciplinary actions

  • Telephone follow-ups with insurance representatives and clients on
         account status

  • Meet deadlines for Patient Commencement and Medicaid Audits

  • Approve trial balances, issue refunds, and followed up with
         accounts payable

  • Close and post nursing home revenue Modify and calculate billing disk
         for weekly Medicaid update

  • Responsible for all pay classes to reduce outstanding balances on
         receivables

  • Billed all pay class in SNF and maintained PNA and SSI accounts



1984-1994



Biller-Cash-Control




  • Billed insurance handled receivable, payments, adjustments, trial
         balance and timely follow up

  • Register and discharge patients, collect payments for in-room services

  • Nursing home biller

  • Commercial collections clerk

  • Trained billers on Medicare and Medicaid billing



_______________________________________________________________________________________



SKILLS



Omnipro, Epaces, Edifice,
SDK, Accuplus, AS400, Excel, Client Management, Keane Care, IDX ,EMEVS.eMEDny, Knowledge
of various government and commercial insurance claim forms



Proficient in working with
insurance representatives as well as fellow employees



TRAINING





Blue
Cross, Medicare and Medicaid seminars; various commercial insurance seminars



Certified
Denial Recovery Specialist/ Cert#0072 July 8 2010



Certificate
of Attendance Medico legal Issues/ March 19, 2004



Certificate
of Completion for Confidentiality Training, 
CASAC Section 4, CPP Section, CPS Section,



   Drug and Alcohol Confidentiality RE:
Treatment and Records            



   HIPAA Privacy and Security



   Mandatory Child Abuse Reporting



   NYS HIV Confidentiality / April 21, 2011
Provide by OASIS



Certificate
of Completion Course HIPAA 101/ May 13 2010 by HBS



Certificate
of Training STARS/ August 24, 2010 BY NYC Human Resources Admin.



Certificate
of Training  Keane Care Inc. Vistacare
Computer System /June 22, 2001



Seminar,
How to Supervise People/ April, 6, 1999 



 



 





References upon Request

  • ID#: 67292
  • Location: Brooklyn, NY , 11204

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