Julia Nabiullina, Crc, Cpc, Cpma, Cpco Email and Phone Number
Julia Nabiullina, Crc, Cpc, Cpma, Cpco personal email
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Global experience in healthcare/public health sector. Solid background in healthcare policy, operations, billing, contracting/ credentialing , quality, healthcare law and compliance, finance. Personal characteristics: ambitious, reliable, strong-minded individual, trying to hold to a higher standard. Easy-going and good in troubleshooting and setting up new relations and communications.• Health Information Management; strong supervisory skills• ICD-9/ ICD-10; CPT4/ DSM-4/ DSM-5 Coding • Strong knowledge of compliance regulations and governmental audits (CMS, OIG, OIMG, HRSA, OASAS etc)• FQHC Operations (program requirements, policies, legislation and regulations, governance, Medicare/Medicaid certification, billing, wrap payments, clinical administration)• Knowledge of FIDA, HARP, DSRIP, Medicaid Reconstruction. NCD and LCD rules• Knowledge of Article 28 (Medical); Article 31 (Mental Health); 822 (Outpatient Treatment), 816 (Substance Abuse) Program Facilities and their accreditation• Setting-up Master Fee Schedules based on Cost Pool, RVU, 75th and 90th Percentile and National Average • Knowledge and Analyses of Administrative and Financial Reports (AFS, AHCF and others) • Rules and regulations governing billing/ credentialing/ contracting for Medicare and other Health Insurances (MCO, HMO, PPO, CHP, FHP, ACO etc), No Fault, Worker's Comp • Knowledge of credentialing and accreditation (JCAHO, AIUM, AIM, AAAASF)• Knowledge of APG Outpatient Clinic Billing, Revenue Calculations• Knowledge of Ethic and Compliance for SNFs• Knowledge of medical softwares and EHRs (EPIC, Athena Health, Kareo, IMA, eClinicalWorks ECW); EFT, EDI and Clearing Houses • Strong knowledge of of malpractice and other legal issues in Healthcare.• Performance Audits in accordance with Government Auditing Standards (GAGAS)• Extensive experience with Council for Affordable Quality Healthcare (CAQH)• Strong computer programs skills (Microsoft Word, Excel, Power Point, Outlook)• Excellent verbal and communication skills, ability to multi-task• Strong problem solving skills• Fluent in Russian
Ajhc
View- Website:
- ajhc-fp.com
- Employees:
- 4
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Managing Partner, Healthcare And Finance ConsultantAjhcNew York, Ny, Us
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Ceo And Founder, Healthcare & Finance ConsultantAjhc May 2020 - PresentNew York City Metropolitan AreaSubject Matter Expert and Advisory Board to Governmental Agencies, hospitals, non-profit organizations and private sector.
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Delivery Manager, Advisory And Regulatory ComplianceKpmg Us Dec 2019 - Dec 2022New York, New York -
Manager, Provider Documentation Education; Quality And OutcomesAtlantic Health System Jul 2017 - Jan 2020Morristown, NjResponsible for oversight of organization’s Provider Documentation Education: regulations, payer rules, best practices/ workflow for accurate and thorough documentation and coding to optimize Revenue while maintaining compliant and improving patient care. Improving numbers for Health Risk Adjustment (HCC) and value-based contracts, Transitional Care Management, Chronic Care Management and Preventive Services. Close collaboration with CMO and ACOs. Training/optimizing EPIC system for less-click more RVUs. Setting platforms for Quality Metrics, including patient satisfaction, preventive care and reporting (MIPS, HEDIS, etc). Involved in Workgroups to drive the processes, policies and procedures to support better patient care and Revenue Cycle optimization/ reconciliation. Strategic Planning to improve performance. Help providers get out of Coding Audits and reviews. One-on-one and massive training/presentations of the providers and staff. -
Fiscal Department; Healthcare Contract ManagerProject Renewal Oct 2013 - Dec 2016200 Varick Street, New York, Ny 10014Developing and implementing strategic, operational, and tactical business plans to meet QA, compliance/ risk management and optimize financial performance in a non-profit Federally Qualified Health Center (FQHC) serving homeless population of NYC. Overseeing all aspects of healthcare contracts; compliance; billing; credentialing. Conducting financial analyses and considering impact of applicable regulatory requirements. Guiding, directing, and supporting senior management team in the business development, production, promotion, and financial aspects of the organization’s projects, products and services. Including FIDA, HARP, ICD-10, Patient Center Medical Home, DSRIP, Health Homes, NYS Article 28 and OASAS Article 32, 816 and 822 provisions. Relationship building. Supporting the preparation of short-term and long-range plans and budgets based on corporate goals and growth objectives. Development and Implementation of new initiatives and programs which in pursuit of corporate mission, goals, and objectives. Analysis and interpretation of financial and operating reports. Reporting directly to CFO, collaborating with all other senior management and the Board on new lines of business and altering existing ones. Developing contracting plans and forecasts, monitoring and (re) negotiating Managed Care contracts. Maintaining superior relationships with MCOs. Development and implementation of policies and procedures relating to workflow and quality assurance to ensure maximum collection from payers, as well as staff compliance. Effectively managing denial process and identifying root causes and solutions for systemic issues. Performing reimbursement management and coding audits (including Medicaid compliance audit). Project Manager for ICD-10 implementation. -
Executive AdministratorNrj Healthcare Solutions Jan 2013 - Oct 2013Brooklyn, NyExecutive Administrator of a small consulting/practice management company of 14 employees. Overseeing billing, credentialing, contracting, coding and compliance for Private Practices and Doctors in Nursing Homes of NY and NJ. Close cooperation with SNFs. Specialties include: internal medicine, pediatrics, ObGyn, wound care, psychiatry, cardiology, neurology, surgery. Doctors and staff education on compliance, coding and credentialing. Audits for private practices and independent providers to improve the compliance and billing situations. -
Contracting/Credentialing Manager, BillingBoro Park Ob/Gyn Jan 2010 - Jan 2013Responsible for credentialing and accreditation, contracting and billing matters for 20 providers. Re-negotiation of the fee-schedules, Getting special MGAgreements and VIP contracts with insurance companies. Dealing closely with Provider Relations Advocates and Directors and constant updates with their system, policy and product changes. Quality Assurance implementation for the practice, Changing billing policies and implementing new rules, re-coding visits and procedures where necessary; Responsible for the hospital credentialing, Network management with all health insurance companies. Accreditions: AIUM, AIM, OBS (JCAHO, AAAASF), ASC; responsible for Medicare/Medicaid EHR Meaningful Use, ERx and other incentive programs. Educating Providers in Healthcare Changes, Regulations and Compliances. Dealing with legal issues of the practice, close cooperation with accountants and lawyers. Involved in all researches, problem solving and other issues of the practice as they come up. Credentialing duties include: constantly maintaining, renewing and updating paperwork and databases for all phycisians pertaining their education, licensure, certifications and additional training informations. Working with CAQH, Meipass databases. Hospital Credentialing maintenance, including re-appointment processes; being a liaison in Doctor-Hospital communications. Constant meetings and conferences with State, Insurance and Hospital Advocates for new implementations and renovations, Department of Health Meetings and Medicare Meetings.
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Office Manager/ Billing AdministratorCornell Medical Diagnostics Aug 2009 - Jan 2010Specializing in: VENG, NCV, Electrocardiogram, Carotid, Ultrasound (abdomen, full aorta, thyroid, renal doppler, pelvic, LE arterial/venous, etc). Responsible for coding, billing; setting up new medical software, links with Medicare, EDI and Clearing House; patients' issues, Practice/office management, educating other staff in business related questions, dealing with all other issues as they may come up.
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Collector/ Claims Follow-UpComplete Radiology, P.C. Nov 2008 - Aug 2009Prompt cooperation with insurance companies, including Commercial insurances, No Fault Ins Companies, Workers' Comp. Researching overdue account balance that is not paid or partially paid; Reviewing all denied claims and underpaid claims for appeal according to the payer guidelines; Verification of payment information and processing adjustments; Complying with the Fair Debt Collector practices Act; Responding to customer inquiries regarding account status; Resolving discrepancies and preparing adjustments and refunds as necessary; Coordinating with patient pay billing center; Ensuring that all information regarding collection activity is entered accurate into the billing system; Timely resubmitting claims as necessary and processing refunds according to the refund policy; Calling on patient's eligibility, Deductible and Co-pay information, working with EOBs, ERA letters, sending patients' info as required to Ins Companies, writing Letters of Medical Necessity, and other duties as assigned.
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Biller/CollectorMetrostar, Inc Apr 2007 - Oct 2008DME. Responsible for billing functions, coding, claim status tracking, denial reconciliations, posting, maintaining super-bills, AOBs, NF-3 and other forms, collecting patient demographic info, working with arbitration, packing medical supplies for patients, receiving and responding all correspondence from insurance companies and others
Julia Nabiullina, Crc, Cpc, Cpma, Cpco Skills
Julia Nabiullina, Crc, Cpc, Cpma, Cpco Education Details
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Naberezhnochelninski Pedagogical CollegeLinguistics And Cultural Study -
Accounting -
Master Of Business Administration - Mba
Frequently Asked Questions about Julia Nabiullina, Crc, Cpc, Cpma, Cpco
What company does Julia Nabiullina, Crc, Cpc, Cpma, Cpco work for?
Julia Nabiullina, Crc, Cpc, Cpma, Cpco works for Ajhc
What is Julia Nabiullina, Crc, Cpc, Cpma, Cpco's role at the current company?
Julia Nabiullina, Crc, Cpc, Cpma, Cpco's current role is Managing Partner, Healthcare and Finance Consultant.
What is Julia Nabiullina, Crc, Cpc, Cpma, Cpco's email address?
Julia Nabiullina, Crc, Cpc, Cpma, Cpco's email address is nr****@****ail.com
What schools did Julia Nabiullina, Crc, Cpc, Cpma, Cpco attend?
Julia Nabiullina, Crc, Cpc, Cpma, Cpco attended Naberezhnochelninski Pedagogical College, Montclair State University, Montclair State University.
What skills is Julia Nabiullina, Crc, Cpc, Cpma, Cpco known for?
Julia Nabiullina, Crc, Cpc, Cpma, Cpco has skills like Medicare, Healthcare, Medical Billing, Healthcare Management, Medicaid, Medical Terminology, Credentialing, Hospitals, Emr, Practice Management, Health Insurance, Icd 9.
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