Kimberly M. Marturano Email & Phone Number

New York, Ny, Us

Uniondale, New York, United States

Uniondale, New York

• Partner with Personal Injury Attorney to negotiate outstanding accounts, generating over $6 million in revenue.• Oversees $70 million in lien balances by examining medical reports, reviewing case records, and maintaining files with attorney status updates• Identify process improvement opportunities in an effort to enhance company-wide productivity and increase in revenue.• Providing legal support regarding personal injury from the onset of a car accident, liability, handling injury claims, investigating claims, arbitration, provider billing, claims and denial management, denial appeals, arbitrating provider claims, medical treatment review, to legal negotiation when a case settles.• Govern caseload of over 10,000 accounts by tracking new and existing accounts through regular written and verbal communication• Leverage expertise in rules, regulations, and laws to partner with staff counsel regarding claim denials and investigations, increasing insurance payments and reduction in liens and loss of revenue.• Analyzes denial trends that may potentially be problematic and result in loss of revenue.• Determines coverage and liability negotiates with claimants or their attorneys, settles claims, and sets reserves.• Continuously promotes business relationships with attorneys and strengthen working relationships with new paralegals, attorneys, and legal staff• Maintains staff by recruiting, selecting, orienting, and training employees. Accomplishes staff results by communicating job expectations; planning, monitoring, and appraising job results

Garden City, New York

• Orchestrated all facets of physician’s practice from collections and billing to verifying patient data accuracy, ensuring 100% compliance with state guidelines; confirmed the proper submission of # documentation for the appeals process• Followed all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements and abided by all rules, policies, procedures, and standards.• Processed claims by assessing delinquent accounts, endorsing arbitration, and validating insurance information based on research of prior denials

Garden City, Ny

• Drove success of entire business function by auditing operational procedures to maximize profitability, adapting AR processes, expediting revenue cycle, and addressing client concerns with offshore team• Facilitated training regarding best practice documentation for #-member operations team supporting AR management processes• Oversaw inventory for 20 outsourced facilities, which entailed AR follow-up, denial management, and processing payments• Established and sustain effective working relationships with # clients through a regular cadence of communications to address trending denials and escalations• Defined innovative performance metrics for company-wide workflow by partnering with operations executives to account for denial and collections management

Melville, Ny

• Advanced knowledge of coverage, medical, liability and complex claims handling procedures. Must be knowledgeable of state and federal laws in the jurisdiction in which incumbent operates.• Direction of all aspects of the arbitration and litigation processes to create value for clients.• Employment of business management principles in meeting the litigation needs of clients in a cost-efficient manner.• Active participation in the development of effective litigation plans and negotiation with the defense counsel.• Proactive involvement in the negotiation of settlements by practicing effective tactics with third-party representatives.• Strategic partnership with various attorneys to prepare trial proceedings, as well as monitor the progression of large injury and litigation claims.

Melville, Ny

• Systematic oversight of a high volume of claims from the first contact through closure without compromising the New York State Regulation 68.• Impartment of suggestions on independent medical examinations (IME), peer review, examination under oath (EUO), and special investigations unit (SIU) • Generation of medical bills for payment, while ensuring adherence to the New York State fee schedule.• Maintenance of regular communication with various key personnel, including policyholders, claimants, attorneys, and providers.• Hands-on engagement in determining cases for subrogation potential

Conduct Examinations Under Oath with injured Parties to obtain detailed information regarding the treatment they received from Medical Providers. Review medical records and billing from Doctors and compare them to the details of the statements received from the injured parties.

Certificate In Court Reporting, Court Reporting/Court Reporter, Gpa: 3.92/4.0

Education record