Merill Adams Sideno Email & Phone Number

Needham, Ma

* Primarily charged with timely medical claims submission and follow up to Tufts and Harvard Pilgrim* Facilitates high-volume effort to maintain and, ultimately, see reimbursement of hospital medical claims per full revenue cycle standards of timely filling and adequate charge payment * Maintains a close collaboration with finance leadership and teammates in determining insurance reimbursement anomalies and trends with assigned payers, and active investigation of claim denials through medical policy lookups, correct coding reviews, and communication with insurance representatives

* Researches and validates patient insurance coverage for specialist office visit, as well as initiating specialized benefits investigation for in-office infusion* Interprets patient benefits report, to determine financial coverage of procedures and potential cost to the patient. Submits recommendations to the infusion coordinator on report findings, advises on pre-certifcation requirements, and updates on follow-up status on completion* Maintains practice-wide spreadsheets monitoring patient accounts receivables, submits finalized reports for collections* Assists in updates on office procedures and protocols addressing various aspects of the practice

* Responsible for billing Managed Care Medicaid insurances, like Aetna and Illinicare, and Blue Cross Blue Shield * Managed electronic claims, including claims generation, batch uploading to clearing house, and claims tracking via insurance provider portals* Monitored outstanding balances in claims within a set time frame via aging, and investigates causes for delays in payment* Read electronic health records and extracts both ICD-9 and CPT codes for charge entry * Answered patient calls on billing issues and offers solutions in a timely manner* Assisted in research projects from the Finance Department

Itasca, Il

* Warehousing and order filling

Schaumburg, Il

* Managed and reconciled nightly auditing for hotel transactions* Greeted guests, processed check ins and check outs, and other hospitality responsibilities