Robin Webb Email & Phone Number

Brooklyn, New York, United States

Under supervision, and with informed judgement conduct investigations in NYC Health and Hospitals Corporation (HHC) facilities to: Use accounts receivable reports to verify claims validity and make an analysis of whether claims require retroactive authorization requests or appeal for not medically necessary claims.• Call medical carriers to inquire when claims were received and what is the determination of claims received.• Create correspondence for claim appeals and submit to carrier… Show more Under supervision, and with informed judgement conduct investigations in NYC Health and Hospitals Corporation (HHC) facilities to: Use accounts receivable reports to verify claims validity and make an analysis of whether claims require retroactive authorization requests or appeal for not medically necessary claims.• Call medical carriers to inquire when claims were received and what is the determination of claims received.• Create correspondence for claim appeals and submit to carrier with all supporting documentation, including ERMs and/or itemized bills.• Determine the ability of patients and their legally responsible relatives to pay for hospital or health care charges and take the necessary actions to bill and collect for these services.• Explore alternative sources for payment of hospital or health care services rendered.• Verify, modify and code demographic and insurance data obtained from source documents, and enter such data into a computerized system.• Perform billing and collection functions in order to obtain maximization of a hospitals or health care facility’s revenue. Create adjustments when necessary. Track denied claims and track claim’s appeals. Show less

Brooklyn

Greater New York City Area

Contracted position. To review authorizations for clients and create claims from weekly and bi-weekly invoices from various locations throughout Florida for home healthcare services to the elderly. Using Availity portal, review and research any denied claims and resubmit, create reporting using Excel, etc.

New York, Ny

Claims management, claims processing, denied claims management, successful NY State OIG audit, patient records, patient records auditing, account reconciliation, account adjustments, account audit for accuracy, patient/customer assistance, facilitator of informative meetings, special project management/team leader, etc, etc. and so on. 23.11 years.

New York

• Successfully managed NY State OIG audit while locating lost funds• Collaborated with IT in customizing dental center’s software (Dentrix 1st Enterprise Edition)• Advise senior clinic management, middle management and staff on best practices for handling all activities of patient accounts • Train lead project manager for various special projects for senior management• Published reference manuals for clinic staff and management as reference, published training manuals for… Show more • Successfully managed NY State OIG audit while locating lost funds• Collaborated with IT in customizing dental center’s software (Dentrix 1st Enterprise Edition)• Advise senior clinic management, middle management and staff on best practices for handling all activities of patient accounts • Train lead project manager for various special projects for senior management• Published reference manuals for clinic staff and management as reference, published training manuals for department • Bill for dental treatment of patients using NY State MMIS and managed care reference manuals, commercial products using policies and procedures• Post payments from NY State Medicaid and managed care plans, commercial insurance plans, balancing entries and reconciling account balances• Track claims denial reasons, denial frequency and contractual issues • Audit patient accounts and make adjustments in processing refund requests• Assist facility patients, in- house customers and outside vendors on policies and procedures as it relates to all aspects of billing, Medicaid requirements, managed care plan requirements, commercial insurance products requirements, etc.• Facilitated informative meetings for middle management and staff as it related to all aspects of billing, including university and entity policies and procedures• Make recommendations for streamlining and improving billing practices.• Assist upper management with various projects relating to outreach programs, Medicaid and managed care plans, exchange plans and FIDA compliance and procedures, etc.• Cash management and reconciliation• Creating and using reports to gather pertinent information in reference to claim frequencies, denials, treatments and documentation requirements• Track claims for reimbursement frequencies and review amount of payment received to ensure university charges are current• Follow- up on patient complaints and process appeal requests, ETC. Show less