Valentina Murphy Email & Phone Number

New York, NY, US

New York City Metropolitan Area

New York City Metropolitan Area

• Review all managed care contracts to provide analytical support regarding modeling, changes impacting contracts and other provisions of managed care
• Support the contract negotiation process and contract information dissemination by preparing current and projected financial performance models to identify areas of contract improvement and preparing contract proposals.
• Audit payor contracts in the Epic patient billing system to reduce future discrepancies
• Work with other finance and MCIT departments to assist with contractual inquiries
• Organize and review financial and utilization data including insurer claims, eligibility, hospital and physician billing data, payors physician fee schedules and Medicare payment methodologies
• Utilize Business Objects and Excel to help summarize vast amounts of data for easier viewing and comprehension

New York City Metropolitan Area

• Performed audits to identify and recover underpayments caused by contract misconstruction and invalid denials to maximize reimbursement and lower A/R
• Created and analyzed contract compliance and trend reports for the Managed Care Department
• Maintained data integrity when manipulating data files for purposes of analysis to ensure data does not become corrupted through conscientious use of tools
• Evaluated and escalated eligibility, authorization, billing and claims processing inaccuracies to the appropriate Billing Office Operations Management in order to implement upstream resolution

• Analyze and adjudicate accounts receivable including payment discrepancies from all commercial payers to ensure maximum reimbursement to the medical center
• Review commercial managed care contracts and report errors for updates/corrections for process improvement
• Report coding and charge issues for claims billing review to ensure payment settlement
• Assist the billing and self-pay teams with adjustments and reimbursement rates
• Contact carriers to review underpayments and assign accounts for follow-up or appeals
• Review refund requests and process refund checks for all carriers for Tisch and HJD

Greater New York City Area

• Managed various financial activities for the billing department for Tisch and HJD, including requesting or transferring balances, adjusting payments, and posting self-pay charges
• Oversaw the processing of all refunds for payments made out of pocket by the patient (self-pay), processing an average of 150+ refunds per month
• Prepared end-of-month Visiting Nurse Service billing report including the preparation of claims consisting of room charges and services provided for Tisch and Lutheran
• Liaised between the Finance Department and Patient Access Department to confirm and dispute private room charges, billing issues and payment disputes
• Reviewed late posted charges for possible revenue opportunity
• Performed parent location conversions to ensure proper authorizations are in place

Greater New York City Area

• Served as a liaison between patients of the Emergency Department and the hospital Finance Department to manage all patient issues with service or billing
• Completed all patient registration activities including the precertification of insurance, payment options and collection of time of service payments at the point of registration
• Updated physician lists to prevent system issues with billing and reimbursement