• Coordinate and monitor the reimbursement cycle with the Provider Operations, Medical Management, Ancillary, and Claims departments across Healthfirst’s provider network• Responsible for preparing and loading provider rates files (fee schedules) to company claim system (MHS)• Perform monthly analyses to ensure successful claims processing against associated rateso Aggregate and distribute findings and recommendations to applicable teams• Company-wide Managed Long Term Care (MLTC) subject-matter expert• Designated Reimbursement Lead for the implementation and maintenance processes with Managed Service Organizations (i.e. North Shore LIJ, Montefiore, etc)• Ensure proper research and identification of published updates to fee schedules from Medicare, Medicaid, and third party sourceso Download updates and accurately update impacted fee schedules• Led the onboarding with Hebrew Home & Hospital for “Project Honey” through four onsite training sessions• Responsible for maintaining relationships with HHH to ensure successful reimbursement and claims processes• Create test scenarios to be used in Claim Testing, for both positive and negative test caseso Accurately audit load files for completeness, accurate reflection of source data and correct function• Collaborate on special projects for the analysis of fee schedules, claims, and provider records. Extract data from the data warehouse, and analyze for patterns, accuracy, and automation opportunities. Prepare Executive Summaries for management consideration• Monitor Medicare and Medicaid changes. Communicate and report on changes. Prepare Executive Summaries for management consideration

• Monitor and analyze revenue associated with Continuum’s $2.8 Billion operating budget and provide recommendations on improving billing timeliness to upper management• Secured self as a crucial asset to Revenue Control & Integration Department by interpreting monthly and yearly variances and trends of cash flow throughout organization in a timely manner• Create new and revamp existing analysis techniques adopted by hospital managers and administrators and delivered to over 50 hospital administrators • Develop innovative tailored summaries resulting in a substantial elimination of Outpatient Denials for Continuum’s hospitals via improved reporting techniques• Lead Analyst on the implementation of SQL and Access databases which have streamlined reporting techniques and improved overall processes. • Head analyst in the support and delivery of data to both internal and external Audit departments.• Developed Customer Valuation models for measuring the monetary loss from an increase in claim denials, and provide recommended solutions to senior management • Provide ongoing support to the charge capture team helping to improve in the reduction of posted charges throughout organization.