KARNIE_LEE_resume_update_7-20-16
•Download as DOCX, PDF•
1 like•185 views
Karnie Lee has over 20 years of experience in medical billing and revenue cycle management. She has worked in managerial roles at several hospitals in New York, supervising staff and ensuring accurate billing and insurance processing. Her resume highlights skills in areas such as Medicare/Medicaid billing, medical coding, and working with various insurance and billing software programs. She holds a Bachelor's degree in Economics and Management and seeks to utilize her expertise as a team player in an efficient organization.
KARNIE_LEE_resume_update_7-20-16
- 1. KARNIE LEE 2753 Tenbroek Avenue, Apt. 1 Bronx, New York 10469 732-259-8029 raskahl@aol.com OBJECTIVE: To be a team player in an efficient, excellent and cost effective Organization,utilizingthe knowledge and skillsalready acquired. SUMMARY OF QUALIFICATIONS:  Thorough knowledge of medical billing,Medicareand Medicaid billingguidelines  Insuranceindustry experiencein the area of claimresolution,over payments and underpayments  Understandingof medical codingprocedures and medical terminology  Basic accountingskillsincludingexperiencein Excel and Access  Experience with insurancecontractnegotiating  Knowledge of UB92s, HCFA 1500s,and EOBs  Over 20 years of experience at both NY Presbyterian and NYU Langone Hospitals with bed capacity of 1,205 between both facilities  Strong analytical skills EDUCATION: 1989 City College of New York, NY Bachelor’s of Arts Degree in Economics and Management Certificateof Finance EXPERIENCE: 02/16 – Present Revenue Cycle EDI Manager Acacia Network, Inc. Bronx, NY  Retrieve, convert, upload and postERAs for commercial and government insurance(Medicaid) usingEmdeon, PaySpan,PNC, NextGen Dental, NextGen 5, Fidelis Mailbox,EmedNY, Smart, ADL, Basics,FundEZ,and AIRS software.  Create spreadsheets to document daily,weekly, monthly and yearly totals.  Develop procedures manual. 08/13 – 02/16 Special Projects Manager BrookdaleHospital Medical Center Brooklyn,NY  Provideitemized bill for medical services to patients and insuranceproviders.  Retrieve and submitmedical records for out-of-state Medicaid patients,as required.  Providemedical records in supportof medical necessity denial appeal requests.  Set up payment plans for financially distressed patients.  Collectco-pays,co-insuranceand deductibles and/or providefinancial assistanceeducation to patients and their families.  Responsiblefor accurately resolvingMedicaid,Medicareand privateinsurancecreditbalances.
- 2.  Update vendor closeout reports, remittance lists and invoices.  Generate reports detailingIPRO,RAC and Lack of Medical Necessity Denials. 01/11- 8/13 Manager Help In Home Agency, Inc. Long Branch,NJ  Prepare journal entries associated with monthly payroll and enter in to accountingsystem.  Responsiblefor quarterly payroll tax preparation.  Maintain financial statistics.  Handlecustomer enquiries and providesupport.  Responsiblefor schedulingof appointments of aides with clients.  Process accounts payable/receivable.  Prepare and distributeclient’s invoiceand handlebillingclaims. 04/09 - 09/10 Rusk Business Office Supervisor NYU Langone Medical Center – Rusk Institute New York, NY  Responsible for hiring, coaching, conducting, performance appraisals and disciplining of staff. Supervised the activities of up to 8.5 subordinate staff.  Provided guidance and leadership for staff to ensure employees are achieving customer satisfaction through effective communication, problem-solving, professional phone etiquette, and efficient processes.  Responsiblefor resolvingpatient/customer complaints by identifying problems and coordinating appropriate corrective action.  Additional duties included implementing proper intake procedures, performing patient registrations, insurance benefits verifications, co-pay collections, and charge posting.  Input charges for clinical areas for billing purposes. 10/06 – 04/09 Financial Services Supervisor NYU Hospital for Joint Diseases New York, NY  Supervised up to 24 employees within the Therapy, Clinic and Radiology departments. Other duties included compilingmonthly statistical data including time of service, staff attendance and timesheets.  Responsible for verifying patient insurance coverage, pre-certifications and authorizations.  Provided on-site customer serviceand handled billinginquiries. Also maximized reimbursements by ensuring accurate diagnostic and procedure coding.  Provided ongoing training to staff on intricacies of insurance submissions, codes and intake procedures to minimize rejections.  Worked collaboratively with patient accounts department to ensure accurate billing and resolve claim denials.  Responsible for billing clinical charges and ensuring any corrective action in regards to general billing for various accounts. 04/04 – 10/06 Senior Financial Services Associate NYU Hospital for Joint Diseases The Orthopaedic and Sports Therapy Center New York, NY
- 3.  Interviewed physical and sports therapy patients regardingdemographic and insurance coverage and accurately entered this information into Hospital’s database.  Verified insurance coverage and obtained appropriate authorization.  Counseled patients regarding financial responsibilities and collected time of service payments, issued receipts, and prepared cash settlement records.  Also filled vacancies due to cancellations. Reviewed and prepared next day cases and schedules for physical therapists.  Performed other tasks related to registration of patients requiring sports physical therapy services at the The Orthopaedic and Sports Therapy Center.  Billed accounts when appropriate. 09/01/ - 04/04 Senior Financial Services Associate NYU Medical Center New York, NY  Researched patient accounts to identify and rectify billingissuesconcerning patient or insurance responsibility.  Reviewed patient accounts receivable in accordance with general credit policy and coordinate appropriate reimbursement.  Maintained liaison with other areas of financial service department to advise patients regarding financial coverage, to refer accounts and determine collection progress.  Performed extensive customer service via telephone and face-to-face interviews.  Assisted discharging patients with inquiries and provide itemized bills upon patient request.  Also rebilled accounts with appropriate correction when necessary. 11/89 – 08/01 Technical Support/Patient Representative Columbia Presbyterian Hospital New York, NY  Acted in-lieu of Supervisor or Manager of Medicaid Eligibility Unit in their absence.  Assisted in computer training for proper financial coding of cases.  Responsible for maintenance of office equipment as well as processing accounts, verifications, invoices and executing transaction,fact-findinginformation pursuantto determining eligibility of a accounts for Patient Financial Services.  Acted as liaison between patients, Presbyterian’s City On-Site Medicaid Office, Third Party Insurance, and other departments within Patient Financial Services.  Also responsible for billing Medicaid and commercial Insurance and referring cases to appropriate agencies and compiling necessary statistics. AFFILIATIONS: Montserrat Cultural Connection Inc. (Non-Profit Organization) 1998 - Present Vice- President SKILLS: Software: Adobe Illustrator, Photoshop, QuarkXPress, Pages, Keynote, Microsoft Office, HIS, Eagle, Epass.