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Natalya L. Ni

Name : Natalya L. Ni
Experience : 14
Specialty : Internal Medicine, Family Practice, Behavioral Health, Cardiology, Chiropractic, Gastroenterology, General Surgery, Neurology, OB Gyn, Orthopedic, Pain Management, Physical Therapy & Urology
Location : StudioCity,CA
Description :

Natalya L. Ni is an Associate level of business professional with experience in Administration, Operations, Customer Service, Sales, Collections and Project Management, looking for medical business management opportunities. A self-starting high motivated individual looking to join an emerging team that will use my experience to the full potential while expanding my level of knowledge by acquiring new skills.

Skills:

  • Microsoft Word, Excel, WordPerfect, Medical Manager,  TinyTerm (Prime-Clinical), MediSoft, eClinicalWorks, Lytec, Mac Practice, Apex Software (medical billing software), PeachTree, QuickBooks, MSOutlook, RSSQL Administration/Operation, Great Plans, Basics of ADP, Act.
  • Bilingual – English and Russian languages
  • Previous experience implementing cross-functional initiatives
  • High degree of accuracy, neatness and attention to detail
  • Problem-solving & strong analytical skills
  • Able to multitask and meet deadlines
  • Ability to work to consistent high standard under pressure. Ability to work under fast paced environment and adapt to ever changing priorities
  • Willing to undertake additional responsibilities as required
  • Self-motivated, able to work in a team and demonstrates the ability to work independently
  • Possess an ability to clearly communicate complex issues to all levels of management
  • Excellent organizational, interpersonal and communication (written and verbal) skills

Experience:

Revenue Cycle Manager, Coding, Billing and Reimbursement Management:

  • Front Office, Registration, Billing & collections, Network Insurance verification/contracting & credentials;
  • Works compensations, PI, PPO, Medicare, HMO:
  • Billing and reimbursement management: starting from front office, registration, billing, collections, reimbursement analysis;
  • Clinic billing for following locations: Fresno, Lancaster, Los Angeles, Sherman Oaks, Miracle Mile (each office seen about 67-80 patients);
  • Hospital billing for following locations: Cedars Sinai Medical Center, Olympia Medical Center, Miracle Mile Medical Center, Sherman Oaks  Medical Center, Glendale Multi surgical facility, Encino Hospital and St. Joseph Medical Facility;
  • WC cases: EAMS verification, categorize each account, manage status update on litigated cases, authorizations, rebuttal, peer reviews, updates and changes, network activities:
  • PPO cases: Verification of COB (including surgeries, injections, fusions, diagnostic testing, MRI, MRA and more), life updates on procedure codes and diagnosis (CPT and ICD 9/10), audit recoveries and more;
  • Medicare and Department of Labor cases:  Verification of COB and claim eligibilities (including surgeries, injections, fusions, diagnostic testing, MRI, MRA and more), life updates on procedure codes and diagnosis (CPT and ICD 9/10), audit for recoveries and more;
  • Coding for WC, Department of  labor, PPO, PI and Medicare cases (including surgical procedures in ambulatory and in-patient settings,);
  • Records review, implementation of EMR, compliance, document management;
  • Practice analysis by Procedure, referral, location, diagnosis;
  • Report directly to COO and CFO daily, weekly, monthly, quarterly, yearly:
  • Production, Forecast and distribution;

Revenue Management/Medical Billing Manager/Finance Administration:

  • Financial Management, Billing, Collections, Medicare Advisor/ Consultant, Insurance verification, Pre-authorization, Legal/Workers Comp cases, Credentials, CLIA Certification, Network/Out-of Network contracts/ adjustments:
  • The Revenue Service Analyst is responsible for conducting and documenting moderate to complex data analysis projects;
  •  Responsible for planning and implementing projects that drive efficiency and quality within the Billing department;
  • Licensing, credentialing & enrollment;
  • Insurance verification & pre-authorization for services;
  • Managing in and out-of-network adjustments and contracts;
  • Clinic Billing: transcripts, dictations and reports verification – correct data, compliance & regulations;
  • Hospital  billing: following up on outpatients & inpatients information, verifying correct admission dates, referred MD’s NPI, Hospital progress notes and more;
  • Applied/updated CPT codes to billing software (Medicare updated/changed CPT codes, CPT codes updates for Private Insurance, E & M Schedule of payment for legal/ w/c cases);
  • Followed up on each new CPT codes (including appropriate diagnosis codes/procedures);
  • Managed patient AP/AR reports for each account;
  • Submitted claims Electronically to Medicare’s Clearing house;
  • Electronic/Paper billing (primary, secondary & third parties);
  • Post payments & corrections;
  • Patients & Insurance AR;
  • Collections (knowledge of AB1455, Knox-Keene Act, Health & Safety Codes, etc.),  insurance claims denials/appeals ( M-care, M-cal, Medi-Medi, PPO, HMO);
  • Billing & Collections of Legal & Workers Comp cases (including updated codes, reports & regulations), Payer’s negotiations and contracting;
  • Provider care updated information (including In/Out-of-Network contractual adjustments; PECOS/ PQRI enrollments and more (depends on specialty);
  • Any additional information on PQRI, PEQOS, UHC Legal Cases regarding unpaid secondary or primary claims (including sub insurance companies) as well Medicare future (November 2010) Providers payment cuts and deductions, off-set payments on incorrect billing due to new regulations and new CPT/ICD-9 codes and more alerts/ updates from AMA or CMS provided on daily basis.

Business Office:

  • Financial Management, Billing, Collections, Medicare Advisor/ Consultant, Insurance verification, Pre-authorization, Legal/Workers Comp cases, Credentials,