Wayne Woronkowicz
Whitesboro,NY
Summary
Reliable Billing Representative proficient in obtaining Diagnostic and insurance information. Strong analytical and Problem Solving Ability. Works well within a team environment or Individually with a strong work ethic.
Overview
34
34
years of professional experience
Work History
Billing Specialist
Primary Urgent Care
Utica, New York
11.2021 - Current
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Performed targeted collections on past due accounts aged over 60 days.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Managed invoicing and payment processing operations.
- Trained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance.
- Utilized talents and expertise to complete on-time and accurate monthly closing processes, journal entries and accruals.
Medical Coding Specialist
Oneida Center
Oneida, New York
06.2019 - 10.2021
- Reviewed outpatient records and interpreted documentation for 60 patient to identify diagnoses and procedures.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Worked with individual patients to code medical observations and professional services.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
Medical Billing Specialist
Upstate Family Health
Utica, , NY, New York
02.2018 - 05.2019
- Performed account reconciliations and resolved variances.
- Oversaw financial operations, producing invoices, processing payments and preparing deposits.
- Tracking payments on spreadsheets
- Obtaining, Sending and tracking of Workers Compensation information and No Fault information for payment.
- Working Aging Report
- Assigning CPT coding
- Maintained all confidential personnel files, license and CPR compliance records.
- Printed and sent around 60 patient Statements monthly for payment
- Collected copays and deductibles.
- Work Rejections to resolve errors to send to Clearinghouse and ultimately Insurance Companies.
- Ensure HIPPA Regulations.
- Write offs, due to timely filing, contractual obligations.
- Creating day sheets for verification of payment.
- Obtaining and verifying banking statements.
- Running Postage meter
- Set up requisitions to go to Accounts Payable from Interpreters
- Verifying if and when providers Lock progress notes for creation of claims
- Answer any billing questions for patients
- Resolving issues for payment ie reduction in amount owed
- Payment reduction and sliding scale
- Creating Primary Care letters to send to insurance companies
- Updating patient files. ie new address and phone numbers.
- Contacting insurance companies for payment or denial
- Verified important patient information such as Insurance verification, medical coding, EOBs, for patients financial situations
- Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients.
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.
Accounts Receivable Clerk
North American PArtners In Anesthesia
East Syracuse, NY
04.2017 - 07.2017
- Made outbound calls to vendors and customers to discuss and resolve account needs.
- Calculated discounts, percentage allocations and credits and spearheaded process improvements to secure prompt and regular receipts for organization.
- Posted high volume of monthly payments, performed research and tracked misapplied payments, prepared monthly reporting and trained new associates.
- Followed up with customers to collect information and verify details.
- Researched topics and completed due diligence to resolve issues in timely manner.
- This was a temporary job
Medical Secretary
St Josephs Hospital
Syracuse, NY
09.2016 - 02.2017
- Routinely collaborated with department managers to correct problems and improve services.
- Performed monthly inventory and maintained office and medical supply counts.
- Scheduled patient admissions and discharges.
- Performed office related support tasks and clerical functions, including Fax, Copier, Patient charts
- Obtained all necessary information to facilitate the assessment or admission process in a timely manner.
- Reviewed and maintained charts to ensure completeness and EMR guidelines.
- Answered the phone by the second ring and greeted callers enthusiastically.
- Handled all calls and face-to-face contact with clients in a professional and enthusiastic manner.
- Processed and filed records such as [Name], [Name] and [Name].
Billing Specialist
CentrexLaboratories
New Hartford, NY
07.1998 - 01.2016
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances.
- Generated and submitted invoices based upon financial schedule.
- Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients.
- Trained others for the same position.
- Aging Reports.
- Assigned Coding CPT and ICD 9 and 10 diagnostic codes
- reviewed EOBS for Accuracy
- Obtained and verified insurance information.
- Obtained Diagnosis and translated to ICD 9 and 10.
- Distributed work according to volume
Claims Representative
Metropolitan Life Insurance Company/United Healthcare
Oriskany, New York
09.1990 - 07.1998
- Checked level and type of coverage and evaluated contracts.
- Approved claims for payment
- Customer Service
Education
Bachelor's Degree - Business Administration
State University of New York College of Technology
05.1991
Associate of Science -
Mohawk Valley Community College
Sherman Drive12.1986
MEDICAL CODING - MEDICAL CODING
Utica School of Commerce
Utica, NY05.2017
Skills
- Medicare and Medicaid process
- Medicaid management information systems
- ICD 9/10 ICD forms
- Analytical thinking
- Healthcare billing
- Payment processing
- Superior attention to detail
- Team player
Interests
Professional Coding
, Hobbies Sports Model railroads Reading
Sports, Model trains
I'm very athletic and have model train tables set to detail.
Timeline
Billing Specialist
Primary Urgent Care
11.2021 - Current
Medical Coding Specialist
Oneida Center
06.2019 - 10.2021
Medical Billing Specialist
Upstate Family Health
02.2018 - 05.2019
Accounts Receivable Clerk
North American PArtners In Anesthesia
04.2017 - 07.2017
Medical Secretary
St Josephs Hospital
09.2016 - 02.2017
Billing Specialist
CentrexLaboratories
07.1998 - 01.2016
Claims Representative
Metropolitan Life Insurance Company/United Healthcare
09.1990 - 07.1998
Bachelor's Degree - Business Administration
State University of New York College of Technology
Associate of Science -
Mohawk Valley Community College
MEDICAL CODING - MEDICAL CODING
Utica School of Commerce
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