Cecilia Puglisi
Whittier
Summary
Knowledgeable Reimbursement Specialist with solid history in managing complex reimbursement processes and resolving billing issues. Efficiently handled claims and appeals, ensuring compliance with regulatory requirements and minimizing denials. Demonstrated analytical skills and attention to detail in optimizing reimbursement strategies.
Overview
20
20
years of professional experience
Work History
Admissions and Reimbursement Specialist
Rise MG formally Companion MG
01.2016 - Current
- Submitted claims to insurance companies
- Researched rejections, investigating problems to appeal claims
- Collected coinsurance and deductibles from patients for rendered services, posted and managed patient account payments
- Monitored past due accounts and pursued collections on outstanding invoices
- Performed insurance verification, pre-certification and pre-authorization
- Participated in workshops, seminars and training classes to gain stronger education in industry updates and federal regulations
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries
Patient Care Secretary, Scheduler
Companion Home Health and Hospice
10.2010 - 12.2015
- Medical Records-Complied physical and digital documents, charts and reports for auditing and closing charts
- Retrieved physicians' signatures on all proper documentation
- Staffing Continuous Care Cases, checking in nurse notes
- Preparing IDG Agenda, Filing, Faxing, Mailing, Scanning
- Scheduling Clinicians
- Getting Authorizations for visits
- Answered phone calls to provide assistance, information and medical personnel access
- Updated reports and daily logs for management use and permanent files
- Entered information into system to update status reports
- Set up delivery of materials, medical equipment
Receptionist
Janney & Janney Attorney Service, Inc
05.2010 - 10.2010
- Answered and directed incoming calls using multi-line telephone system
- Delivered administrative support to team members by making copies, sending faxes, organizing documents and rearranging schedules
- Sorted incoming mail and directed to correct personnel each day
- Served visitors by greeting, welcoming and directing to appropriate personnel
- Handled payment processing and provided customers with receipts and proper bills and change
- Pulled and organized requested documentation
Data Entry Clerk, Proof Reader
Priority Posting
03.2008 - 11.2009
- Reviewed and edited documents to fix grammatical and spelling issues
- Input client information into spreadsheets and company database to provide leaders with quick access to essential client data
- Reviewed and updated account information in company computer system
- Completed administrative work to support team needs for correspondence, answering phones and copying documents
- Organized billing and invoice data, prepared accounts receivable and generated revenue reports to support audits
- Responded to daily inquiries and requests within mandated timeframe to meet deadlines
Clerk
BFSaul Wholesale
01.2007 - 11.2007
- Customer Service, answering phones
- Enter client info, Prepare chart for Funding
- Filing, Mailing, Faxing, Scanning
Clerk
Downey Savings & Loan
01.2005 - 01.2007
- Customer Service, answering phones
- Enter client info, Prepare chart for Funding
- Filing, Scanning, Mailing, Faxing
Education
Diploma - LVN
Pacific College
Costa Mesa, CA06.2015
Diploma - Medical Assisting
Everest College
Anaheim, CA10.2008
Skills
- Multitasking and prioritization
- Data entry
- Excel
- Insurance/Eligibility verification
- Netsmart
- Payment posting
- Claims and Appeals processing
- Copay collection
- Microsoft office
- Medicare, MediCal, Commerical and Managed Care
Timeline
Admissions and Reimbursement Specialist
Rise MG formally Companion MG
01.2016 - Current
Patient Care Secretary, Scheduler
Companion Home Health and Hospice
10.2010 - 12.2015
Receptionist
Janney & Janney Attorney Service, Inc
05.2010 - 10.2010
Data Entry Clerk, Proof Reader
Priority Posting
03.2008 - 11.2009
Clerk
BFSaul Wholesale
01.2007 - 11.2007
Clerk
Downey Savings & Loan
01.2005 - 01.2007
Diploma - Medical Assisting
Everest College
Diploma - LVN
Pacific College
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