Candidate Description
Harleyann Diaz Mackenzie
646-765-7882 Harleyann1102@Gmail.com
Qualifications and Skills:
• Extensive knowledge of MS Office products – Excel, Word, PowerPoint, Spreadsheets
• Claims Management and Insurance Verification Specialist – Specializing in Out of Network Claims,
Prior-Authorizations for Testing, Referrals, Online Claim Submission, Eligibility and Benefits Details
Prior-Authorization and Referrals with all Online Claim Systems such as NaviNet, UHCOnline and all
Major Insurance Company Claim Websites
• 3 years Management Experience and 5 years Medical Personnel experience
• Customer Service and Problem Solving Management
• Ability to work in a fast paced environment
• A clear and pleasant telephone manner
• Ability to communicate effectively with a wide range of patients and customers
• Experience in dealing with customer and patient complaints on a Management level
• HIPPA Certified 2011
Relevant Experience
Brain Resource Center Medical Office Manager
Upper West Side NYC August 2013, April 2016
Setting up children and adults with special needs with empathy and care for Neurofeedback.
Disorders such as Autism, ADHD, Anxiety, Bipolar Disorder, MDD, Depression, PTSD etc.
Answering, Setting up and dealing with all sorts of problem solving, appointments, doctor’s
requests, insurance verifications and lawyer inquiries
Listening, addressing and solving all patient needs, questions, concerns and requests in a pleasant
manner
Maintaining up to date paper and computer based files and administrative systems.
Handling objections professionally.
Setting up and downloading all necessary software for remote patients
Ordering all supplies through our dedicated suppliers as well as keeping inventory
Expert knowledge of CMS-1500, CPT Codes, ICD-9 & ICD-10 Diagnostic Codes, Medical billing for
Multi-Doctor practice and Research Facility in an Out Of Network Scale
Responsible for all Practice Billing using 1500 and Electronic Health Records systems, Knowledge of
all billable procedure codes, diagnostic codes and scales.
Generating online and phone referrals and Prior Certifications for testing and services
Intensive knowledge of all insurances and benefits/eligibility
Time Management- such as implementing EHR online claims through each insurance website such
as BCBS, Empire, Aetna, Anthem, Optum, United Healthcare, Oxford, Magna Care and 1199 from
paper claims and establishing a network of online EHR services
Providing professional patient management and confidential file review
Recruited, hired and trained all staff, providing direct supervision, ongoing staff development,
payroll and continuing education to 4 employees
Formulated, wrote and implemented new employee orientation manuals
Supervised daily staff activities, establishing an effective and smooth work environment
Led billing record software implementation and customization
Developed billing guidelines and processes
Initiated HIPPA-related compliance policies and procedures
Managed all supply orders within budgeted guidelines
Responsible for clinic operations including calendar management, scheduling meetings/ diagnostic
testing, patient appointments, informational material and preparing material for investor meetings
Improving practice efficiency by creating and implementing systems for staff as well as myself
including spreadsheets for accounting, administrative, intake forms, insurance forms, etc.
Providing Executive Administrative Support to the CEO and Director of Neuropsychology practice
Networking with Attorney’s and other doctors for referrals
Orlin and Cohen Orthopedics Front Desk Associate/ MRI
Long Beach, New York 2011-2012
Checked in and out patients at a very busy multi-doctor Orthopedic Practice
Gave instructions for MRI procedures/ brought them to the room
Checked in and out patients for MRI procedures
Verification of insurances/ referrals/ collecting copayments
East Meadow Family Practice Front Desk/ Check Out
Bellmore, New York 2010-2011
Entered all CPT Codes into database along with ICD codes
Ensured that they had whatever external appointments booked(Echocardiogram, MRI, CT Scan Etc)
Collected copayments and ran end of day financial reports
Ensured that all Credit Cards, Cash and Check Payments matched up on the reports
The D’Aria’s Home Health Aid for Dementia Patient
Long Beach, New York 2009
Buena Vibra Productions – Production Assistant San Juan Puerto Rico 2011-2013
Tropical Trailrides- Assistant Manager San Juan Puerto Rico 2011-2013
Education:
Interamericana University- Puerto Rico Nursing 2012-2013
Nassau Boces at Barry Tech, Hicksville NY Dental Assisting 2010
Nassau Community College- Long Island NY Business 2009-2010
Borough of Manhattan College- New York NY Business 2008-2009
Brittany Beauty School-Levittown NY Cosmetology 2007-2008
Volunteering:
Freeport Animal Shelter –Kennel Care/Adoptions for Cats & Dogs 2004-2006
Bobby and the Strays- Kennel Care/Adoptions for Cats & Dogs 2007-2011
Hillsong Church- Host Team & Kids Team Leader 2015-2016