Kateryna Patskovska

Health Care Program Analyst out of Network Negotiator at Metroplus Health @NYC Health + Hospitals

New York, NY, US

Negotiate Single Case Agreements with Out of Network Providers-Create and foster positive relationships between MetroPlus and Out of Network Providers-Serve as a liaison between multiple departments including UM/Claims/Reimbursment/Provider Contracting-Ensure that current medical coding and billing guidelines are followed by the Out of Network Providers/UM/Claims department/Reimbursement Department-Advise Claims department on Proper reimbursement amounts for Out of Network claims w/Single Case Agreements-Resolve Patient Complaints: Balance Billing-Resolve Provider complaints: underbilling: ex. out of state ER claims-Assist Compliance Department with IDR cases-provider payment negotiations-Assist UM department with educating providers regarding unlisted codes and selecting proper codes that represent the performed procedures-Identify and refer potential fraud waste and abuse cases to SIU department

SUNY Westchester Community College

Associate's degree, Business Administration and Management, General