Elena Novak

I’m a Medical Billing professional with 20 years of experience managing multi‑payer billing operations in fast‑paced homecare environments. My background includes Medicare, Medicaid, commercial insurers, and SCO/MCO programs such as CCA, Tufts, UHC, and SWH. I specialize in eligibility verification, prior authorizations, claims management, and denial resolution, with a strong focus on accuracy, compliance, and clean‑claim submission.
I work extensively with HealthWyse/Net Health, HHAeXchange, Availity, Inovalon (MyAbility), the MassHealth Provider Portal, Payspan, and other payer‑specific systems. I’m known for identifying root causes of billing issues, improving workflows, and strengthening communication between providers and payers.
I enjoy roles where I can apply deep billing expertise, solve complex claim issues, and support efficient, compliant reimbursement processes. I bring a calm, structured approach to problem‑solving and a strong understanding of how payer rules, documentation, and clinical workflows connect.
I’m open to opportunities in Medical Billing, Claims Resolution, and Provider Relations where I can contribute my experience and help organizations achieve accurate, timely reimbursement.

Billing Manager in Training (Medical Billing)

International Health Solutions, Inc. October 2025 - January 2026

- Acted in a full billing manager capacity while completing a structured 90‑day leadership training program.
- Oversaw eligibility verification, authorization management, and multi‑payer claim submission for two office locations.
- Managed pre‑billing audits, corrected claim errors, resolved denials, and posted ERAs/RAs to maintain accurate revenue flow.
- Supported daily billing operations using Devero and Homecare IT, contributing to workflow improvements during organizational transition.
- Collaborated with payers to resolve escalated issues and ensure clean‑claim submission.
- Assisted with documentation review, and process optimization initiatives

Medical Billing Manager 

Multicultural Home Care , a Modivcare service September 2005 - August 2025

- Led all billing operations for Medicare, Medicaid, commercial insurers, and SCO/MCO programs (CCA, Tufts, UHC, SWH).
- Managed eligibility verification, prior authorizations, claims submission, denials, and collections.
- Resolved escalated claim issues by collaborating directly with payers and provider teams.
- Oversaw month‑end and year‑end closing, reconciliation, and revenue reporting.
- Used Availity, MyAbility (Inovalon), MassHealth Portal, and Payspan daily for eligibility, claims status, ERA retrieval, and payer communication.
- Utilized Medicare DDE/FISS, HealthWyse/Net Health, and HHAeXchange with advanced proficiency.
- Implemented process improvements and quality assurance initiatives to reduce denials and improve clean‑claim rates.
- Trained, mentored, and supervised billing staff; managed workflow, productivity, and accuracy.
- Led special billing projects and supported billing system upgrades and implementations.

Medical Billing and Coding Instructor 

Boston Career Institute Inc May 2005 - January 2020

- Taught CMS‑1500 and UB-04 medical billing forms, including field‑level requirements and payer rules.
- Taught Medical Terminology and Human Anatomy & Physiology to support accurate coding.
- Educated students on Medicare, Medicaid, and commercial insurance billing rules.
- Developed curriculum for ICD‑9/10, CPT, and HCPCS coding and claims workflows.
- Trained students to interpret remittances, identify denial reason

Boston Career Institute

Medical Billing and Coding Certification  2004-2005

Massachusetts Institute of Technology. The Lowell Institute School

Certification, Computer Programming, Specific applications 1993-1993

Moscow State Textile University

Bachelor's degree, Engeneering