DOMONIQUE JETER

PROFILE

Highly motivated accounts receivable specialist. I have worked in the medical field for over 10 years. With vast knowledge in medical insurance billing, coding, and pharmacy reimbursement. Including various backgrounds in long term care, skilled and hospice billing. Proficient in MS Office products as well as Point Click Care, Home Base Home Care, and Quadax software. Comprehensive understanding of IDC 9 and 10 coding

CONTACT

PHONE:

216-***-****

EMAIL:

ad5azo@r.postjobfree.com

EDUCATION

Hondros School of Nursing

2012 - 2014

Medical Terminology

Penn Foster

2009 - 2010

Medical Billing and Coding

ICD 9 and 10 certifications

Variable Life Health and Accident Insurance

Maple Heights High School

2000 – 2004

General Studies {High School Diploma}

WORK EXPERIENCE

Embassy Healthcare

Billing Specialist

06/2022 – 12/2023

Verification of insurance and policy coverage. Submit claims to insurance companies on behalf of long-term care facilities, including but not limited to Anthem BCBS, AmBetter, WellCare, United Healthcare, Buckeye and CareSource for the States of PA and Ohio. Confirm inpatient authorizations for LTC and skilled stays as well as submitting Workers Comp claims. Posted Cash, monthly bank reconciliations and adjustments. Appealed any claim denials.

Brentwood Healthcare Campus

Billing

08/2021 – 11/2021

Clerical duties, updating and maintain census. Long term care and rehabilitation billing, Ensure prior authorization as well as verification of resident benefits and eligibility coverage. Review and update payor contracts and maintain credentialing. Reconcile billing and assisting in month end closing.

Communicare Health Services

Managed Care Biller & Pharmacy Reimbursement

05/2017 – 04/2020

Verification of prior authorization, Managed care Billing for 6 separate facilities in various states including Ohio, Virginia, Maryland, Indiana, Pennsylvania, and Kentucky. Worked A/R aging and followed collection protocols. Submitted appeals and worked claim denials. Update and maintain contractual agreement with insurance companies to ensue fee schedules were being reconciled and billing in accordance with contractual agreements. Submitted Pharmacy Reimbursement claims while coordinating with facility medication management team. Aided in A/R monthly closing.

Grace Hospice

Service Coordinator

10/2016 –05/2017

Coordinate staffing for terminally ill patients, consisting of Case Managers and Nursing Aides. Data entry, clerical duties, receptionist skills, Hospice Billing and other duties as assigned.

SKILLS

Medical Billing and Coding with proficient in Pharmacy Reimbursement. Comprehensive knowledge of Managed Care Billing within Long Term Care facilities in numerous states. Establishing and forming outstanding working relationships with various state and federally funded insurance providers. Proficient in Point Click Care and other third part billing software.

Contact this candidate