Customer Service Medical

Mrs. Jamie L. French

***** ****** ****

Spiro, OK 74959

Tel: 479-***-**** Email: *****.*****@*****.***

Medical Billing Specialist & Patient Account Representative

Career Details

Reimbursement Specialist / Charity Care & Alternate Payer Specialist

(October 2010 - current)

Mercy Medical Clinics

Reviewed, corrected and completed follow up procedures for government

and non-government insurances.

Prepared Appeals and Hearings for Medicare, Medicaid and all

non-government insurance companies

Submitted primary and secondary corrected claims on paper, and online

and for Medicare, Medicaid and all non-government insurance

companies.

Prepared AR reports and submitted results to supervisors

In March I was asked by our Director to transfer departments to be a

part of a new team within Mercy Medical Clinics. At this request I

transferred to the Charity Dept Team.

Charity & Alternate Payer Source Specialist

(March 2011-current)

Reviewed Charity Care applications to decide if patient qualifies for

an Alternate Payer Source or Charity Care.

Assist patients with completing applications and obtaining requested

documents.

Complete Charity Care adjustments on accounts that qualify.

Attend all Charity Dept team meetings to continue to build processes

and procedures for this new department.

Prepare departmental reports for Charity Care adjustments.

Patient Account & Benefit Representative (October 2006 September

2010)

HCFS, Inc., Addison, TX

Major Accountabilities:

. Educated and experienced in the rules and regulations for state,

federal and county assistance programs such as Medicare, Medicaid,

SSDI/SSI Disability and VA Benefits.

. Completed proper customer service by personally speaking to

patients admitted into the hospital with no payer source.

. Built a professional relationship with the DHS county offices in AR

and OK

. Scheduled and completed home visits with patients that were not

able to get transportation to the hospital or DHS office.

. Assisted patients with the entire application process and obtaining

necessary medical documents, up to when the final decision was made

and medical facility received payment.

. Completed and scheduled Medicaid / Medicare Hearing and Appeals for

patient at the assigned DHS office.

. Completed month end financial reports and prepared invoices.

. Assisted with training new employees.

. Worked any and all over time that I was requested to work and

worked every Saturday for the past year.

Medical Billing and Marketing Manager (October 2005 September

2006)

Anderson's Discount Pharmacy, Fort Smith, AR

Major Accountabilities:

. Responsible for entire DME department and all marketing for the DME

Dept.

. Billed all Medicare, Medicaid and commercial insurance claims for

DME supplies

. Obtained and submitted documentation and medical records needed

from physician to bill insurance company for DME supplies.

. Assisted in customer service by consulting with patients about the

DME Equipment that is available to them and how to use their

equipment and supplies.

. Created and implemented a training program to train the pharmacist

and other employees on that DME supplies and equipment.

. Designed and coordinated "Health Fairs" at the pharmacy for the

public to learn about the DME equipment that is available.

. Developed marketing program within the pharmacy to advertise the

DME Dept.

. Due to the success of marketing, the pharmacy obtained contracts

with BOST, The Diabetes Education Center, Sebastian Co Detention

Center, Mercy Crest Nursing Home and numerous other long term care

facilities.

Reimbursement Specialist (May 2004 September 2005)

Medisav Homecare, Fort Smith, AR

Major Accountabilities:

. Prepared and billed Medicare, Medicaid and insurance claims for

DME supplies using EDI and PES programs.

. Reviewed insurance EOB and statements to research and correct and

resubmit denied claims.

. Posted insurance payments and prepared customer statements.

. Prepared and completed Medicare and Medicare Appeals and Hearings

up to the ALJ stage.

. Due to attention to detail and knowledge of the rules and

regulations, 97% of the Appeals and Hearings I was involved in

resulted in a favorable decision and payment received.

. Worked the monthly past due AR Reports.

Reimbursement Specialist (August 2002 August 2005)

Group One Healthsource, Barling, AR

Major Accountabilities:

. Reviewed, corrected, and resubmitted Medicare, Medicaid and

insurance claims.

. Prepared and completed Medicare and Medicaid Appeals and Hearings.

. Educated in Medicare and Medicaid rules and regulations for the

states of AR, OK, TX, CA, MO and IL.

. Was given the option to stay employed by the company and to prepare

claims at home when the local office was closed.

Reimbursement Specialist (September 1999 July 2002)

Sparks Medical Foundation, Ft Smith, AR

Major Accountabilities:

. Reviewed corrected and electronically resubmitted medical insurance

claims.

Used ICD9 and CPT coding system

. Achieved staying in the top 5% off the office in my productivity

level.

Receptionist / Medical Records Clerk (October 1998 September

1999)

Parham & Sills Clinic w/ Sparks Medical Foundation, Ft Smith, AR

Major Accountabilities:

. Supplied customer service to each patient.

Schedule new patients and follow up appointments

. Filed medical records and copied medical records upon insurance and

attorney's request.

. Was promoted to the Business Office with Sparks Medical Foundation.

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Educational Qualifications

Carl Albert State Community College, Poteau, OK (October 2005

- October 2005)

Market Seminar - Marketing,

West Ark Community College, Ft Smith, AR (November 2001 -

December 2001)

Vocational - Management,

Eckerd College, Ft Lauderdale, FL (June 1994 - August 1996)

Assoc Degree - Zoology / Marine Biology, 3.4

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Additional Skills

. College Grad - Biological & Biomedical Sciences

. Health Care - Health Care Customer Service, Medical Billing,

Pharmaceutical

. Customer Service - Customer Service Manager, Customer Service Rep,

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References

Multiple References and Letters of Recommendation available on

request.

Contact this candidate