Customer Service Medical

Jessica knowles

Email: abpg28@r.postjobfree.com

Address: **** * ***** **

City: Seattle

State: WA

Zip: 98178

Country: USA

Phone: 206-***-****

Skill Level: Experienced

Salary Range: $110,000

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

Jessica Knowles 6717 S. 120th St, Seattle, WA 98178

abpg28@r.postjobfree.com aa Cellular 206-***-****

Patient Account Specialist and Medical Biller

Highly skilled, knowledgeable, and proficient Medical Biller & Patient Account Representative bringing extensive, specialized experience working in medical billing, Medical Collector, Follow-Up Representative, Medical Reimbursement Specialist, Medicare, Medicaid, hospital/clinical collector, Commercial, Government, Managed Care, Credentialing Specialist and customer care capacities throughout hospital and clinical medical billing environments.

Knowledge, Skills and Ability

Knowledge and understanding of patient accounting processes and procedures

Knowledge of Federal, State Laws and Government regulations

Have communication skills with the ability to listen actively and respond timely, in a competent

Knowledge and ability to work effectively with a team

Knowledge of medical terminology, CPT, HCPCS and ICD9 coding

Knowledge of auditor/coder per CMS guideline

Knowledge of basic bookkeeping, ability to maintain confidentiality

Ability to manage timelines and critical deadlines

Ability to organize and problem solve and work under pressure

Ability to effectively perform job duties under a high level of activity and a variety of conditions

Ability to work independently and take initiative, to willingly accept responsibility

Ability to set priorities and use good judgment

Ability to work flexible hours, some evenings and weekends

Skill in oral, written and interpersonal communication, in time management

Skill and proficient in data entry, NexGen, EPIC, IBM, I&E, MS word, MS excel, RIS.

Experience

Group Health Cooperative, Seattle, Washington 1/2009 to Present

Patient Access Representative

Family Beginning Unit / Extended Observation Stay / Urgent Care/Outpatient Surgery

Perform general patient access and registration duties in EPIC Practice Management, such as, answer telephones, make appointments, and verify patient demographics and insurance coverage. Perform general patient account management duties, such as, obtain prior authorization for services, process high volume of pre admits, process items in the appropriate work queues to complete registration and enter service capture data. Works very closely with clinical staff, Pharmacy RX Account Creations and FBU admits. Ensure patient accounts and coverage structures meet Group Health standards and billing requirements of various payors. Function as liaison to Patient Financial Services and the Health Plan. Communicate with external government payors and employers, as necessary. Excellent customer service required. Work directly with patients on billing related matters and provide fee estimate patients for Group Health services. May perform duties related to cash collection and depositing. Demonstrate strong customer service and communication skills. Adhere to HIPAA and patient confidentiality requirement.

Minor and James Medical, Seattle, Washington 7/2009 to 7/2011

Payment Poster

Processing and applying payments, zero pay vouchers and adjustments received from the lockbox from patients and insurance companies are done accurately and in a timely manner.

Full spectrum involves receiving, sorting, batching and line item posting into the current practice management system. Posting of electronic vouchers. Processes all contractual adjustments as necessary to ensure appropriate third party reimbursement processing of accounts.

Accurately applies collection debt payments on appropriate accounts.

Balances daily posting batches to ensure accuracy and reconciliation of daily lockbox.

Maintains accurate documents and reports following established procedures and policies.

NeighborCare Health, Seattle, Washington 2/2000 to 7/2009

Patient Account Specialist

Process third-party administrator of health benefits, medical and dental, Respond to inquiries from providers on a broad scope of coverage issues pertaining to eligibility, managed / supervised in payment posting department, training employees with new procedures / policy, coordination/explanation of benefits, and payment schedules, Implemented an efficient follow-up system to expedite the recovery of 30-day outstanding payments from non-responsive insurance carriers, Reconciled outstanding balances and incidents of returned claim checks from Medicaid/Medicare, Processed computerized medical and dental billing for patients under private, No Fault, and Workeraaas Compensation insurance plans, Followed up with insurance carriers and patients to expedite the recovery of payment obligations, Contact with patients in person and over the phone regarding their questions on billing and insurance coverage, Researching rejected claims due to registration or charge entry errors. Re-submit claims to government agencies, medical service bureaus and insurance companies ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data, and patient information submitted, Audit system-generated reports for payments, problems, or errors; review vouchers for rejections, underpayments and denials; take appropriate follow-up actions including re-billing when appropriate, posting/entering charges into the Electronic Medical Record, Posts/enters office, hospital and OB/GYN charges using both EMR charge capture and paper fee slips.

Pacific Medical Center, Seattle, Washington 01/1998 to 2/2000

Patient Account Specialist I

Monitored all billing related problems and managed collection process.

Managed all billing queries for all assigned carriers

Evaluated data and corrected all errors to ensure appropriate billing and coding.

Maintained records of patient charts and demographics.

Assisted patients in insurance related queries or referred it to appropriate department.

Analyzed processes and recommended changes to improve efficiency of work.

Prepared patient account refunds and collection accounts for same.

Reviewed data on everyday basis and maintained records of account receivable.

Performed audit on patientaaas accounts and ensured accuracy on same.

Monitored all accounts and arranged payment schedule according to client requirement.

Managed insurance billing and ensured payment receipts dispatched and received.

Investigated all billing complaints and evaluated credit balance report in case of refund.

Coordinated with collection agency and updated all records.

Ensured accuracy in all accounts and identified problems if any.

The Downtown Clinic, Seattle, Washington 2/1995 to 01/1998

Office Manager/ Payroll

Provide management oversight for the registration and scheduling process to facilitate the collection of accurate patient demographic and insurance information; Establish quality control techniques to ensure that correct billing information is collected to produce and generate clean claims for submission; Provide excellent customer service including problem solving, timely follow up, assisting in answering phones and scheduling appointments; Facilitate the preparation and submission of employee payroll to the payroll processing company; Assist in reviewing vendor contracts, invoices and interacting with bookkeeping; Support the Practice compliance program and multifunctional and multi-task, ensure all provider credentialing / licensing are all up to date.

Training

Certificate of participation NexGen EPM Training. Puget Sound Neighborhood Health Centers and NexGen, Seattle, Washington, 2005 to 2005. Recognition of completing more than 25 hours of training

Take Charge Training, DSHS, Seattle, Washington, and 2001 to 2001. Training on how to bill Family planning

Certificate of Attendance, Lisa Peterson, Seattle, Washington, 2001 to 2001. For attending the CPT Coding Training

Medical Terminology Exam, Group Health, Seattle, Washington, 2010 to 2010. Certificate of completion of Medical Terminology

Coding Education and Training. Group Health, Seattle, Washington, 2011 to 2011. Complete 8 hours of training on CPT and ICD

Education

Nathan Hale High, Lake City, Washington 09/1989 to 5/1990

H.S. Diploma, Minor: Accountant

MedCerts Program aaa Online 01/2012 to Present

HI-4000 Electronic Health Records and Reimbursement Specialist

Personal Reference:

Leigh Hester Former Supervisor/Friend 206-***-****

Cicily Brunzell Zornes Former Manager / Friend 208-***-****

Christina Munster Former Supervisor/Friend 954-***-****

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