Jessica Nichols
Email: abqkwc@r.postjobfree.com
Address:
City: martinsburg
State: WV
Zip: 25404
Country: USA
Phone: 240-***-****
Skill Level: Any
Salary Range:
Primary Skills/Experience:
Highly efficient Medical Biller with experience in anesthesia, neonatology, inpatient care and emergency room care. Excellent multi-tasker and demonstrated team player with a positive attitude. Strong attention to detail and extensive knowledge of medical terminology. Familiar with commercial and private insurance carriers and I am well practiced in and strictly adhere to HIPAA regulations. I have worked with medical systems including; Kredo, Nextgen and Realmed. I am also very familiar with Excel and Word. I am organized, diligent and proficient and also fully understand the need to adhere to strict time constraints. Seeking a position of increased responsibility and authority.
Educational Background:
High School Dipolma from Middletown High School, Middletown MD 1/2001 to 6/2000 (Arts and communications)
Job History / Details:
Professional Summary
Highly efficient Medical Biller with experience in anesthesia, neonatology, inpatient care and emergency room care. Excellent multi-tasker and demonstrated team player with a positive attitude. Strong attention to detail and extensive knowledge of medical terminology. Familiar with commercial and private insurance carriers and I am well practiced in and strictly adhere to HIPAA regulations. I have worked with medical systems including; Kredo, Nextgen and Realmed. I am also very familiar with Excel and Word. I am organized, diligent and proficient and also fully understand the need to adhere to strict time constraints. Seeking a position of increased responsibility and authority.
Skill Highlights
I maintain strict confidentiality
I understand the importance of HIPAA compliance
I have extensive knowledge of HMOs, Medicare and Medicaid Electronic Medical Record (EMR) software
I have knowledge and understanding on CPT and HCPCS coding
I accurately verify patient insurance information to ensure correct billing of claims
I have worked with medical billing software
I posses strong planning skills
I have a strong work ethic
I am a team player with positive attitude
I am very deadline-driven and understand the importance of this
I have good written and oral communication
Professional Experience
September 2010 to Current
Emergeny Medicine Associates Germantown, MD
EOB/Appeals Analyst
-Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate information.
-Carefully reviewed medical records for accuracy and completion as required by insurance companies.
-Strictly followed all federal and state guidelines for release of information.
-Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
-Ensured compliance with medical/legal requirements.
-Consistently ensured proper coding, sequencing of diagnoses and procedures.
-Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
-Thoroughly reviewed remittance codes from EOBS/AR's.
-Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
-Completed appeals and filed and submitted claims.
-Carefully prepared, reviewed and submitted patient statements.
-Meticulously tracked and resolved underpayments.
-Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables system and clearing house.
-Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
-Maintained record of all accounts/claims I worked on to ensure they processed correctly.
-Attended regular meetings wherein new issues with insurances, procedures and practices were addressed and resolved.
January 2008 to September 2010
AHMA Frederick, MD
A/R representative
-Thoroughly investigated past due invoices and minimized number of unpaid accounts.
-Demonstrated analytical and problem-solving ability.
-Carefully reviewed medical records for accuracy and completion as required by insurance companies.
-Strictly followed all federal and state guidelines for release of information.
-Accurately entered procedure codes, diagnosis codes and patient information into billing software.
-Consistently ensured proper coding, sequencing of diagnoses and procedures for anesthesia charges.
-Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.
--Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
-Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
-Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
-Thoroughly reviewed remittance codes from EOBS/AR's.
-Completed appeals and filed and submitted claims.
-Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
July 2001 to May 2005
United Healthcare Frederick, MD
Supervisor/Customer advocate
-Assisted members and call reps in resolving claims issues.
-Received and handled escalated calls from sometimes irate members, in a professional and proficient manner.
- Assured claims were entered properly and adhered to system and insurance regulations.
-Recognized trends that may cause problems in processing future claims.
-Maintained a follow up log to ensure members were having issues resolved properly and timely.
-Acted as a liason between patient and doctors ensuring patients were not being improperly billed.
-Entered data to update and maintain member accouts.
Education and Training
2000 Middletown High School Middletown, MD
High School Diploma Arts and communications