Aqueelah F. Jones

ac5gv4@r.postjobfree.com

813-***-****

Summary:

Performed a wide range of duties and responsibilities with 7 + years’ experience. Background in medical claims, billing, medical records, insurance claims, and payroll duties. Effectively, address internal and external customers questions, complaints and concerns. Committed to delivering excellent quality results with minimum supervision.

CoAdvantage June 2017 – Feb 2018

Benefits Specialist

Conduct ancillary review and system set up for my book of business.

Audit files based on accounting reconciliation standard operating procedures.

Conduct benefits confirmation with employee and employer and conduct benefits audits when requested.

Batch files for each carrier, Conduct client count maintenance.

Resolve issues with client and employee accounts.

Review all submitted forms for compliance with applicable policies

Provide data entry.

Review accounts to ensure clients meet eligibility requirements.

Maintain accurate status client Health Savings Accounts and Flexible Spending Accounts.

Reconcile billing and payments posted.

I am proficient in HRP, Client Space, Open NOTUS.

Appointed Team Lead companywide for the project “Evidence of Insurability” which was designed to review the accuracy of ancillary benefits.

Health Plan

Billing and Enrollment Nov 15- Feb 16

Responsible for Maintain and releasing all-ship-verified claims from bill review.

Insurance verification, enrollment billing and processing payments for the members.

Analyzed and verify all dates of service and billed amounts, sending out all claims with corresponding documentation.

Prepared billing packets for quality review, maintaining a billing hold report for all unbillable claims.

Oversees several client care groups, responsible for planning, managing, and

evaluating team performance to ensure internal and external customers are receiving high levels of service aa well as meeting service level agreements and standards.

Health Port, Tampa

Medical Records and Retrieval Nov 13- Jan 15

Reviewed records for completeness, accuracy, and compliance with regulations.

Retrieved patient medical records for physicians, technicians, or other medical Personnel.

Released information to persons or agencies according to regulations.

Planed, developed, maintained, or operated a variety of health record indexes or storage and retrieval systems to collect, classify, store, or analyze information.

Compiled and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.

Transcribe medical reports.

Identify, compile, abstract, and code patient data, using standard classification systems.

Managed the department or supervise clerical workers, directing or controlling activities of personnel in the medical records department.

Protect the security of medical records to ensure that confidentiality is maintained.

Pulse Communications

Telephone Communications April 13- Nov 13

Retrieve and review customer requests and questions, referencing alphabetical and geographical directories to provided information and answers. Assisted switchboard operator, with answering and transferring calls from multiple lines and extensions, while greeting callers and providing information using professional telephone etiquette. Aided customers with special billing requests. Kept chronological records of calls, sales orders and messages received, by stamping and filing appropriately according to company regulations.

Humana Tampa, FL

Medical Records and Retrieval Nov 11 – April 13

Posted medical insurance billings.

Prepared statistical reports, narrative reports, or graphic presentations of information, such as tumor registry data for use by hospital staff, researchers, or other users.

Developed in-service educational materials.

Consult classification manuals to locate information about disease processes.

Processed patient admission or discharge documents.

Compiled and maintain patients' medical records to document condition and treatment.

Enter data, such as demographic characteristics, history and extent of disease, Diagnostic procedures, or treatment into computer.

Planed, developed, maintained, or operated a variety of health record indexes or storage and retrieval systems to collect, classify, store, or analyze information.

Processed and prepare business or government forms.

Trained medical records staff.

Dr. Leila Attar

Medical Front Office Feb 08 – Oct 11

Answered telephones and direct calls to appropriate staff.

Schedule and confirm patient diagnostic appointments, surgeries, or medical Consultations.

Used various software applications to prepare reports, invoices, financial statements, letters, case history and medical records.

Operate office equipment, such as voice mail messaging systems, and use word

Processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.

Complete insurance or other claim forms.

Interview patients to complete documents, case histories, or forms, such as intake or insurance forms.

Receive and route messages or documents, such as laboratory results, to appropriate Staff.

Compile and record medical charts, reports, or correspondence, using typewriter or Personal computer.

Transmit correspondence or medical records by mail, e-mail, or fax.

Maintain medical records, technical library, or correspondence files.

Perform various clerical or administrative functions, such as ordering and maintaining an inventory of supplies.

Perform bookkeeping duties, such as credits or collections, preparing and sending financial statements or bills, and keeping financial records.

Transcribe recorded messages or practitioners' diagnoses or recommendations into Patients' medical records.

Arrange hospital admissions for patients.

Prepare correspondence or assist physicians or medical scientists with preparation of

Reports, speeches, articles, or conference proceedings.

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