Insurance Medical

MYKHEAL JONES

**** ********* ********, ** *****

************@*****.***

Cell 281-***-****

Home 281-***-****

OBJECTIVE

Seeking a position with a company that is willing to employ a self-sufficient hard and loyal worker with an opportunity for advancement

PROFESSIONAL EXPERIENCE

Medcycle: Patient Services Liason: July 2017- Oct 2017-Contracted

- Responsible for recalling bad debt accounts from collection agency

- Made necessary discount adjustments to patient accounts that were on payment plans

- Rebill insurance claims that were never filed or received due to eligibility issues

- Update and load patient demographics including insurance verification

- Resolve patient account issues by assisting them with payment plan options

- Transfer distributed credits on patients account between TCH hospital and Physician accounts

- Applied missing payments

UT Health: Sr Support Specialist: Oct. 2014- Oct 2016

- Scheduling of patient appointments

- Obtaining and updating Patient demographic information

- Training staff - Insurance verification, referrals, billing, and AR follow up

- Responsible for fulfillment of Medical Records requests, in accordance with HIPAA

- Responsible for daily charge entry; responsible for retrieving medical records from the Psych Units

- General office duties include answering and transferring calls; educate patients regarding benefits

- Assistance with department budgets utilizing Excel

McKesson Corp: Sr Physician Rep Aug. 2010-Aug. 2014

- Collection on accounts 30 days and older

- Insurance verification/correct claim errors on the front end that prevents clean claim filing

- Updating patient demographics

- Suggest resolution to client's ongoing trends and issues

- Analytical and problem solving of accounts

Physician Capital Group: Front End Operations Manager Mar. 2008- Dec. 2009

- Manage front end claims operations department

- Oversee employees in completing projects and assignments

- Manage daily insurance verification and precertification schedule

- Train New PCG employees and New Client staff

- Edit claims being rejected by EDI and PCG's clearinghouse

- Manage the quality and quantity of charges being entered by the team

- Create Team Goals along with Incentives

- Participate in the building of PCG's collections and billing software

- Update the providers charge capture in MD Coder showing current status of charges

- Perform Employee Evaluations

- Made final decisions on employee Compensation

- Implementation of new ideas with the IT department increasing the accuracy and quantity of accounts - Work closely with the Client Liaison coming up with resolutions to issues related to the practice revenue/procedures

Baylor College of Medicine: Physician Billing Specialist 2 Oct. 1999- Mar. 2008

- Intake charge documents from the clinics and hospitals

- Setup CVCP (Cardiovascular Transplant Cases) and Mental Health cases

- Receive, sort, and batch charge documents independently

- Charge Entry

- Responsible for resolving transaction level edits

- Patient Registration

- Charge Corrections

- Research missing info from documents that are pending charge entry

- Print E-Bills (electronic billing) from shared billing server

- Charge capturing

- Train and Educate employees

- Independently obtain and enter timely, accurate registration data including, but not limited to, interface data from multiple systems

- Multi specialty medical billing and collections

- Insurance Verification and Pre-certification

- Update patient demographic information

- Work edit/rejections through WebMD Ecommerce electronic system

-Improve IDX usage by providing payer information accurately into IDX system for electronic claim

-Update rejected claim with proper CPT, ICD9 and modifiers

- Resolve insurance correspondence

- Responsible for daily follow-up on patient accounts

- Audited insurance contracts and patient accounts to ensure that claims were being paid accordingly

Education

Charles H Milby: Graduate 1996 San Jacinto College: Sept. 2010-Jan. 2011 (Health Information Management)

Skills

Proficient in using: IDX,Ecommerce, Microsoft Office, Epic, PCS, Scantrax, TMHP, Medical Terminology, CPT, ICD9, Customer Service, 10 Key by sight, 55+ wpm including: Patient Accounts, Workfile Maintenance, Collections, Patient Billing, General Office Skills, Management, Nuesoft, Centricity Allscripts, MD Coder, Scanning, Medical Records Tech, Scheduling

References available upon request

Contact this candidate