Customer Service Medical
Resume:
Candice Jackson
Houston, TX 77064
Objective: To obtain a rewarding career in a health care facility or physician's business office that will utilize my medical administrative skills as a Medical Collections Specialist/Supervisor.
Education:
08/04- 05/05 Sanford Brown Institute
2627 North Loop West, Ste. 100
Houston, TX 77090
Medical Billing and Coding Certificate
Honors Graduate
An intensive 900 hour course comprised of theoretical and practical application pertaining to all aspects of health information management including medical billing and coding.
Administrative Duties and Health Insurance
Extensive knowledge of computer applications in a medical office, proper HIPPA regulations, bookkeeping (both manual and computerized), collection procedures, health insurance claims processing, CPR, and anatomy and physiology.
03/05- 05/05 Clinical Externship
Doctor's Clinic Houston
Houston, TX 77090
Hands on experience in correcting denied claims for various insurance companies using Medical Manager Software, gained all knowledge of proper procedures in resubmitting corrected claims on the HCFA-1500 forms, and helped the company correct several credentialing issues to avoid further claim denials.
08/94 - 05/98 North Mesquite High School, Mesquite, TX
National Honor's Society Member, Treasurer of the Distributive Educational Clubs
of America. (DECA)
Experience:
08/2013 to current PFS Group Houston, TX
Insurance Collector/ Trainer (Mentor)
PFS Group is a third party collection company that contracts with Hospitals across the country to assist in following up on accounts outstanding on their books. I am currently remotely using EPIC, IDX, and Citrix medical software and working accounts for 3 different hospital systems with great success. I have well exceeded the required accounts worked by an average of 15 additional accounts.
10/01/2012 to 5/2013 1960 Family Practice Houston, TX
Team Lead/ Account auditor/ Trainer
I am currently working all outstanding claims for the outside facilities they bill for. In my time in this position I have increased the overall collections from these facilities by about a Million dollars. My duties include but are not limited to account and billing audit to the claims, research of demographics, bill refilling and corrections including coding, and claim appeals.
07/10 – 07/12 The Brown Hand Centers- Corporate Houston, TX
Reimbursement Specialist
I was responsible for the overall collections of two facilities with monthly goals set. This is a non- network collections position. Responsible for working all accounts including government and worker’s compensation accounts, negotiating discounts with bill review companies, and correcting and appealing denied or underpaid claims.
10/08 – 03/10 Memorial Hermann Specialty Hospital Kingwood, TX
Supervisor of Insurance Verification and Payment Posting/ Collections Lead
Responsibilities include but were not limited to assisting verifications with calculating patient portion based on insurance contracts; assisted payment posting with all posting duties, reports, and month end reporting; all collections of all insurance types to ensure prompt and accurate contracted payment including appeals, and also worked directly with the CFO for month end reporting of revenue.
03/08 – 09/08 Coworx Satffing Houston, TX
Medicaid Collector
This contract position included several responsibilities is respect to Medicaid collections including but not limited to: filing appeals, correcting the claims on their electronic billing system, calling other insurance to verify other coverage, and following up with Medicaid coverage providers to check status of first time claims as well as appealed or corrected claims.
01/07 to03/08 North Texas Medical Center Gainesville, TX
Medicare Specialist
My responsibilities include the collections for all military and Aetna claims. I also handle the collections for several Medicare supplement policies, issue patient statements, and customer service to patients. Used hospital owned software.
05/06- 03/07 Endeavor Medical Systems Bellaire, TX
Medicaid Collections Representative
Responsible for the collections for all Medicaid claims for the St. Luke's emergency room physicians and all old patient pay accounts using MedInformatix software.
05/05- 05/06 Doctor's Clinic Houston Houston, TX Billing
Collections Specialist
Hands on experience correcting and resubmitting denied claims to the insurance carrier by constantly contacting the various insurance companies as well as the clinics and patients, knowledge and experience with Medical Manager Software, assisting the clinic staff with the payable codes for Medicare and Medicaid, and answering calls and questions from patients about their billing statements.
*References upon request
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