Customer Service Insurance
Resume:
Tamika Jones
**** ******** **** ******, ** *****
***************@*****.***
Summary: Offering more than 8 years of experience in medical and non-profit
administrative service positions, providing exceptional levels of customer service,
performing collection functions, and processing medical claims. Interact easily with people
of diverse backgrounds, cultures, and professional levels and possess excellent
interpersonal relationship skills. Seeking professional position in health care industry
where skills and abilities can be fully utilized and enhanced.
Computer & Technical Skills: Insurance Claims Processing • Patient Collections, Pledge
Processing • Billing Processes • Data Entry & Retrieval • Receptionist Microsoft Excel,
Access, and Word • Medical Manager 9.2, Medisoft, Meditech, Internet Research • E-mail
Communications, IDX, Lnyx
Experience: Davis & Harrison Private Cardiology Healthcare: 10/2008-Present
Sr. Billing Specialist: 10/2010-Present
Coordinates the patient flow by escorting patients to exam rooms, collecting information
from the patient on nature of visit, preparing patient for physician visit.
• Payment Posting/ Post EOB’s according to each account
• Sent patient letters for balance on accounts
• Schedule tests, appointments, surgery and other ancillary scheduling for patients.
• Oversee front desk to ensure appointments are coordinated and collections from
patients are processed.
• Synchronize physcians schedules between research and patient care.
• Answer telephones and route calls.
• Retrieve, prepare, copy and file patient charts.
• Pre-certify patients insurance for clinic procedures.
• Assume back up duties for Receptionist, Cashier and Scheduler.
• Expedites and maximizes payment of insurance medical claims by contacting third
party payors and patients.
• Review third party payors Aged Trials Balance Report to locate and resolve
accounts.
• Collaborates with management in developing a plan to reduce aging of accounts
over 90 days by providing verbal and written communications.
• Investigate and appeal unpaid or partially paid claims by insurance companies.
• Resolve denials as they appear.
• Review claims to verify payments are made according to fee schedule and
contractual adjustments are taken appropriately.
• Process over 200 claims weekly.
• Document clear, concise and completed follow up notes in system for each account
worked.
• Reconciled billing and invoices, checked balances, produced statements and
maintained client files.
Entered financial data into system to begin A/R process.
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• Sometimes performed insurance billing clerical work, including reviewing and
verifying insurance accounts against program provisions.
• Verify insurance coverage and eligibility reviewing new patient registration.
• Communicates with patient and/or third parties about covered and non-covered
charges.
• Enter new patient demographics.
• Process PCP referral forms.
McKesson HealthCare Greenville, TX 75401 Asst. Business Office Manage 01/2004 to
04/2008
Contributed to company success by providing timely and accurate accounts
receivable processing for resident accounts, Monthly A/R review, Month end
processing and reconciliation each month.
• Check all insurance payors (Medicare, Medicaid, HMO) post all cash received,
processed all necessary adjustments and refunds, and reconcile daily census and
cash.
• Took full responsibility for resolving business issues with clients, insurance carriers
and family members at my discretion.
• Benefit verification, reports on all insurance payors, and input all related
information in the data system.
• Reconciled room and board charges, some ancillary charges related to some specific
payors.
• Identify, research and post payments to the appropriate patient account in the
billing system by the date of service.
• Processed collections and insurance claims, including workers compensation, HMO,
private insurances and Medicare and Medicaid.
• Provided patient information for use by collection agency, physicians, and business
office manager. Efficiently managed telephone and in-person inquiries related to
billing, insurance and general information.
Airbrush Images Conroe, TX. 77301
Customer Service 01/2001-12/2004
• Answered switchboard, sent faxes, made copies, data entry
• In bound and Out bound calls
• Communicated with clients to market and advertise specially requested new
billboards
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