Pamela Jackson

***** ********** ****. #***

Katy, TX 77450

832-***-****

acec2w@r.postjobfree.com

Summary: Billing and Reimbursement Specialist with experience in precertification and verification of benefits. Comprehensive

knowledge of ICD-9, CPT-4 and HCPCS coding. In-depth knowledge of Medicare, Medicaid, Champus, Worker's Comp and

Manage Care programs. Ability to communicate efficiently with good time management skills. Familiarity with third party payor

requirements, rules and regulations that govern collection activity, including prompt pay laws. Compliance with HIPAA

regulations. Ensure strict confidentiality of financial records. Ability to create a positive productive environment.

Experience:

Experience Infusion Center, LLC. – Houston, TX 03/2013 – Present

Out Patient Infusion Therapy Center – Reimbursement Specialist

• Out of Network claim collections

• Review insurance payments to verify correct reimbursement

• Handle appeals for reconsideration of denied or low allowances

• Generate and maintain monthly aged receivable/billing reports

• Handle single case agreements with cost containment companies regarding fee negotiations

• Communicate with referring physicians and registered nurses concerning medical necessity reviews

eCardio Diagnostics - Houston, TX 09/2011- 03/2013

Independent Diagnostic Testing Facility-Level II Collector

• Follow-up on aged account receivables

• Appeal out of network and denied claims

• Assist with patient insurance verification process

• Assist with inbound patient and/or insurance company phone calls

Sinai Medical Group - Westchester, IL 08/2009-07/2011

Professional Provider Organization-Medical Billing Specialist

• Responsible for the accuracy, quality and timeliness of all billable services

• Review EDI edits

• ICD-9 and CPT coding

MedCom Practice Management – Schaumburg, IL 01/2006-08/2009

Medical Billing Service-Medical Billing and Reimbursement Specialist

• Charge entry, electronic claims submission

• Process EOB/ERA for review of correct payment, adjustments and appeal opportunities

• Customer and client service support

• Generate and review billing and collection reports

Trellis Health Partners – Rolling Meadows, IL 10/2000-09/2005

Medical Billing Service-Practice Manager

• Multi-Specialty billing, coding and collections

• Charge entry and payment posting

• Follow-up on insurance denials and appeal protocols

• Generate monthly financial reports

• Customer and client service support

Education:

Harry S. Truman College – Chicago, IL 01/1998-11/1998

Fundamentals of Medical Billing and Coding

Advanced Medical Billing and Coding

Medical Terminology

Skills - MS (Word, Excel, Outlook), Typing 50 wpm, outstanding written and oral communications

Medical Software Systems–Collaborate, Centricity, NextGen, Meditech, LSS, Lytech, Medvantage, Vera, EMR

Contact this candidate