Administrative Assistant Medical

Cheryl JONES

Medical Billing & Coding

QUALIFICATIONS

Medical Billing & Patient Accounts Professional offering Bachelor’s Degree from Tuft’s University and 10 years healthcare/Patient Services experience. Bilingual Spanish.

Areas of Expertise:

ICD-9 & CPT Codes Third-Party Billing Collections Insurance & Coding Medicaid Billing Patient Accounts

Electronic Medical records (EMR) Health Claims Patient Billing Medical Terminology

Technology Skills:

CMS IPD Meditech Microsoft Excel, PowerPoint & Word Core HomecareNet Keane CMS Ivad

EMPLOYMENT

2015-Present A/R Coordinator/Rayner Equipment Systems

Sent out invoices monthly. Resolved account discrepancies. Posted cash. Closed out at

the end of each month. Maintained spreadsheets.

2015 Medical Biller/The Experts

Contract position working for Cape Cod Health Care. Researched unpaid claim to

correct insurance information and updated patient’s accounts so that the correct payer

could be billed. Took contractual adjustments on paid claims. Compiled a list of unpaid

claims for the primary biller to resubmit. Researched claims on websites to determine

status and patient responsibility and notated accounts accordingly.

2011-2014 DME Re-Openings Clerk/Hewlett Packard

Reviewed and corrected claims per request from providers, paying or denying in accordance with Medicare policy and current coding rules.

Documentation Claims Reviewer/Hewlett Packard

Reviewed Durable Medical Equipment claims to insure compliance with Medicare regulations and standards; paid or denied claims accordingly. Reviewed provider appeals, requests for reconsideration and corrected claims. Processed claims and entered data.

2009-2010 Medical Biller Contract Assignments

- Accountemps/Working at EOS CCA

Medical Biller working on Workers Compensation collections. Entering billing info into Meditech. Checking claim status, submitting UB and HCFA claims.

- Medix Staffing /Working at Mass Eye and Ear

Medicaid Biller working on collections researching old accounts, rebilling, sending corrected claims and appeals. Submitting claims for write-offs and keeping logs.

- Accountemps/Working at Boston Home Infusion

Medical Biller working in collections to research old accounts, rebilling, sending corrected claims and appeals as necessary.

2008-2009 Medical Biller/Nesco Accounting Company/Working at Faulkner Hospital

Original biller for both electronic and paper claims. Handling rejections due to incorrect insurance information and coding problems. Arranging, logging and keeping scrubbers and acceptance reports in order. Also train permanent Billers on Meditech.

2004 – 2007 A/R Coordinator/Commonwealth Community / Kindred Health

Producing and monitoring accounts receivable reports. Weekly analysis of all patient accts: outpatient, outpatient Rehab. Accurately projecting future collections, work to achieve monthly collection goals. Follow-up with Insurance Company, adjusters and attorneys for payments. Work denials and rejections to ensure payment of all submitted claims. Maintaining all patient financial files, maintain correct billing information. Posting write offs, contractual adjustments and closing cases. Monitoring monthly claim submission.

2002-2004 Self-employed Taxi Driver

1996-2002 -CSR Technician /Harvard Pilgrim Healthcare /Perotsystems

Received phone calls from all levels of provider services offered by HPHC policyholders regarding the status of claims.

Explain necessary steps to providers to receive payment of claims.

Make adjustments to put claims for processing if no further review is required.

Researched claims, sent back to proper department for review.

Responsible for adhering to and being knowledgeable regarding all federal and state laws regarding claims processing, as well as Harvard Pilgrim’s confidentiality policies and procedures.

-Administrative Assistant in the Functional Therapies Department

Responsible for keeping an Excel log sheet tracking all Benefit Exception cases for Speech, Occupational, and Physical therapy appeals.

EDUCATION

Tufts University - BA International Relations Massasoit Comm. College - Dean’s list Electrical Engineering

Contact this candidate