Jessica Green

**** **** ***** **

DALLAS,TX *****

214-***-****

acyadw@r.postjobfree.com

Professional Summary

Organized Billing Specialist with a foundation in all aspects of revenue cycle management. Experienced in billing, collections, and utilization review procedures. Strong background in quality assurance and revenue cycle analysis.

Experience

December 2015 - PRESENT

Phoenix Houses of Texas, Dallas, TX- Reimbursement Analyst

●Assisted with providing explanations of existing reimbursement policies and analysis regarding third party reimbursement and regulatory changes that impacted payments and operations.

●Maintained payor and procedure tables in billing system.

●Designed and generated data queries to extract specific information from the billing system for clients and operational staff.

●Resolved accounts receivable requests and billing discrepancies.

●Generated fee schedules, cash-per-visit analysis, and impact analysis, as needed.

●Performed payor policy and contract research and analysis.

September 2014 - November 2015

Conifer Health Solutions, Frisco, TX - A/R Collections Specialist

●Performed verbal and written collection activity with government and commercial insurance carriers for expediting claims reimbursement.

●Executed 50+ claims per day.

●Compiled necessary patient record information for effective appeals as required using department resources in a timely manner.

●Performed consistent follow up practices with insurance providers, written and verbal.

●Researched account denials in Advanced Claims, Noridian, Availity, Passport, and other provider portals.

May 2012 - March 2013

Community Portable X-Ray, Plano, TX - Collections/Billing Specialist

●Reviewed, researched and resolved coding denials for diagnostic services, studies, and minor surgical procedures. This includes CPT, diagnosis, modifier and bundling type denials.

●Rectified payment and coding trends in an effort to maximize collections.

●Identified billing errors, short payments, over payments, unpaid claims, and resolved accordingly.

●Reviewed residual balances after payments were applied and generated necessary adjustments, overpayment notification, refund requests, and/or secondary billing.

●Always in contact with payers, via website and/or phone correspondence regarding reimbursement of claims denied for coding related reasons.

●Interpreted Managed Care contracts and/or Medicare and Medicaid rules and regulations to ensure proper reimbursement/collection.

September 2009 - December 2011

Total Sleep Diagnostics, Irving, TX - Insurance Verifications/Utilization Review Specialist

●Verified patient's eligibility and claims status with insurance agencies and online provider portals.

●Precisely evaluated and verified benefits and eligibility.

●Posted and adjusted payments from insurance companies

●Maintained and updated collections tracking spreadsheet to help organize payment information.

October 2007 - June 2009

Coventry Healthcare, Carrollton, TX - Associate Technical Claim Specialist

●Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.

●Reviewed and resolved claim issues captured in ADVANCED CLAIMS and the clearing house.

●Accurately posted and sent out all clean medical claims.

●Conscientiously reviewed medical record information to identify appropriate coding based on CMS standards.

●Resourcefully used various coding books and procedure manuals.

Education

AUGUST 2006 - NOVEMBER 2008

Everest College, Dallas,TX - Medical Insurance Billing and Coding

Learned all aspects of the nonclinical side of healthcare information management, billing, coding, transcribing and processing of patient data.

October 2013

University of North Texas, Denton,TX - General Equivalency Diploma

Skills

Good understanding of medical terminology and HIPAA guidelines and regulations

Thorough knowledge of Medicare, Medicaid, and payor billing standards and policies

Substantial knowledge of coding techniques and HCFA/UB guidelines

Comprehensive knowledge of the revenue cycle compliance and auditing processes

Ability to prioritize work activities with minimal supervision

Ability to communicate information in a professional and confident manner

Ability to present information in one-on-one and group settings

Expert in Health Information Management

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