Vanessa Jones

**** * ***** *** *** •Lewisville, Texas 75067

Cell: 469-***-****• E-Mail:ad3au6@r.postjobfree.com

SUMMARY OF QUALIFICATIONS

• Over 10 years of responsible work experience in Medical Claims Processing, Medical Collections

• Knowledge ICD -9/CPT Codes and Medical terminology

• Medicaid, Medicare, Government and Private Payors

• Customer Service Representative Experience

• Excellent Oral and Written Communication Skills

• Extensive Computer Skills

• Quick Learner, People Person and Proven Leader

• Multi-tasker who is dependable, self-motivated and detail-oriented

• Works well independently as well as part of a team

• Works Collaboratively and seamlessly with all personnel PROFESSIONAL EXPERIENCE:

IKS

Patient Care Coordinator Specialist- Coppell, Tx

6/21-Current

The ability professionally handles any patient inbound and outbound calls concerns with their billing statement of a health care nature and collect past due while maintaining and provided excellent customer service, maintain appropriate levels of confidentiality regarding calls. Aware of HIPAA laws while leaving voice mail message and ability to work in a culturally diverse atmosphere

Mckesson/Remx

Patient Care Coordinator Specialist- Irving, Tx

10/2020-3/2021

Provided new and existing patients with the best customer service in relation to their drug prescription. Coordinate patient care by scheduling orders, communicating information to the patients regarding shipments, assessing supply needs, verifying patient information, notifying the pharmacist of issues or changes in the patient's conditions, show initiative and take an enthusiastic proactive approach to work strong telephone skills. Answers incoming phone calls and provides necessary information. Contacting patients and gathering essential information for coordination of shipment of prescription. Process prescription refills to include: refill confirmation when appropriate, review pending refills with the supervising pharmacist, generate refill documentation and process third party claims adjudication. Accurately process all orders in a timely manner

Alliance Rx Specialist/Aerotek

Patient Care Coordinator Specialist-Irving, Tx

9/2019-1/2020

Provided new and existing patients with the best customer service in relation to their drug prescription, clinical services, billing inquiries, patients suggestions and complaints. Assisted patients, parents/family member and caregivers with Referral to specialists, other care providers, subspecialty physicians and support parental concerns. Coordinate patient care by scheduling orders, communicating information to the patients regarding shipments, assessing supply needs, verifying patient information, notifying the pharmacist of issues or changes in the patient's condition, completed other stages of the order process as assigned including but not limited to scanning prescriptions, imagine indexing, preQA, load insurance information, run test claims, work issues and facilitate prior authorizations. Problem solving to promote the patient’s well being, provided correct information or directs the call to the appropriate team member or department while maintaining a high level of professionalism. CVS Caremark/Datalink Staffing

Intake Healthcare Enrollment Specialist-Irving, Tx 10/2018-08/2019

Responsible for collecting and entering patient demographics, payer information for new patients referred to the appropriate special pharmacy with a very strict deadlines in a fast paced environment. Schedule deliveries of pharmaceuticals for specialty customers. Daily requirement involves the manage multiple priorities simultaneously in order to toggle with different resources and screens with heavy workload. Identified mistakes, omitted information, and missing forms and attachments and relayed the information to the provider and/or the provider’s representative to ensure timely completion. Ensured integrity of enrollment eligibility processes Oversaw member information reconciliation procedures and paperwork. Processing of preparation of new member enrollments. Completed dis-enrollments as needed Conducted all work in accordance with the confidentiality requirements mandated by HIPAA for member information. Enter data accurately into various databases CMI GROUP

Customer Services Collectors-Carrollton, Tx

1/2018 – 8/2018

Assisting Customers in resolving their past due cable television service accounts, while maintaining excellent customer service. Negotiating payment arrangements on past due amount Represent the company effectively, while establishing a sense of urgency. Resolve customer complaints / concerns through active listening, empathy and professionalism. Demonstrates ability to establish and maintain effective relationships with customer.Ability to negotiate, close deal, and secure payments. Communicate with customers by telephone to attempt to collect on severely past due accounts. Posted payments electronically Baylor Family Medical Center/Jobnet Staffing

A/R Specialist –Midlothian, Tx

05/2017 – 09/2017

Utilized EOBs to perform daily duties within billing, collections, and payment posting Posted payments electronically. Researched patient records for proper posting Prepared account for collection as needed, Followed up and resolved outstanding patient balances. Evaluated patient account to determine actual charges owed Sent letters and made phone calls to patients with outstanding balances Methodist Medical Center/Jobnet Staffing

Medical Hospital Billing –Dallas, Tx

1/2017– 04/2017

Accurately billed electronic and manual 1500 claims to Secondary Payers in a timely, proficient fashion .Reviewed all manual claim forms for accuracy prior to the claim submission, including documentation attachments .Contacted patients, and/or third party payers to resolve outstanding insurance balances or inappropriately paid claims.Processed billing and soft collections Appealed denied claims via mail or telephone. Posted payments electronically DELL INC.

Medical Records/Customer Service –Plano, Tx 08/2015-01/2017 Responsible for providing efficient support to customer service representatives, making calls to insurance to verify status of benefit and mailing address. Applies medical billing knowledge to coordinate day-to day work knowledge of related regulations and standards, Strong understanding of current process and procedures and may identify opportunities for improvement. Resolve more complex situation by applying demonstrated knowledge and skills generally acquired and Frequently resolves problems through research of multiple alternatives. Applies experience and judgment to make decisions or resolve issues within defined options or standard protocols. Anticipates problems and recognize when to deviate from standard practices. Exceptions are usually resolved with the concurrence of a team lead or supervisor. Normally receives no instruction on routine work: receives instructions for new work or special assignment. Work guided by assignment objectives, typically establishes own priorities within guidelines. Regularly adjusts to multiple demand and shifting priorities. May provide procedural guidance to others. Independently gathers resources and information needed to complete projects with daily decisions and actions must demonstrate engagement, a sense of job ownership, and compassion and sensitivity to others, Also daily decisions and action must also reiterate our desired outcomes-high patient satisfaction and safety, optimal productivity, and high employee morale. Contribute to a positive and productive work environment, provided a pleasant and comfortable environment; demonstrate respect and maintain patient’s dignity and confidentiality. Complete all annual learning modules, as assigned, prior to their due dates. Analyzes information to select appropriate option s from defined alternatives. Contribute to overall patient satisfaction by consistently providing superior customer service to all patient and their families with positive and productive work environment, demonstrate respect and maintain patient dignity and confidentiality.

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