Jacqueline D. Antonio

MEDICAL CLAIMS COLLECTOR APPEALS SPECIALIST

Van Nuys, CA 424-***-**** ad3vha@r.postjobfree.com

Ambitious claims specialist with 10+ years of experience in resolving complex underpaid and denied claims. Implement new tactics to form specialized written and verbal appeals resulting in expeditious payouts.

CORE COMPETENCIES:

SOFTWARES

Run Aging Report

Written & Verbal Complex Appeals

Credentialing

Revenue Cycle management

Initial and retro authorization request

AS400

EPIC

ATHENA SOFTWARE

ECW-eClinical Works

PROFESSIONAL EXPERIENCE

KNOWTION HEALTH TORRANCE, CA

Patient Account Representative 11/2022-PRESENT

Follow up on unpaid and denied Claims.

Verbal and written disputes for denied and underpaid claims

Resubmission of claim not on file/Corrected claims

Communicate with Codes for coding denials.

Request retro authorization.

Communicate with the Patient regarding COB issue.

Collecting Patient balance and set up payment plan.

SANTA CLARITA ENT Santa Clarita ENT

Patient Account Representative 05/01/2022-11/15/2022

Follow up on unpaid claims, verbal and written disputes on denied and underpaid claim.

Payment posting, process of credit card payment.

Run and work aging A/R reports, obtain prior authorization.

Revenue Cycle Management

Silver State Hearing And Balance Reno,NV

Medical Billing/Collector 08/2021-04/08/2022

Enter Super Bills in system and submit electronically/correct all rejected claims and resubmit

Credentialing

Follow up on unpaid claims, verbal and written disputes on denied and underpaid claims.

Payment posting, process of credit card payments

Run and work aging A/R reports, obtain prior authorizations

Sierra Neurosurgery Group Reno, NV

Account Representative April 2019- 6/2021

Med School Associates North Reno, NV

Account Representative April 2018- April 2019

Patient Disputed underpaid and denied claims, negotiated outstanding balances, generated A/R reports weekly, preparing refund requests, generated patient statements for unpaid co-pay/insurance deductibles, and mentored new and existing collectors on all responsibilities listed above.

Renown Reno, NV

Authorization Specialist October 2015- February 2017

Verified status of authorization and qualifications, processed authorizations and approved requests via facsimile, and utilized Health Connect CRM system to access encrypted information for authorization requests.

L.A. Care Health Plan Los Angeles, CA

Authorization Specialist April 2014- April 2015

Approved, verified, and denied authorizations. Reviewed medical records for potential auto authorization per matrix guidelines and communicated with case managers at the IPA’s on pending and denied authorizations.

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ADDITIONAL EXPERIENCE:

Worked as Medical Biller at Cedar Sinai as Medical Biller for 8 years, US Healthworks for 5 years, relocated to Reno NV, moving back to Los Angeles on 04/09/2022

U.S. Health Works Medical Group, promotion to Eligibility and Appeals Specialist

Cedars-Sinai Medical Center, 5-year Certification of Recognition

TECHNICAL SKILLS & SOFTWARE:

Microsoft Suite Office Ally 10-key at 10,000 keystrokes Real Med Clearinghouse Athena EPIC Papers Office Ally

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