Human Resources Accounting Specialist
Resume:
CAITLIN
JARA
ad5uzj@r.postjobfree.com
Vancouver, WA 98660
SKILLS
• Strong ability to resolve denied
claims
• Credentialing providers
• ICD-10 Coding and CPT
proficient
• Coding Error Resolution
• Charting, Treatment and
Clinical Documentation
• Knowledgeable in multiple EHR
systems
• Workers' Compensation, Auto
and Government claims
proficient
• Staff Recruitment and Hiring
• Problem Anticipation and
Resolution
• Procedure Optimization
• Medical Transcription
EDUCATION
AAPC
Kansas City, KS • Expected in
09/2022
CPC, CPB: Medical Insurance
Coding
PROFESSIONAL SUMMARY
Results-driven Medical Biller with coding and medical terminology knowledge. Polished and hardworking
performer with background overseeing accounts and
handling records management tasks. Team-oriented
person with great decision-making skills.
WORK HISTORY
Moda Health – Membership Accounting Specialist
Vancouver, WA • 08/2022 - Current
• Primary point of contact between Group
Administrators/Human Resources and Moda Health
Insurance.
• Managed over 250 small business groups with 50-2500 members each.
• Responsible for eligibility, maintenance, and
reconciliation of group business accounts via paper enrollment and EDI enrollment processes.
• Sole support contact for each groups billing and eligibility needs, questions and concerns.
• Daily e-file preparation and error correction for multiple groups.
• Responsible for denying coverage when necessary and issuing proper explanation to group administrators.
• Timely and accurate entry and maintenance of
member eligibility data, generation of member ID
cards, customer billing preparation and reconciliation processes, and customer service for group business accounts.
• Identify, communicate and approve all billing
discrepancies and adjustments including requests for retro-active membership terminations.
Currently in the process of
completing certifications.
LANGUAGES
Spanish
Professional Working
• Handle all requests from Accounting for reconciliation of premium received and clarify premium posting
issues.
• Proper maintenance of billing records and allocation of cash received receipts that have direct effect on the integrity of reports for Underwriting and
Accounting.
• Responsible for monitoring and upholding enrollment rules.
• Knowledge of probationary periods, waiting periods, late enrollee rules, COBRA rules, Oregon Continuation rules, retro termination procedures, domestic partner procedures, Medicare and Medicaid guidelines.
• Integrated Pain Solutions - Medical Billing Specialist
• Vancouver, WA • 07/2015 - Current
• Began as Receptionist- Scheduled patients, answered phone calls, handled patient account ledgers and
payments
• Migrated to Chiropractic Assistant and Medical Scribe, completed all chart notes for office chiropractor, prior authorizations, referrals and documentation
• Established protocol for patients and office, including all required, HIPAA compliant patient paperwork
• Marketing, creating website content, Facebook and Instagram content as well as digital materials for marketing new and retaining current patient base via email
• Organizing events, booking venues, creating materials and running seminars including patient Q&A to expand patient base
• Billing and coding for Nurse Practitioner, pain
management patients and Chemical Electrotherapy
patients. Researched CPT and ICD-9 coding
discrepancies for compliance and reimbursement
accuracy. Obtained claim status to update patient
billing and quickly processed incoming payments and posted to correct account
• Notified registration team of errors in enrollment, patient information or identification verification. Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances
not covered under policies when applicable.
• Evaluated patients' financial status and established appropriate payment plans. Identified and resolved patient billing and payment issues
Courtyard By Marriott - Front Desk Agent
Portland, OR • 01/2007 - 07/2011
• Managed over 50 rooms without support staff
frequently
• Took reservations over phone, in person and via
computer for guests and provided confirmation
information
• Collected room deposits, fees and payments
• Welcomed each new arrival pleasantly and confirmed reservations and identification
• Liaised with housekeeping and maintenance staff to address requests and complaints made by guests
• Increased guest satisfaction ratings through prompt and quality service
• Balanced property accounts and completed regular audits of room charges and finances.
LANGUAGES
Spanish
Professional Working
.
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