JENNIFER JENKINS

LEWISBURG, OHIO

937-***-****

adrnig@r.postjobfree.com

Technical Skills

Knowledgeable in Excel, Word, Outlook, medical billing, Medicare, Medicare Advantage plans, other Commercial plans, Medicaid, and BWC.

Innovative

Coordinate current workflow, assign work accordingly.

Monitoring daily, weekly and month my own aging queues and working to resolve any outstanding issues to ensure timely regulations.

Participates in team meetings on occasion to fill in for management when needed.

Trainer, Mentor and Coach.

Coordinating with other departments on projects needing resolution in a timely manner

Monitoring and reporting requests from management to track specific lines of business/products requested by higher management.

Supporting providers by providing information regarding contracts.

Communicating with Market representatives

Performed document quality checks

Auditing

Credentialing

Customer service oriented

Problem solving

Created Standard Operating Procedures - Claims

Service now

Cactus, Facets, Choreo, Onbase

Professional Experience

Jenkins Excavating and Concrete, LLC

Office Manager

April 2022- Present

Setting up business accounts

Coordinating schedules

Accounts Payable/invoicing

Advertising/marketing

Scheduling appointments

Kettering Health

Office Assistant II

May-2021-March 2022

Abstracting medical records and uploading into EMR for Onboarding providers.

CareSource

Provider Network Analyst II

March 2020-April 2021

Analyzes contracting documents in Choreo to identify if a new agreement is required.

Submits new agreement requests to the Configuration team for creation.

Updates Facets records with new agreements as appropriate

Maintains agreement grids

Research and resolves SNOW tickets.

Creates Scripts for agreement updates and overlays as required and provide UAT

Research and resolve items and requests queued to HO-Contract Analyst in Cactus.

Experienced in Facets, Choreo, Cactus, Onbase, Access and TFS.

CareSource August 2017-March 2020

Contract Specialist

Assign Onbase work to ensure timely processing of new contracts

Document process changes and new procedures to promote consistency in contracts operations

Actively participate meetings as appropriate

Assist with hiring and oversee orientation and training of new hires

Monitor level of inventory; notify management of levels outside of established thresholds

Create, review, revise and enforce company and department policies and procedure (SOPs)

Does the training of new team members, management, other Caresource employees

Does quality reviews and gives performance feedback to management

Represent Provider Lifecycle team and participate in cross functional meetings for new initiatives

Act as Subject Matter Expert for our department

Coordinate mailbox and onbase activities related to assignments, problem solving, and project management

Collaborate with business partners and senior leadership to prioritize data-driven projects, and to provide claim information to support business processes

Identify, develop reporting and/or processes to ensure adherence

Manage special projects

Create Contracts/Amendments

Work escalations using Cactus for Maintenance

Research and resolve provider escalations related to contract onboarding, credentialing and PIM

Handles Closed Panel Spread Sheet, and Closed Panel requests from Angie B

Act as point of contact for other departments within and outside of HPLC

Work with department management to develop new processes to accommodate market requirements and improve operational efficiencies

Proficient in all systems needed to create, research and process new contracts and maintenance

Working OESS, RR & T and Service Now escalations

CareSource May2016-August 2017

Medicare Advantage Claims Analyst

Accurately process medical, facility and/or dental claims for Medicare members.

Research and process COB (Coordination of Benefit) claims

Meet production and quality goals for claim processing and payment

Perform claim adjustments and recoveries

Process and respond to provider inquiry intakes from the Service Center

Perform any other job related instructions as requested

CareSource March 2015-2017

Claims Analyst I

Accurately process medical, facility and/or dental claims for Medicaid and Medicare members

Research and process COB (Coordination of Benefit) claims

Meet production and quality goals for claim processing and payment

Perform claim adjustments and recoveries

Process and respond to provider inquiry intakes from the Service Center

Perform any other job related instructions, as requested

XC Claims

ChangeMed, Inc. Sept 2013- March 2015

Medical Billing Specialist

Entering demographics, patient phone calls, receipt posting, reviewing accounts for collections, and working denied claims.

Billing claims to Medicare, Medicare Advantage plans, other Commercial plans, and Medicaid.

Vernon F. Glaser & Associates October 2012-May 2013

Medical Billing Specialist

Managed small group of Billing Specialist on Pain Management Practice. Pulled reports to assign, corresponded to practice for billers, monitored A/R and answered questions.

Experience in billing with the HCFA 1500 hardcopy and electronic; including Medicare,

Medicaid, and BWC, etc.

Entering demographics; answering multi-line telephone; filing; receipt posting $250,000/per month; entering charges $300,000/per month to Medicare, Medicare Advantage plans, other Commercial plans, and Medicaid; following up with insurance problem claims. In addition, experience in multi-specialty billing.

Collaborate with business partners and senior leadership to prioritize data-driven projects, and to provide claim information to support business processes

Contribute to business process improvement through comprehensive requirements to resolve pended claims

Premier Healthnet- Fairborn Medical Center July 2008-October 2012

Medical Billing Specialist

Responsible for maintaining company A/R goals and guidelines. Pulled reports, to monitor current stats and work aging claims.

Receipt posting, auditing charges to be filed to Medicare, Medicaid and other commercial plans. Trained on Epic billing systems.

Education

Greene County Career Center (GCCC)

Medical Terminology Certificate

Medical Transcription Certificate

Office Technology Specialist Certificate

Tecumseh High School

High School Diploma

References

Tamra Pruitt

adrnig@r.postjobfree.com

Director of Health Partner Operations at Caresource Management Group

Trudy Huffman

adrnig@r.postjobfree.com

Manager, HPLC Operations

Jennifer Nichols

adrnig@r.postjobfree.com

HPLC Market Relations Specialist

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