Latonya Jones

A jack of all trades when it comes to medical billing and coding.

Fayetteville, NC 28301

adu5jx@r.postjobfree.com

+1-919-***-****

Customer service oriented professional with 2+ years of healthcare industry experience and strong leadership skills; facilitates efficient workflows and communicates effectively with co-workers, patients and staff. Follows policies, procedures and guidelines to ensure consistent quality. Maintains and safeguard patient privacy and confidentiality.

• Critical thinking and active listening skills necessary to interpret, analyze, and apply information.

• Demonstrates independent work initiative, sound judgment, and attention to detail.

• Driven and self-motivated with strong problem solving skills.

• Good time management, adopting a flexible approach to work.

• Experience with Greenway; MS Excel; MS Word; MS PowerPoint; EMR / EHR; Typing Speed: 32 WPM. Willing to relocate: Anywhere

Authorized to work in the US for any employer

Work Experience

Credentialing Specialist

Sutherland Global Group - Texas

November 2021 to January 2023

I credential doctors for Anthem for commercial PPO, HMO, and Medicaid remotely.I do credentialing for providers through Anthem Blue Cross Blue Shield. I scrub the providers application to make sure everything is correct on the application. Contact the provider if there is missing information. Verify if the provider is credentialed or not. Also verify if the providers license is up-to-date or not. And if there is any violations on their license. And then process the application. Credentialing Specialist

GDIT Health & CIV - Raleigh, NC

June 2021 to October 2021

I do the credentialing for the doctor's medical assistance, medical billers, front desk, and office managers for Medicaid and Medicare.I scrub the providers application to make sure everything is correct on the application. Contact the provider if there is missing information. Verify if the provider is credentialed or not. Also verify if the providers license is up-to-date or not. And if there is any violations on their license. And then process the application.

Reimbursement Specialist

TrialCard/ Aerotek - Morrisville, NC

November 2020 to February 2021

• Called and verified a patient's insurance, authorizations, referrals, and predeterminations for specialty drugs.

• Putting the information in the system.

• Created VOB's to be sent to the providers of our findings. Medical Billing Specialist

The Arc of North Carolina - Raleigh, NC

April 2020 to November 2020

Submitting the medical claims and authorizations for children and adults with special needs for services. Abstracted, interpreted, and reviewed medical record documentation to assign appropriate accurate CPT-4 procedure.

• Billed and coded medical claims for special needs services.

• Did authorizations for special needs for services.

• Fixed denied or sent back claims.

• Scanned in employee records

Physician Billing Specialist

Cape Fear Valley/ Robert Half Staffing - Fayetteville, NC March 2019 to October 2020

Abstracted, interpreted, and reviewed medical record documentation to assign appropriate accurate CPT-4 procedure.

• Submitted claims for the hospital for multiple clients.

• Assigned and checked appropriate modifiers and cpt codes on claims before submitting claims.

• Fixed denied and resent claims.

• Accounts receivables and reimbursements.

Accounts Receivable Clerk

Fast Med / Ramstad Staffing - Clayton, NC

September 2017 to November 2017

• Submitted and resent re-billed and corrected medical claims on an Accounts Receivable spreadsheet for clinics throughout North Carolina, Texas, and Arizona.

• Helped patients with billing, worker's compensation, and insurance questions.

• Contacted insurances about denied, unsent, or benefits for claims and doctors visits. Medical Biller

Calvary Pediatrics - Fayetteville, NC

November 2016 to September 2017

• Billed insurance companies for 2 pediatric offices throughout North Carolina.

• Fixed claims that were denied, and submitted claims daily.

• Took payments over the phone, and answered question about patient bills.

• Added insurance payments, scanning in EOBs and checks, and added payments to claims into the systems.

• Called insurance company about denied claims, and verified patient insurances.

• Made sure that all information on claims and accounts was correct.

• Set up payment arrangements, reimbursement and collections.

• Did accounts receivable by putting payments in the system for doctors visits and collections payments.

• Did medical records request for patients leaving the client or specialist visits. Medical Biller

Kidzcare Pediatrics - Fayetteville, NC

November 2015 to November 2016

• Billed insurance companies for 21 pediatric offices throughout North Carolina.

• Fixed claims that were denied, and submitted claims daily.

• Took payments over the phone, and answered question about patient bills.

• Added insurance payments, scanning in EOBs and checks, and added payments to claims into the systems.

• Called insurance company about denied claims. and verified patient insurances.

• Made sure that all information on claims and accounts was correct.

• Did accounts receivable by putting payments in the system for doctors visits and collections payments. Sales / Customer Service Representative

Sykes - Fayetteville, NC

May 2014 to November 2015

* Sold products like cellphones, accessories, and Direct TV service.

* Helped customers locate merchandise.

* Communicated customer requests to management.

* Assisted in completing price changes within the department.

* Participated in year-end inventory and cycle counts.

* Rang up sales at register.

Education

Associate of Science degree in Management

Ultimate Medical Academy

2018

Associate in Medical Billing and Coding

Motte College - Fayetteville, NC

March 2013 to July 2015

Skills

• Medical Billing And Coding (3 years)

• Customer Service Skills (10+ years)

• Management (8 years)

• Front desk experiences (3 years)

• Billing (3 years)

• claims (3 years)

• Accounts Receivable (3 years)

• Collections (3 years)

• Medical Billing (3 years)

• Data Entry

• Excel

• Microsoft Excel

• Outlook

• accounting

• coding

• CPT Coding

• Medical Office Experience

• ICD-9

• ICD-10

• EMR Systems

• Insurance Verification

• Human Resources Management

• Workers' Compensation

• Epic

• Medical Records

• Medical Receptionist

• Anatomy Knowledge

• HIPAA

• Medical Terminology

• Transcription

• ICD Coding

• Medical Scheduling

• Physiology Knowledge

• Patient monitoring

• Analysis skills

• Phone Etiquette

• Auditing

Assessments

Electronic health records: Best practices — Completed October 2020

Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: Completed

Medical billing — Proficient

November 2021

Understanding the procedures and forms used for medical billing Full results: Proficient

Customer service fit — Highly Proficient

December 2019

Measures the traits that are important for high-quality customer service. Full results: Highly Proficient

Protecting patient privacy — Familiar

January 2022

Understanding privacy rules and regulations associated with patient records Full results: Familiar

Medical receptionist skills — Familiar

January 2022

Managing physician schedules and maintaining accurate patient records Full results: Familiar

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

Additional Information

Accounting, Payroll, and Banking Systems * Healthcare Law * HIPAA Compliance * Charting * Filing Processing Co-Payments * Human Resource Management * Organizational Improvements * Appointment Scheduling

Insurance Billing Procedures * CMS1450 * UB04 * CMS1500 * Healthcare Claim Cycle * Insurance Verification

Interpersonal Professional Communications * Business Office Operations Medical Office Procedures * Medical Practice Management Systems

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