Data Entry Production Assistant

Christopher M. Jones

951-***-**** Email *******************@*****.***

Hard working professional with versatile skill sets developed through experience as an administrator,

professional, billing manager, Production Assistant, Production Assistant Manager, Technician, Customer Assistant, Admission, CEO, Financial Director, Insurance Director.

Mastery knowledge regarding Insurance billing and UR Reviews, requirements, Medical Necessity, Clinical Requirements, Reimbursement Rates, Verification for Benefits.

Resolve Insurance challenges with innovative solutions, systems, and process improvements proven

to increase efficiency, executive productivity and client/Insurance satisfaction.

Analytical thinking, Analytical and Problem-solving skill.

Financial, operations, corporate compliancy experience

Health care or Organization compliancy experience

Advanced computer proficiency: Windows OS, Mac OS, MS Office Suite, Adobe, QuickBooks, CRM, MLS, Point, MS Exchange Servers, Printer Networks, and other software systems. Multiple billing software’s.

Core Competencies

Office & Vendor Management

Professional Correspondence

Staff Development & Training

Insurance Correspondence

Chart Auditing

Analysis Skills

Accounting,

Leadership,

Organizational Skills,

Communication Skills,

Web & Print Content Development

Report & Document Preparation

Spreadsheets & Databases

Verification of Benefits

Collection Calls

Supervising Experience

Data Entry

Certification/Credentialing

Business and Corporate compliancy

Graphic & Visual Design

Managing High Call Volume

Medical and Behavioral health billing

Professional/Institution billing.

Admission

Contract Management Experience

Experience

JHENDONS LLC Rancho Mirages CA 2016-2023

Financial Director/ Insurance Director

Chart Auditing/ Prescreening of Clinical charts

UR reviews for admit, Current review, DC multiple program tracks.

Behavioral health/ Professional/Institution billing.

Admission Intake

Knowledge of ASAM/ LOCUS

Optimized operations to ensure patient care and patient satisfaction

Increased patient satisfaction and retention through improved services

Maintained a database of patient records, facilitating data entry and analyzing trends to determine the need for additional services

Fully managed all aspect of revenue cycle

Developed compliant internal process which algin with corporate business profit and budget

Developed multiple program tracks and policies and procedures for compliancy

Business operation

Customer service

Staff training

Developed policies and procedures for compliancy for State, Federal, and Private sector requirements

Certification/ Credentialing compliancy

Contract compliancy

Revenue reporting for institution and multiple programs levels daily weekly and monthly

Developed new business strategies that increased revenue by 89% and improving customer service and satisfaction by 90%

Lucrative Consulting Lake Elsinore 2018-2022

CEO

Providing consulting support for senior executives, accompanied by a proven track record of helping clients improve their business strategies.

Payroll for the company

Maintained a database of patient records, facilitating data entry and analyzing trends to determine the need for additional services

Implemented an analytics dashboard to provide insight into key business indicators and trends which resulted in improved performance forecasting and forecasting accuracy

Monitored and updated all systems and software used in the office to ensure optimal performance and user experience

Training Staff

Ensure all invoices are billed accurately and timely for all database

Audited and correct complex accounts for contractual obligation and payment

Maintained Knowledge of all government and Insurance regulations for Institutions

Facilitate the cycle invoicing collection, credit, auditing, and reporting

Responsible for managing operations and financial activity for company and clients

THE HILLS TREATMENT CENTER: Los Angeles, CA 2014- 2016

Billing Manager/ ADMISSION /UR / Sober living Manager / TECH

Verification benefits

Knowledge of criteria and medical necessity per Insurance Companies regarding Billing and Professional billing/charting.

Chart Auditing/ Prescreening of Clinical charts. / Knowledge of Aging claims and Aging reports.

Behavioral health Billing

Professional/Institution billing.

Knowledge of requirements for Behavioral health Billing regarding levels of cares and requirements per Insurance Company.

Knowledge of Starting a billing department/Insurance Enrollment process for providers/Documentation Requirements

Critical thinking skills regarding Clinical Requirements per Insurance Companies.

Collection calls

Knowledge regarding reimbursement rates from insurance companies such as Reasonable Customary, allowed amount, Usual Customary etc.

Knowledge of the UB 4 form and CMS 1500 form.

Knowledge of forming/writing appeal letters for insurance companies regarding billing issues.

Upper management decision-making regarding Insurance billing/to ensure maximum reimbursement rates.

Knowledge of the Department of Managed Health Care, Department of Insurance, and the United States Department of Labor Laws and requirements.

Knowledge of the Knox Keene act requirements for insurance companies/ providers

knowledge of Behavioral health/ Medical diagnosis

Knowledge of insurance correspondence.

Knowledge of writing policies and procedures.

Knowledge of requirements for Out of Network providers per Insurance Company.

Knowledge of Deductibles/Out-of-Pocket/Coinsurance Requirements for Insurance Companies.

Knowledge of the Parity Law/Equity Act

Knowledge of Individual/Company Policies

Knowledge of requirements for state law/CARF/ JACHO

Knowledge of UR reviews detox RES PHP IOP OP

Knowledge of UR reviews for admit, Current review, DC

Knowledge of COW and CWS

Knowledge of medical necessity and Clinical Requirements per Insurance Companies for UR Authorizations

Knowledge of managing a 16-bed sober living

Knowledge of ASAM

Knowledge of Admission Intake

Knowledge of the Kipu system

Knowledge of Admission Intake for Inpatient and Outpatient

Cri Help INC: North Hollywood, C A 2012-2014

Detox Technician

Charting on Client

Treatment Plans

D/C plans

Client 1x1’s

Observing client self-medicating

Taking clients vitals and recording them

Phone Assessment

Intakes

Searching clients and property

Transcribing Med order from MD

Recording Medication on unit for each client

Doing psych social assessment

PILGRAM STUDIOS: Studio City, CA 2009-2011

Production Assistant Manager / Production Assistant / Janitorial

Assisted with office duties

Processed incoming and outgoing mail

Problem solving

Stock and Prepped Food Areas

Loaded and unloaded trucks for shoot

Web & Print Content Development

Graphic & Visual Design

General clean up after shoot

Customer Service

Managed six employees

Cleaning office after hour

Preparing and maintaining clean work

Janitorial duties

Education

High School Perris High School 2005

Riverside Community College: 2/2012

2012 to 2014: Los Angeles Valley College Bioengineer/Accounting AA Degree

2016 AAPC Billing School.

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