Eligibility Specialist/ARIES Surge Support Trainer/Revenue Cycle Team Lead/ Billing Specialist/ Verification Specialist

Jacqueline I. Yarbrough

adyos4@r.postjobfree.com

731-***-****

Summary:

Jacqueline has extensive year of experience as Billing Specialist, AR Specialist and Eligibility Specialist.

Experienced in maintaining knowledge of all billing and benefit changes for third party insurance carriers.

Respond to staff or patient questions regarding billing procedures Managing or supervising the entire department or subsections of the A/R department.

Calculates contractual discounts owed and adjusts accordingly in property management system.

Communicates directly with guest/clients of the hotels to collect payment for direct-billed balances; keeps accurate records of collections activities.

Performs daily audit of department’s financial transactions to ensure accuracy and compliance.

Maintain a good working knowledge of the EMR system to assist in training and troubleshooting

Candidate is local from Antioch, TN 37013 and ready to join ASAP.

Professional Experience:

INNOVA SOLUTIONS/Deloitte/Contract

03/2023 – Current

Manage assignments of paying medical bills limit in depth that include organizing and researching regulations as pertain to veterans eligibility.

Demonstrate competency in basic understanding of Medicaid, policies, forms and DHS policy.

Case management and maintenance, updating and completing conversion, eligibility, renewals and case changes.

Conduct Medicaid verifications, resources, income and expense.

Updating cases using multiple data base systems to assess and determine Medicaid eligibility coverage for healthcare.

Symentria Recovery Sep 2022 to Mar 2023

AR Specialist / Billing Specialist

Prepare and complete multiple Excel spreadsheets

Submit electronic claims daily

Prepare and submit secondary claims

Review and identify patient registration errors; work with front desk to minimize patient registration errors

Maintain knowledge of all billing and benefit changes for third party insurance carriers

Work with clinic staff to ensure timely and accurate capture of charges for all services performed within the clinics

Maintain an in-depth understanding of billing policies and procedures along with current patient treatment protocols and the effects on reimbursement under payor contracts and Medicare, Medicaid and Medi-Cal

Respond to staff or patient questions regarding billing procedures Managing or supervising the entire department or subsections of the A/R department

Work with physician and/or clinic staff to ensure that correct diagnosis/procedures are reported to third party insurance carriers

Monitor claims for incorrect coding, missing information, authorization/control numbers

Loews Hotels Jan 2022 to Jul 2022

AR / Specialist / Billing Specialist

Compiles final invoice for wholesale, tenant, rental, membership, corporate, and VIP accounts and ensures timely delivery to third party partners.

Uses hotel sales, financial, and property management systems to reconcile charges posted to third party accounts.

Research and resolves missing or discrepant charges to ensure highest levels of billing accuracy.

Calculates contractual discounts owed and adjusts accordingly in property management system.

Collaborates with other Billing Services and hotel team members to resolve guest billing disputes.

Communicates directly with guest/clients of the hotels to collect payment for direct-billed balances; keeps accurate records of collections activities.

Applies payments in hotel’s property management system as specified on remittances daily as they are received.

Prepares and maintains reports of aged receivables and collections progress to be shared regularly with hotel team.

Performs daily audit of department’s financial transactions to ensure accuracy and compliance.

Accountable for achievement of metrics and targets associated with the position

TennCare Member Services Oct 2020 to Jan 2022

Eligibility Specialist

Determine patient insurance eligibility and communicate results effectively

Manage multiple insurance portals efficiently

Monitor the appointment reports for missing or incomplete data

Review and identify patient registration errors and work with front desk to minimize registration errors.

Maintain knowledge of billing and benefit changes for third party insurance carriers

Timely obtain all insurance authorizations required and communicate results effectively.

Communicate insurance company process changes with other back-office staff

Maintain a good working knowledge of the EMR system to assist in training and troubleshooting

Acadia Healthcare

November 2019 to October 2020

•Responsible for the accurate and timely resolution of the Practice Management System.

•Thoroughly researches credit balances to determine if an overpayment occurred and initiates the refund process accordingly outlining the reason for the refund and including explanation of benefits (EOBs), if needed.

•Handles payer refund requests including validating the refund following review of the account history and submission of a refund request to Accounts Payable.

•Meets or exceeds established performance targets (productivity and quality) established by their supervisor. Partners with the Reimbursement Specialists, as needed, to research accounts and validate self-pay and insurance refunds. Maintains a working knowledge of CPT-4 and ICD-10 coding principles, government, managed care and commercial payers, payment posting, ERA processing, claim adjustment reason codes, contractual adjustment, copays, coinsurance and deductibles. Demonstrates the ability to be an effective team player. Upholds “best practices” in day to day processes and workflow standardization to drive maximum efficiencies across the team.

Blue Cross Blue Shield Oct 2018 to Dec 2019

Member Service Representative

•Inbound call center, answering phone, handling insurance questions, data entry, taking personal information.

•Adding billing information credit card, debit cards and banking information.

Skills:

Data Entry

MS Word

Technical Support

Answering Calls Accurately

EMR Systems

Insurance Billing

Medical Billing

Invoicing

Insurance Verification

Conflict Management

HIPAA

Medical Office Suite

Computer literacy

Microsoft Outlook

Medical Scheduling

Billing

Administrative Experience

Medical Coding

Clerical experience

Documentation review

Time management

Microsoft 365

AR/AP

Ring central

Microsoft Teams

Education

Penn Foster College

Pharmacy Technician 2011

Remington College

Certified Medical Administrative Assistant 2020

Recertification 2022

Contact this candidate