Billing Specialist Project Management

JESSICA JOHNSON

*****************@*****.*** 769-***-**** Brandon Ms

Qualified credentialing, contracting and billing specialist with 9+ years of total experience. Solid skills, knowledge, and experience in healthcare billing, credentialing, reporting, financial modeling, project management and policy administration in various settings. Currently seeking a new career opportunity with.

EXPERIENCE

December 2022 — November 2023

Outreach Specialist / Billing Specialist, Prime Therapeutics “Remote”

Developed interpreted and implemented complex financial and accounting concepts, or techniques for financial planning and control. Leveraging domain knowledge, experience and strong accounting and administration skills to ensure timely and accurate reporting of financial metrics and results monthly.

Identified, researched and resolved billing variances to maintain system accuracy and currency.

Work effectively with medical payers such as Medicare, Medicaid, Tri Care and commercial insurance companies to obtain timely and accurate payments.

August 2021 — February

Grievance and Appeal Specialist, La Care “Remote”

Transmitting appeals of clinical denials to the appropriate professional for review and tracking review completion to ensure final closure of the associated case.

Verify claims adjudication utilizing appropriate resources and applications.

Edit Claims to meet and satisfy billing compliance guidelines for electronic submission to payors.

August May — June 2021

Provider Service Representative II, Magnolia Health “Remote”

Identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment.

Identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment.

Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment Edit Claims to meet and satisfy billing compliance guidelines for electronic submission to payors.

EDUCATION

Bachelor of Arts – Business Administration

Strayer University – Online

SKILLS

Proficient with Claim Processing Software

Medical terminology knowledge

Clerical

Billing

Administrative Support

Faxing, Printing, Filing

Excel, PowerPoint, Microsoft Words, Microsoft Outlook

Inbound and Outbound Calling

Excellent Phone Etiquette

Actively Listen

Empathy

Problem Solving

Decision Making

Policy Knowledge

Dependable

Attentiveness

Communication

Leadership

Time Management

Interpersonal Skills

Adaptability

Organizational Skills

Multitasking

Medical Assistant Certification

Reference upon Request

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