Medical Billing Specialist

Jennifer Jimenez

**** ** **** **, **********, FL 33313 ********@*****.*** 754-***-****

Key Skills

Accounts Receivables

Accounts Payables

Customer Service

Self-Starter

Results Driven

Leadership skills

Knowledge of Medical Terminology

Excellent Communication Skills

Microsoft Office Suite

CMD

KIPO

Sales Force

CMS

Knowledge of EMR

Meditech

QuickBooks

Artiva

AS400

Smart

E-Medsys

Emdeon as Billing Clearinghouse

Manage large classroom sizes

Languages

Fluent in Spanish and English written and communications

Education

FAU

Pursuing Bachelor of Science in Business Accounting [B.S.B.A],

Boca Raton, FL

BROWARD COMMUNITY COLLEGE

Associate’s Degree Criminal Justice [A.A], Davie, FL

Summary

I am currently seeking a position where I can expand my skills and expertise that will be used in a growth-oriented organization.

Experience

RBHN

Senior Patient Advocate

August 2024-December 2025

- Answered patient calls and assisted with registration, initiated authorizations and referrals for selected insurances, and any other patient inquiries.

- Verified insurance coverage, claims (UB-04), denials, and appeals

- Maintained accurate patient records and negotiated rates.

- Assisted in resolving patient concerns and coordinated with staff or management for optimal service and payment plans.

- Processed payments, co-pays, deductibles, OOP max, and managed billing-related inquiries.

- Processed patient paperwork and updated electronic medical records.

Phoenix Behavioral Health

Collections Specialist

February 2024-July 2024

- Worked with more than five facilities per month with a high cash flow whilst negotiating and resolving conflict resolution to recover outstanding debts.

- Handled third-party insurance (i.e. Blue Cross, Aetna, Cigna, United Health care, Humana, etc.), overturned denials, and worked with unbilled claims on time.

- Balanced daily activities and completed work charts before due dates.

- Worked on special projects

Exact Billing Solutions

Senior Reimbursement Specialist

August 2022-November 2023

- Maintained excellent communication with third-party insurance carriers to resolve issues w/cash flow.

- Monitored/created reports that were aging and collected on high-dollar accounts.

- Added CPT codes, created claims, rebilled, and updated status in the system (CollaborateMD)

- Escalated any issues to specific department leadership.

- Adjusted deductibles, co-pays, etc.

Infinity Behavioral Health Services

Reimbursement Specialist/Patient Care Manager

October 2019-July 2022

- Submitted appeals and worked with the medical records team

- Lead for Pre-litigation accounts for REVA-Air ambulance

- Researched and followed up on claims/denials, medical records, and appeals

- Managed new special patient accounts by calling patients, set up appointments, litigated accounts, eased financial burdens, set up payment plans, drafted collection notices, and worked with patients under government-assisted programs such as Medicaid/Medicare/Ambetter, etc.

- Led new team, trained, and assisted with payroll

- Worked on several spontaneous projects

Cornerstone Legal Group LLC

Legal Assistant/Negotiator

September 2018-October 2019

- Worked with attorneys to resolve accounts where the collection effort had been exhausted.

- Negotiated client debts to completion by communicating client hardships, reviewed client savings to determine funds necessary to complete settlements, and obtained a settlement that would have halted legal action.

- Gathered and submitted required legal documentation for approval and payment of accounts

- Assisted Customer service and sales teams

Envision Physician Services

Reimbursement Specialist

September 2016-March 2018

- Researched and processed all assigned contracted, non-contracted carrier, Medicaid/Medicare, and self-pay accounts to ensure the proper payment through reports, spreadsheets, special projects, etc.

- Responded to customer service calls and strived for a one-time resolution of accounts received.

- Resubmitted improperly paid/denied claims to carriers for proper payment on time.

- Identified and corrected any claim processing errors due to data entry, verification, coding, and/or posting mistakes. Ensuring that accounts are properly documented.

- Called and checked claim status, working A/R and insurance carrier reports, and insurance denials.

- Handled and organized all aspects of the appeals process for all insurance payers (i.e., through letters, phone calls, and special projects from carriers).

- Posted all charges and payments for accounts and balanced daily activity.

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