Credit Resolution Specialist for Medical Accounting

JANELLE L. CHATMAN

Email: *******.*********@*****.***

EXCEPTIONAL CREDIT RESOLUTION SPECIALIST

A detail-oriented and well-organized Credit Specialist with strong customer service skills and a solid understanding of medical billing, insurance claims, and credit resolution. Proficient in Microsoft Office and Excel, with a strong ability to communicate effectively, resolve account discrepancies, and manage time efficiently. Adept at researching and resolving complex credit issues to ensure accurate financial processing.

PROFESSIONAL EXPERIENCE

Galt Foundation Records Management Specialist II(06-202*-**-****)

Check eligibility, review rejected claims in the clearinghouse for errors. Review denied claims in the clearinghouse and in Medicaid UCE files for denial reasons. Enter payment and non payment data from remittance.

SSM Health Patient Account Representative (Dec 2023 – Nov 2024)

• Follow up on denied claims by performing appeals and analyzing credit balances.

• Process insurance and billing claims efficiently to minimize errors and delays.

360 Medical Billing Patient Account Representative (April 2016 – Jan 2023)

Laid off January 2023

• Resolved account discrepancies and followed up on unpaid accounts and insurance claims.

• Reviewed billing activity for accuracy, posted zero-paid/paid claims, and verified third-party insurance claims.

• Identified payer underpayments and submitted appeals as needed.

Mercy Health Network Patient Account Representative (June 2007 – June 2015)

Laid off June 2015

• Managed patient accounts, credit resolution, refunds, and insurance follow-ups.

• Investigated and resolved unpaid claims to ensure timely reimbursement.

PPO Oklahoma / Coventry HealthCare Data Entry Specialist (Oct 2004 – June 2007)

• Processed and redirected medical claims, maintaining a daily production goal of 400+ claims with an accuracy rate of 98.5%.

Phycon, Inc. Accounts Receivable Representative (Oct 2003 – Oct 2004)

• Managed accounts receivable, balance billing, coding, credit balance adjustments, and third-party payor regulations.

Unisys Data Entry Operator (1990 – 2002)

• Processed high-volume data entry tasks while ensuring compliance with client billing policies.

SKILLS & PROFICIENCIES

• Strong oral and written communication

• Customer service and account resolution expertise

• Microsoft Office Suite (Excel, Word, Outlook)

• Medical billing and coding knowledge

• Insurance claims processing and appeals

• EPIC and other medical billing systems

EDUCATION & TRAINING

• John Marshall High School – Diploma (1987)

• Draughon College – Executive Word Processing (1988-1989)

• Unisys – Advanced Excel Training

• Francis Tuttle – Medical Terminology & CPT Coding

ADDITIONAL INFORMATION

• Extensive experience in patient accounts and insurance claim resolution

• Strong analytical and problem-solving skills

• Ability to multitask in a fast-paced healthcare environment

Contact this candidate