Medical Billing & Coding Specialist

Jonette Dixon

**** ***** ****** **** #**** Lombard, IL 60148 630-***-**** *******.*****@******.***

PROFESSIONAL PROFILE

Well-regarded professional backed by medical secretarial and healthcare industry experience. Able to provide timely and accurate data to ensure reimbursement for patient services. Follow policies, procedures, and guidelines to ensure consistent quality. Maintain and assure patient privacy and confidentiality. Accustomed to working in fast-paced hospital environment.

High Academic Honors Recognition / Dean's List / Honor Roll.

Ultimate Medical Academy – HIPAA Essentials for Healthcare Professionals Certificate.

Attention to detail needed to maintain high levels of accuracy.

Able to make decisions based on facts and experience and implement course of action.

Function independently with minimal direction and guidance.

Electronic Health Records (EHR) – Epic.

Electronic Medical Records (EMR) – Citrix.

Communication Platforms – Zoom, Google Meet, and MS Teams.

Microsoft Office Applications – Word, Excel, Outlook, and PowerPoint Type 44 WPM.

KEY QUALIFICATIONS

Front Office Operations Medical Office Procedures Scheduling Medical Terminology Anatomy & Physiology

HIPAA Compliance Medical Coding (ICD-10-CM HCPCS CPT) Medical Billing Accounts Receivable Collections

Co-Pay Deductibles Co-Insurance EOBs Revenue Cycle Management Posting Payments

Government (Medicare & Medicaid) Third Party Payers CMS 1500 CMS 1450 (UB-04)

Electronic Health Records (EHR) Electronic Medical Records (EMR)

Managed Care (HMO PPO POS) Workers Compensation Insurance Verification Insurance Claim Processing

EDUCATION

Ultimate Medical Academy Diploma – Medical Billing and Coding, 2026

Introduced to the following concepts:

Medical terminology, medical billing and coding, claims processing, medical office procedures, insurance verification, accounts receivable, collections, co-pays, and deductibles.

Electronic health records systems and healthcare claims preparation and submission processes.

Coding for diseases, surgeries, and medical procedures using ICD-10, CPT, and HCPCS coding systems.

Organizing, analyzing, and examining health insurance claims for reimbursement and resubmitting rejected claims.

HIPAA rules and regulations related to patient information privacy and security.

PROFESSIONAL EXPERIENCE

Centene Corporation – Burr Ridge, IL 02/2022 – Present

Authorization Specialist II

Train new hires, answer and transfer inbound calls, and process faxes within established standards.

Initiate authorization requests for Outpatient and Inpatient Services in accordance with the prior authorization list.

Submit request to the facilities for additional information needed.

Initiate Behavioral Health Inpatient stay via the portal.

Cook County Hospital – Chicago, IL 10/2021 – 03/2022

Medical Secretary

Served as initial point of contact, greeted patients, and maintained a warm and welcoming atmosphere.

Assisted with patient admissions and discharge procedures and filled out census reports.

Handled inbound and outbound calls, scheduled appointments, gathered necessary documents, and collected payments.

Ensured strict adherence to security and confidentiality guidelines as outlined in HIPAA.

Entered patient demographic information into computer and verified insurance coverage.

Utilized Epic EHR.

OptionCare – Addison, IL 05/2018 – 09/2020

Patient Registration Specialist

Trained new hires and coordinated the onboarding of referrals across multiple functional areas, including pharmacy, nursing, warehouse, and revenue cycle.

Collaborated with external service providers and the Commercial Team to transition new patients into service.

Communicated with the Commercial Team to provide updates on patient referral status and resolve related issues.

Collected, reviewed, and completed applicable care transition documents.

Determined patient eligibility and benefits according to insurance policies.

Entered physician orders into the database and calculated the correct formula quantities to ensure patients received the appropriate number of cans per month.

Aim Specialty Health – Westchester, IL 12/2009 – 05/2018

Referral Specialist

Trained employees and provided information to referring and rendering physician offices and network imaging centers regarding program requirements.

Screened preauthorization requests using approved criteria and guidelines.

Entered demographic and screening information from a requesting physician office or provider via telephone or facsimile into the preauthorization computer system.

Issued approval numbers to providers within authorization limits or forwarded cases for nurse review.

Maintained current personal client files updated with the most current face sheets provided.

Used MS Excel.

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