Medical Billing

Denise R. Jewell

Summary: Extensive experience and knowledge in Medical Claims Adjudication and Reimbursement, Medical Billing & Coding and Medical Terminology. I have supervised new hire training classes; I am Driven, Self motivated and Passionate about the profession of Health and all it entails and am self motivated to continuing education and excellence. I have a Medical Coding Certificate and am pursuing my CPC.

Experience: Medical Recovery Systems Cincinnati, OH

2006-2011

Financial Services Representative II

• Consistently assigns appropriate codes from medical records/documentation

• Worked with CPT, HCPCS and ICD-9 Databases

• Identified and reduced daily errors on confirmed orders for billing and coding

• Oversaw daily reporting and editing of Source Reports for Government and Commercial DME/REHAB orders

• Utilized paper and electronic records, as well as chronic disease registries to bill claims

• Maintained HIPAA and JCAHO regulations and standards

• Government and Managed Care Primary and Secondary Billing

• Independent filing and managing of tracking accounts

• Advanced utilization and knowledge of Managed Care contracts and patient Registrations

Humana Inc, Cincinnati, OH

2003-2006

Claims Research Specialist

• Resolved external Humana Professional and Technical providers, members, and employers by written and verbal inquires using extensive knowledge of contracts

• Reviewed medical records and contracts for proper claims adjudication

• Utilized knowledge of medical terminology and patient records

• Consistently resolved member, provider and employer claims, eligibility, referral benefit and reimbursement inquires and adjustments

• Training class subject matter expert for new employees

• Maintained HIPAA and JCAHO regulations and standards

Option Care Inc, Milford, OH

2001-2002

Reimbursement and Billing Specialist

• Managed billing for Commercial and Medicaid insurance claims

• Reviewed medical documentation to submit accurate billing

• EOB remit balancing for Account Receivables

• Insurance claim follow up in timely manner, charge entry month end Accounts Receivables Balancing

• Knowledge of Managed Care and government contracts for proper claims appeals and billing

• Independent filing and managing for tracking accounts

Education: Weston Distance Learning/US Career Institute

Medical Coding & Health Information Technology

Computer Skills:

• EPIC

• FASTRACK

• Windows XP, 2007, 2010

• Microsoft Excel, Access

• Unity(SMS)

• Med Assets

• CP2, Meditech

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