AJ Jones
Atlanta,GA
Summary
Efficient professional in medical referral support, reference laboratory and patient support. High productivity and ability to complete tasks swiftly.
Overview
27
27
years of professional experience
Work History
Referral Specialist/Medical CSR
Bobby Dodd Institute
Marietta, GA
11.2022 - Current
- Coordinated communications between patients, billing personnel and insurance carriers.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Reviewed claims for coding accuracy.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Updated patient accounts with information obtained from internal departments or external sources.
- Responded promptly to customer inquiries regarding their benefits and eligibility status.
- Prepared and submitted detailed reports on insurance verification activities and outcomes.
- Responded to patient inquiries regarding insurance coverage and billing issues.
- Accessed third-party insurance databases to identify coverage of benefits.
- Liaised between physician, site of service and billing department to obtain appropriate documentation.
- Maintained up-to-date knowledge of insurance policies, including Medicare and Medicaid.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or administrative staff.
COVID-19 Swabber/Specimen Processing Specialist
Premier Medical
Atlanta, Georgia
05.2021 - 09.2022
- Performed data entry into electronic medical records systems.
- Collected and prepared nasal-pharyngeal samples for PCR testing of COVID-19 in accordance with standard methods and processes.
- Cleaned and calibrated laboratory equipment.
- Supervised or instructed new technicians on laboratory protocols.
Referral Support
Advanced Homecare
Norcross, GA
05.2016 - 02.2021
- Acted as a liaison between patients, families, physicians, hospitals and other healthcare providers to facilitate efficient coordination of care.
- Maintained up-to-date knowledge of insurance policies and regulations related to referrals.
- Implemented best practices for documentation accuracy when entering patient information into databases.
- Monitored incoming calls from referral sources to ensure timely response to inquiries.
- Prepared, reviewed and transmitted patient demographics, RX, CMN, LMN using Healthcare Management System.
- HCPC, ICD coding knowledge for E codes (L2) J codes for DME supplies.
Bank Customer Service Representative
Fiserv/Bank of America
Phoenix, AZ
06.2012 - 03.2016
- Processed customer transactions accurately and efficiently.
- Researched customer accounts as requested by customers or management staff.
- Assisted members in managing online services and achieving daily banking needs.
- Resolved problems or discrepancies concerning customers' accounts.
Behavioral Health Specialist
Tammy Lynn Center
Raleigh, NC
03.2007 - 03.2012
- Maintained accurate records of client interactions, including documentation of progress notes, evaluations, diagnoses, treatments, referrals.
- Provided direct patient care in a behavioral health setting, including assessment and treatment of mental health issues.
- Monitored client progress through regular assessments and documented changes in behavior or symptoms.
Specimen Accessioner
Quest Diagnostics
Tucker, GA
07.1997 - 02.2007
- Conducted daily quality control checks on equipment used in specimen accessioning.
- Identified potential technical issues with sample collection or processing.
- Accurately accessioned specimens into laboratory information systems.
- Verified patient demographics and collected pertinent clinical data.
- Monitored specimen integrity and ensured timely delivery to testing areas.
- Inspected containers for proper labeling and documentation prior to accessioning specimens.
- Assisted with resolving discrepancies between requisitions and test orders.
Education
Laboratory Science - Clinical Laboratory Assisting
Wake Technical Community College
Raleigh, NCHigh School Diploma -
Alonzo A. Crim
Atlanta, GASkills
- Medical Terminology
- Referral tracking and processing
- Insurance precertification/verification processes
- Appointment Scheduling
- Specimen Processing and prep
- Laboratory instrumentation
- Lab equipment processes
- Equipment Calibration
- Specimen Collection
- HCPC, ICD-10
- Knowledgeable in HDMS, Atrium,
- Patient data identification
- Problem Resolution
- Account updating
- Credit card payment processing
- Customer Service
- 10-Key
- Research
References
References available upon request.
Timeline
Referral Specialist/Medical CSR
Bobby Dodd Institute
11.2022 - Current
COVID-19 Swabber/Specimen Processing Specialist
Premier Medical
05.2021 - 09.2022
Referral Support
Advanced Homecare
05.2016 - 02.2021
Bank Customer Service Representative
Fiserv/Bank of America
06.2012 - 03.2016
Behavioral Health Specialist
Tammy Lynn Center
03.2007 - 03.2012
Specimen Accessioner
Quest Diagnostics
07.1997 - 02.2007
Laboratory Science - Clinical Laboratory Assisting
Wake Technical Community College
High School Diploma -
Alonzo A. Crim