Danielle Jones
Tampa,FL
Summary
To obtain a position allowing me to utilize and expand upon my acquired skills and healthcare knowledge along with a creative approach to problem solving & to be employed with an organization that allows & promotes growth i am loyal , dependable & reliable person with high integrity & willingness to learn.
Overview
17
17
years of professional experience
Work History
Pap Assistance Program Specialist
Amgen
Tampa, FL
09.2023 - Current
- Assist providers Office & Patients in completing applications for financial assistance programs.
- Performed assessments to determine individuals Qualifications.
- Perform day-to-day operations of the program, ensuring compliance with applicable policies and regulations.
- Collect personal information to determine eligibility for assistance.
- Out reach to Health Care providers to make sure requested documents are Accurate & complete
Collections / Accounts Receivable Admin
Akumin /advanced diagnostic
Tampa, FL
09.2021 - 09.2023
- Contacting insurance companies to determine the status of submitted claims & investigating reasons for claim denials
- Contacting attorney for case status updates
- Subrogating for a reasonable payment plan with attorneys & when patients are unable to pay medical bills due to their financial position
- Preparing & submitting billing data & medical claims to insurance
- Review accounts in A/R Reports
- Answer Incoming calls from insurance companies & patient
- Research & resolve denied claims.
Accounts Receivable Admin
Liberty Medical Solutions
Tampa, FL
07.2019 - 03.2021
- Contact insurance companies to check the status of unpaid medical claims
- Monitoring account activity & providing adequate follow up to ensure maximum reimbursement is received from group health, Auto, workers compensation & third party insurances
- File Appeals
- Review accounts in A/R Reports
- Answer Incoming calls from insurance companies & patient
- Research & resolve denied claims
Electronic Data Entry Coordinator
Metlife
Tampa, FL
11.2018 - 05.2019
- Receive a data feed from lexis nexus that has a comprehensive list of reported deaths
- Cross check against data feeds that may have policies with Metlife
- Review matches (including 'fussy', partial matches, i.e., SSN, Last name, etc) that need to be reviewed to see if the policy does belong to the deceased person on the feed
- Initiate a case with our claims department so that they can begin the process of paying the beneficiary.
Front Desk Receptionist
Florida Joint Care Institute
Trinity, FL
04.2018 - 06.2018
- Answered incoming calls
- Checked patients In & out and scheduled appointments
- Obtained Authorizations and Referrals
- Scanned patients information for medical charts
- Verified insurance eligibility & Benefits
Medical Claims Analyst
Auditz
Tampa, FL
09.2015 - 12.2017
- Adjust claims in direct data entry (dde) with appropriate Medical fiscal intermediary
- Verify with Medicare fiscal intermediary or post-acute patient released to post-acute care & Medicaid billed account is Adjusted for Medicare underpayment
- Determine bill type /reason code adjustable
- Verify patient address information from facility
- Verify post-acute care patient discharge status is correct or incorrect.
Customer Service Representative
Humana
Tampa, FL
10.2014 - 09.2015
- Place orders to have Humana Id cards issued & summery of benefits
- Update address changes
- Provide status of authorization & claims
- Creative thinking skills in order to resolve complex issues
- The ability to work in fast paced environment & to handle constant volume of phone inquiries.
Pharmacy Resolution Specialist
Well Care
Tampa, FL
04.2012 - 08.2014
- Place overrides for member’s medication that was re-admitted for Long Term Care on a first time fill
- Process prescriptions
- Complete appeals & process claims Due to denied approval
- Complete and fax prior authorizations for medication requested by physicians
- Assist Pharmacist.
Reception Specialist
New Tampa Urology
Tampa, FL
03.2012 - 04.2012
- Answered incoming calls
- Checked patients In & out and scheduled appointments
- Obtained Authorizations and Referrals
- Scanned patients information for medical charts
- Verified insurance eligibility & Benefits
Medical Billing & Coding (Externship)
Pinnacle Health Group
Tampa, FL
02.2012 - 03.2012
- Answered incoming calls
- Checked patients In & out and scheduled appointments
- Obtained Authorizations and Referrals
- Verified insurance eligibility via Availity
- Assign diagnostic & procedure codes based of service bill insurance companies & 3rd party payers.
Medical Claims Review Rep/Patient Account Specialist
Care centrix
Tampa, FL
08.2011 - 12.2011
- Researched, resolved, and documented patient inbound and outbound calls involving a wide range of issues utilizing multiple information systems
- Collected outstanding balances, offered patients assistance with financial responsibility through various financial options
- Worked with internal and external customers including 3rd party providers to obtain medical claims documentation, work orders, proof of delivery, or other documentation necessary to resolve open account issues
- Authorized transaction dates for medical equipment for BCBS of FL and Cigna Health.
Claims Review Rep/Patient Account Specialist
Coleman & Associates
Tampa, FL
09.2009 - 02.2010
- Exercised good judgment and provided customer support for Verizon Online DSL billing
- Participated in process improvement initiatives; maintained good teamwork
- Ensured quality and operating standards were met based on service objectives as wells as Verizon policies and operating procedures
- Handled billing escalation calls involving a multitude of issues.
Collections Representative
JP Morgan Chase
Tampa, FL
01.2008 - 03.2009
- Corresponded with customers, brokers, title companies, and attorneys in order to facilitate delinquency resolutions through advanced contact, consultation, and collection efforts
- Met daily, weekly, and monthly productivity standards and consistently achieved monthly goal objectives
- This consisted of call standards and accounts worked
- Managed a queue of approximately 200-300 accounts per month.
Collections Representative
I.C Systems
Tampa, FL
02.2007 - 01.2008
- Provided customer service regarding collection issues, processed customer refunds, processed and reviewed account adjustments, resolved client discrepancies and short payments
- Accountable for reducing delinquency for assigned accounts
- Performed other assigned tasks and duties as necessary to support Dell customers
- Met defined department goals and activity metrics including meeting daily save rates, average handle times and customer call quality.
Education
Medical Billing & Coding, -
Sanford Brown Institute
03.2012
Skills
- Hard working
- Motivated
- Dedicated
- Professional individual
- Accounts receivable
- Medical insurance billing
- Medical terminology
- CPR Certified
- Authorizations & Referrals
- CPT-4 & ICD-9 & ICD- 10 Coding
- Centricity Physician Office-Practice Management Software
- GE EMR (Electronic Medical Records ) Software
- MS Word
- PowerPoint
- Excel
- Access
- Lotus Notes
- Cerner
- Epic
- Quadux
- Allscripts PM scheduling
- Allscripts Professional her
- Kareo
Timeline
Pap Assistance Program Specialist
Amgen
09.2023 - Current
Collections / Accounts Receivable Admin
Akumin /advanced diagnostic
09.2021 - 09.2023
Accounts Receivable Admin
Liberty Medical Solutions
07.2019 - 03.2021
Electronic Data Entry Coordinator
Metlife
11.2018 - 05.2019
Front Desk Receptionist
Florida Joint Care Institute
04.2018 - 06.2018
Medical Claims Analyst
Auditz
09.2015 - 12.2017
Customer Service Representative
Humana
10.2014 - 09.2015
Pharmacy Resolution Specialist
Well Care
04.2012 - 08.2014
Reception Specialist
New Tampa Urology
03.2012 - 04.2012
Medical Billing & Coding (Externship)
Pinnacle Health Group
02.2012 - 03.2012
Medical Claims Review Rep/Patient Account Specialist
Care centrix
08.2011 - 12.2011
Claims Review Rep/Patient Account Specialist
Coleman & Associates
09.2009 - 02.2010
Collections Representative
JP Morgan Chase
01.2008 - 03.2009
Collections Representative
I.C Systems
02.2007 - 01.2008
Medical Billing & Coding, -
Sanford Brown Institute