Hi, I’m
Jacqueline Johnson
Healthcare
Jackson,Copiah
Summary
A committed and motivated administrative assistant with exceptional customer service and decision-making skills, strong work ethic, and a professional demeanor, seeking a career with a well-established company helping to make an immediate contribution to its success.
Overview
20
years of professional experience
Work History
Baptist Memorial Hospital Memphis
Specialist
11.2021 - Current
Job overview
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Generated, posted and attached information to claim files.
- Calculated adjustments, premiums and refunds.
- Coordinated with contracting department to resolve payer issues.
- Followed all company policies and procedures to deliver quality work.
- Checked documentation for accuracy and validity on updated systems
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers
- Conducted full claim investigations and reported updates and legal actions
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Assured timely verification of insurance benefits prior to patient procedures or appointments
- Followed up with customers on unresolved issues
- Coordinated with contracting department to resolve payer issues
- Generated, posted and attached information to claim files
- Made contact with insurance carriers to discuss policies and individual patient benefits
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources
- Reviewed insurance and claims documents to verify required information and secure any missing data for payment.
UMMC, The University of Mississippi Medical Center
Physician Scheduler
01.2021 - 11.2021
Job overview
- To facilitate provider schedules to maximize customer service, patient access, provider productivity, and business operations.
- To complete pre-registration process including using practice management software to capture accurate demographics.
- To make referrals for financial counseling and/or physician referrals/authorizations/certifications
- Maintains current and up-to-date knowledge of patient scheduling software, ARG's (appointment request guidelines) for providers schedule and standard operating procedures for pre-registration and scheduling of patient appointments.
- Pre-registers all new patients scheduling appointments with 95% accuracy.
- Obtains demographic data for referring physician when patient is scheduled, including reason for visit, and documents reason.
- Verifies patient's insurance either electronically or by phone to ensure that insurance is active and to communicate to patient what is duel pay at time of service.
- Completes data entry of pre-registration notes into scheduling system.
- Utilizes access resource guidelines/scheduling protocols to determine need for financial counseling.
- Utilized CRM system to track and manage leads, keeping appointments organized.
- Entered daily data in computer systems and documented office activities.
- Addressed client inquiries and updated database information.
- Communicated with management to provide feedback on value and productiveness of appointment setting process.
- Acted as first point of contact and set appointments for prospective clients.
- Handled complaints and questions, and re-directed calls to other team members
- Utilized CRM system to track and manage leads, keeping appointments organized
- Answered phone calls and answered questions from potential customers
- Entered daily data in computer systems and documented office activities
- Addressed client inquiries and updated database information
- Scheduled follow up calls with potential customers to gain interest in scheduling appointments
American Public Life
BENEFIT ADJUSTER
05.2017 - 01.2021
Job overview
- Provide appropriate verbal and written communication to internal and external Customers in positive and knowledgeable manner to ensure high standard of Customer service.
- Obtain and maintain call flow certification in accordance with department performance metrics.
- Acts as direct contact and communicate with Customers and medical providers in positive, knowledgeable, and professional manner, providing them with direction and assistance in all facets of insurance coverage and needs.
- Prompt and reliable with good medical terminology experiences and skills
- Possesses Windows 10 skills and software knowledge in paperless environment.
- Understanding of anatomy and physiology with one to three years of experience
- Possess skills using 10-key calculator.
- Knowledgeable of CPT and ICD-9 coding
- Ability to work flexible schedules.
- Good oral and written communication skills
- Maintain documentation such as Standard Operating Procedures of daily job duties.
- Examined claims forms and other records to determine insurance coverage.
- Organized, planned and documented materials for medical claims.
- Evaluated insurance policies and analyzed EOBs to determine coverage.
- Demonstrated leadership skills in managing projects from concept to completion.
- Proven ability to learn quickly and adapt to new situations.
- Identified issues, analyzed information and provided solutions to problems.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Paid attention to detail while completing assignments.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Gained strong leadership skills by managing projects from start to finish.
REVCLAMS
WORKERS COMPENSATION SPECIALIST/BENEFIT ADMIN
10.2016 - 05.2017
Job overview
- Responsible for all procedures involved in processing claims, including data entry, research, billing and posting funds, handling communications, other tasks necessary for efficient operation of franchise.
- Work in accounts maintenance generating invoices, creating guarantors, and managing Care of benefits.
- Assisted with entering new claims, research accident information, identity insurance coverage for billing.
- Answer and responds to telephone inquiries from clients, attorney and hospital employee and he public.
- Received and screened high volume of internal and external communications, including email and regular mail.
- Make copies, send faxes, and handled incoming correspondence along with checks from insurance and attorney's offices.
- Understanding how to post funds to patient accounts to various hospitals.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Prepared financial statements to provide results of operations, financial position and cash flow.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Accurately posted payments and adjustments both electronically and manually.
GI Associates & Endoscopy Center
MEDICAL BILLING SPECIALIST
10.2014 - 10.2016
Job overview
- Coordinated preparation and processing of claims with patients, insurance companies and service provider, GI Associates
- Work directly with insurance company, Healthcare provider, and patient to get claim processed and paid accounts.
- Interview and answer patient billing questions
- Handle collections and unpaid accounts
- Prepare, reviews, and send patient statements.
- Review accounts for possible assignment and make recommendations to Billing Supervisor, also prepares information for collection agency.
- Performs daily various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
- Perform duties in accordance with HPA's employee by maintaining strictest confidentiality; adhere to all HIPAA guidance regulations.
- Filed and updated patient information and medical records.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
Orthopedic & Sports Medical Center
INSURANCE VERIFICATION SPECIALIST
04.2013 - 04.2014
Job overview
- Worked with patients and insurance companies and other financial organizations to assure successful payments
- Verified patient insurance coverage, to ensure necessary procedures were covered by individual's provider.
- Served as valuable resource to patients, providing them with pertinent information regarding their coverage.
- Worked with patients to explain coverage amounts provided by their insurance policy
- Helped patients arrange payment for services that were not covered by their insurance companies, discussing different financing options to fit their budgets
- Obtained medical and insurance information to screen patient for financial programs.
- Performed various administrative tasks by filing, copying and faxing documents.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
- Assisted with medical coding and billing tasks.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Communicated verification and authorization status updates with department to facilitate decision-making for patient admissions and insurance coverage.
- Answered phone calls and messages for -physician medical facility, scheduling appointments, and handling patient inquiries.
- Scheduled patient appointments in respective doctors' calendars.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Established and maintained relationships with insurance providers for productive communications.
- Frequently double-checked patient histories and current information while scheduling follow-ups and other appointments.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Generated reports to track insurance verifications and claim progress.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Registered and verified patient records before triage with most up-to-date information.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Obtained payments from patients and scanned identification and insurance cards.
- Updated patient records with accurate, current insurance policy information.
- Prepared and processed patient referrals and transfer requests.
University of Mississippi Medical Center
Patient Financial Counselor
06.2007 - 04.2013
Job overview
- Worked with patients on case-by-case basis to achieve financial solutions and settlements of fees for provided services.
- Managed admission and financial matters in manner satisfactory to each individual patient's needs
- Promoted mission, vision, and values of organization.
- Responsible for financially clearing patients at Emergency room, hospital bedsides or Operating Prep registration to obtain cash payment to determine eligibility for various governmental programs.
- Conducted interviews with patients and family members.
- Notified hospital case management, social services, and admissions staff of case screening.
- Calculated and collected cash payments appropriately for all patients.
- Knowledgeable of hospital regulations, such as visit hours, payments accounts, charges, proper procedures as relate to patient.
- Participated in data gathering for financial reporting.
- Set up arrangements and process monthly installment plans for patients to payoff balances within guidelines of hospital collection agency.
- Engaged with patients to provide critical information.
- Responded to inquiries by directing calls to appropriate personnel.
- Greeted and assisted patients with check-in procedures.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Verified patient insurance eligibility and entered patient information into system.
- Organized patient records and database to facilitate information storage and retrieval.
- Provided excellent customer service to patients and medical staff.
- Facilitated communication between patients and various departments and staff.
Parktown Apartment
Assistant Manager
08.2003 - 06.2007
Job overview
- Assisted Property Management with training staff on leasing, entering traffic into computer, marketing, maintenance, and general office operations.
- Maintained over and keep 95 percent occupied 300 units
- Processed lease renewals and new applications
- Showed and leased apartments
- General clerical duties included running background checks, credit reports etc
- Responsible for maintaining property in absence of Manager
- Maintained all accounts receivable including collecting rent, posting rent, making daily bank deposits, and maintaining balanced accurate rent roll
- Collected delinquent accounts balances from previous residents
- Processed evictions, which included processing all necessary paperwork, serving notices, and attending court hearings
- Composed and prepared routine correspondence, rental notices, and other letters and memorandums
- Maintained good relationship with tenants.
- Responsible for lease administration, preparing lease agreements.
- Kept records accurate, detailed and fully compliant with reporting requirements to meet state, local, and federal housing requirements.
- Kept properties in compliance with local, state and federal regulations.
- Conducted property showings to highlight features, answer questions, and redirect concerns to close contracts.
- Introduced and monitored effective lease renewal programs to maintain high occupancy rates.
- Handled tenant complaints promptly and appropriately, calling in repairmen, and other support services.
- Responded to Common Area Maintenance (CAM) inquiries.
- Verified income, assets, and expenses, and completed file tracking sheet for each applicant.
- Maximized rental income while minimizing expenses through effective planning and control.
- Completed final move-out walk-throughs with tenants to identify required repairs.
Education
Baker UniversityFlint, MI
No Degree
Kaplan UniversityChicago, IL
No Degree
Grand Canyon UniversityPhoenix, AZ
No Degree
American Intercontinental UniversityHoffman Estates, IL
No Degree
Skills
- Public Health
- Clerical Support
- Health Care System
- Inputting Claims
- Call Volume and Quality Metrics
- Enrollment Assistance
- Client Relationships
- Administrative and Office Support
- Attention to Detail
- Decision-Making
- Flexible and Adaptable
- Multitasking Abilities
Timeline
Specialist
Baptist Memorial Hospital Memphis
11.2021 - Current
Physician Scheduler
UMMC, The University of Mississippi Medical Center
01.2021 - 11.2021
BENEFIT ADJUSTER
American Public Life
05.2017 - 01.2021
WORKERS COMPENSATION SPECIALIST/BENEFIT ADMIN
REVCLAMS
10.2016 - 05.2017
MEDICAL BILLING SPECIALIST
GI Associates & Endoscopy Center
10.2014 - 10.2016
INSURANCE VERIFICATION SPECIALIST
Orthopedic & Sports Medical Center
04.2013 - 04.2014
Patient Financial Counselor
University of Mississippi Medical Center
06.2007 - 04.2013
Assistant Manager
Parktown Apartment
08.2003 - 06.2007
Baker University
No Degree
Kaplan University
No Degree
Grand Canyon University
No Degree
American Intercontinental University
No Degree
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