Summary
Overview
Work History
Education
Skills
Certification
Work Availability
Quote
Timeline
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Jacqueline Shokes

unemployed
Summerton,SC

Summary

Diligent billing professional bringing a demonstrated history of success in all types of medical billing and effectively reconciling medical claims illustrated over 16 years in financial roles. Accustomed to answering questions, providing information and resolving concerns. Prepares and distributes statements to insurance and patients, while maintaining comprehensive, accurate records. skilled at independently managing filing, report writing and other ad hoc office functions. well-versed in analyzing data to identify ways to reduce costs and improve accounting processes. Skilled at boosting profitability and minimizing accounting errors. Good listening, speaking and problem-solving abilities. Detail oriented, with a passion for learning and applying new skills for professional growth.

Overview

23
23
years of professional experience
1
1
Certification

Work History

Medical Billing Specialist /Authorization Coordinator

Southwest Urology
01.2018 - 09.2020
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Completed and submitted appeals for denied claims.
  • Reviewed claims for coding accuracy.
  • Coordinated communications between patients, billing personnel and insurance carriers.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Organized information for past-due accounts and transferred to collection agency.
  • Handled billing, waivers and claims for private and commercial clients.
  • Kept accounts current with facility-approved reporting and analysis strategies.
  • Submitted and accurately processed insurance claims with related medical code verifications and assessments.
  • Maintained high accuracy rate on daily production of completed reviews.
  • Handled billing for full complement of practice providers.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Liaised between patients, insurance companies, and billing office.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.

Medical Billing Prior Authorization Specialist

Family Practice
01.2004 - 10.2015
  • Resolved billing issues by applying knowledge and completing in-depth research.
  • Developed improved standard operating procedures to increase billing accuracy and cash flow.
  • Conducted insurance verification and pre-authorization, coded procedures and managed patient charts.
  • Managed billing calendar and scheduled claims for payments.
  • Engaged in oversight of all billing.
  • Helped customers to bring accounts into good standing by implementing payment plans.
  • Developed performance improvement plans based on deep reviews of current work.
  • Built high-performance team by collaborating with new members on procedural, administrative, collections and compliance areas.
  • Led team of 35 staff handling more than $10,000,000 in monthly charges.
  • Enforced operational compliance with state and federal laws and industry standards.
  • Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
  • Managed contract administration, including maintaining files, validating codes and monitoring reporting.
  • Fielded telephone inquiries on authorization details from plan members and medical staff.
  • Input all patient data regarding claims and prior authorizations into system accurately.

Medical Assistant Prior Authorization

Endocrinology Dr. Cory White
08.1997 - 12.2002
  • Documented vital signs and health history for patients in clinic and hospital environments.
  • Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
  • Collected and documented patient medical information such as blood pressure and weight.
  • Called and faxed pharmacies to submit prescriptions and refills.
  • Assisted with routine checks and diagnostic testing by collecting and processing specimens.
  • Completed clinical procedures and gathered patient data for interpretation by physician.
  • Scheduled appointments, registered patients, and distributed sample pharmaceuticals as prescribed.
  • Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
  • Taught patients about medications, procedures, and care plan instructions.
  • Sanitized, restocked, and organized exam rooms and medical equipment.
  • Obtained client medical history, medication information, symptoms, and allergies.
  • Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
  • Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
  • Performed medical records management, including filing, organizing and scanning documents.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Updated inventory, expiration and vaccine logs to maintain current tracking documentation.
  • Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.
  • Collected pertinent data and calculations to aid physician in interpreting results.
  • Implemented care and efficiency improvements to support and enhance office operations.
  • Obtained and documented patient medical history, vital signs and current complaints at intake.
  • Measured patient pulse oximetry.
  • Prepared lab specimens for diagnostic evaluation.

Education

High School Diploma -

University of South Carolina Upstate
Spartanburg, SC
12.2004

Skills

  • Account follow-up
  • Insurance collections
  • Medical coding understanding
  • Prior-Authorization fro oncology drugs
  • Prior-authorization fro imaging studies
  • Prior-authorization for procedures both in/out patient
  • Recordkeeping
  • Information inputting
  • ICD-10 coding
  • Claims expertise
  • Claim review
  • Account management
  • Data entry
  • Submission of medical claims
  • Dictation and transcription
  • CPT code modifiers
  • Operations support
  • Data security procedures
  • Reimbursements
  • Training and development
  • Medicare and Medicaid Process
  • Accounts Payable

Certification

  • EMT - Emergency Medical Technician

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote

There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins

Timeline

Medical Billing Specialist /Authorization Coordinator

Southwest Urology
01.2018 - 09.2020

Medical Billing Prior Authorization Specialist

Family Practice
01.2004 - 10.2015

Medical Assistant Prior Authorization

Endocrinology Dr. Cory White
08.1997 - 12.2002

High School Diploma -

University of South Carolina Upstate
Jacqueline Shokesunemployed