Jacy Baker
St Louis,MO
Summary
Accomplished health information management professional skilled in optimizing appeals processes and managing insurance claims. Achievements include enhancing efficiency through thorough data analysis and ensuring adherence to regulatory standards, resulting in improved outcomes and patient satisfaction.
Overview
3
3
years of post-secondary education
12
12
years of professional experience
Work History
Certified Appeals Coordinator
Washington University School of Medicine
St Louis, Missouri
10.2020 - Current
- Coordinated appeals process for patient insurance claims and medical services.
- Investigated appeals to determine validity of claims and established appropriate action plans.
- Reviewed denied claims for potential resubmission or reconsideration.
- Analyzed data related to denials, recoupments, adjustments to identify patterns or discrepancies.
- Reviewed documentation to ensure compliance with regulatory standards and guidelines.
- Evaluated medical records to ensure accuracy of diagnoses and treatments.
- Communicated with patients regarding appeal statuses and required information.
- Assisted with the development of new policies and procedures related to appeals processes.
- Prepared reports summarizing trends in appeal outcomes and identified areas for improvement.
- Collaborated with fellow team members to manage large volume of claims.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Checked documentation for appropriate coding, catching errors and making revisions.
- Managed billing activities related to medical specialties to ensure accurate processing.
- Examined billing regulations to support decision making.
- Prepared and reviewed insurance-claim forms and related documents for completeness.
Front Office Associate
Physical Therapy Services - Pts
Belleville, IL
08.2019 - 03.2020
- Greeted and assisted patients upon arrival at the front desk.
- Scheduled appointments using electronic health record system efficiently.
- Managed patient check-ins and check-outs to ensure smooth operations.
- Coordinated with therapists to confirm appointment availability and updates.
- Handled patient inquiries and provided information regarding services offered.
- Assisted guests with check-in, check-out, and room reservations.
- Resolved customer complaints in a timely manner to ensure customer satisfaction.
Patient Access Representative
Belleville Memorial Hospital
Belleville, IL
03.2018 - 07.2019
- Managed insurance verification and pre-authorization for patient procedures.
- Verified insurance coverage for services provided by the facility.
- Registered patients by completing face-to-face interviews to obtain demographic, insurance, and medical information.
- Facilitated patient check-ins and registration processes for diverse populations.
- Coordinated communication between patients and healthcare providers regarding appointments.
- Handled patient inquiries and resolved issues regarding billing and services.
- Collected co-pays and other payments from patients at time of service.
- Handled phone inquiries to assist patients with their needs. in a professional manner.
- Updated electronic health records with accurate patient information daily.
- Provided a friendly greeting to patients and visitors at the facility. and visitors in a courteous and professional manner.
- Ensured compliance with privacy regulations during patient interactions and data handling.
- Applied HIPAA privacy and security regulations while handling patient information.
Health Information Associate
St. Elizabeth's Hospital
O'Fallon, Illinois
09.2014 - 03.2018
- Managed patient health records using electronic health record systems.
- Conducted data entry in electronic health record systems, ensuring all entries were accurate and up-to-date.
- Assisted healthcare providers with accessing and updating patient information.
- Coordinated data entry for insurance claims and patient billing processes.
- Provided support to physicians, nurses, and other healthcare staff regarding medical record documentation requirements.
- Performed quality assurance checks on medical records for compliance with regulatory standards.
- Ensured compliance with privacy regulations in handling sensitive health data.
- Organized and maintained scanned files in electronic storage systems.
- Organized electronic files for efficient import into software.
Education
Associate of Applied Science - Medical Office Administration
Southwestern Illinois College
Belleville, IL 08.2013 - 05.2016
Skills
- Appeals process proficiency
- Claims processing
- Medical coding
- Health information management
- Insurance regulations
- Regulatory compliance
- Quality assurance
- Data analysis
- Data entry
- HIPAA compliance
- Confidentiality
- Insurance policies
- Document processing
- Records management
- Time management
- Detail orientation
- Organizational management
- Team collaboration
- Problem-solving
- Analytical skills
- Research capabilities
- Microsoft Office Suite
- Lifelong learning
- Professional ethics
- Organizational development
Timeline
Certified Appeals Coordinator
Washington University School of Medicine
10.2020 - Current
Front Office Associate
Physical Therapy Services - Pts
08.2019 - 03.2020
Patient Access Representative
Belleville Memorial Hospital
03.2018 - 07.2019
Health Information Associate
St. Elizabeth's Hospital
09.2014 - 03.2018
Associate of Applied Science - Medical Office Administration
Southwestern Illinois College
08.2013 - 05.2016