Jaleesa Roberts

• Transcribed Referral's
• Scheduled Pediatric appointments for multiple specialty groups
• Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
• Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
• Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
• Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
• Offered simple, clear explanations to help clients and families understand hospital policies and procedures.

• Performed re-billing of claims with changes such as CPT/HCPCS, Revenue codes, ICD-10 Diagnosis and procedure code, charge thresholds, present of Admission, Admission and discharge sources.
• Resolve and review accounts received directly from Manager/Director
• Assist with Worklist issues.
• Updated weekly Apprev summary to provide to leadership.
• Create weekly master report including Medicare, Medicaid and team work report.
• Provided assistance with special projects and reports for business needs.
• Assist Apprev team with daily workflow questions.

Full time/ 40 Hrs weekly

• Verified patients' eligibility and claims status with insurance agencies
• Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation
• Worked traditional KY and IN Medicaid claims.
• Posted and adjusted payments from insurance companies.
• Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house
• Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.
• Worked closely with insurance agencies, provider reps and patients to resolve accounts.

Full time/ 40 Hrs Weekly 

• Use of Groupcast, Sovera, Allscripts, Centricity, Pinicale, Cerner and payer websites for daily job functions.
• Worked secondary claims.
• submitted electronic/paper claims.
• Identified and resolved patient billing and payment issues.
• Confidently and adeptly handled claim denials and/or appeals.
• Examined patients insurance coverage, deductibles, possible insurance carrier payments and remaining balances.
• Precisely evaluated and verified benefits and eligibility. 
• Maintained and updated collections tracking spreadsheets to help organize payment information.
• Negotiated with accountholders to devise repayment plans and minimize collections receivables.

Full time/ 40 Hrs Weekly

• Verified patients’ eligibility and claims status with insurance agencies.
• Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
• Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
• Precisely completed appropriate claims paperwork, documentation and system entry.
• Maintained strict patient and physician confidentiality.
• Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
• Accurately posted and sent out all medical claims.
• Submitted electronic/paper claims documentation for timely filing.
• Responded to correspondence from insurance companies.
• Posted and adjusted payments from insurance companies.
• Maintained and updated collections tracking spreadsheet to help organize payment information.
• Reviewed and resolved claim issues captured in TES/CLAIMS edits and the clearing house.
• Examined patients’ insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.
• Updated patient financial information to guarantee accuracy.

Full time/ 40+ Hrs Weekly

• Managed case load of 200 + cases
• Worked on dual monitor
• Communicated daily with other department's 
• Responded to emails regarding cases
• Followed HIPPA regulations
• Called members and provider when necessary
• Closed an average of 30 cases a week
• Addressed customer inquiries, solving problems and providing information
• Provided an elevated customer experience to generate a loyal clientele.
• Met CMS regulations and requirements

Full Time/ 40 Hrs Weekly

• Documented patient info obtained from interviews
• Evaluated patient care needs, prioritized treatment, and maintained patient flow
• Worked on dual monitor
• Communicated daily with other department's 
• Responded to emails regarding cases
• Followed HIPPA regulations
• Called members and provider when necessary
• Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing invoice statements.
• Followed infection control procedures

transported patients to and from departments.