Janay Draper

• Managed insurance denial cases through paper and electronic work queues, facilitating timely resolution and advancing claims.
• Prepared, collected, and submitted insurance and TPA claims following payer guidelines and workflow procedures.
• Reviewed credit balance reports and processed applicable balances, ensuring accuracy and compliance with financial protocols.
• Answered patient, insurance, and BMG clinic calls, delivering timely support and information to enhance patient experience.

• Review and verify patient account balances to ensure accuracy.
• Confirm whether outstanding balances are patient responsibility versus insurance responsibility.
• Research insurance payments, EOBs, and ERAs to validate balance status.
• Contact patients regarding outstanding balances and facilitate collections in a professional and

compassionate manner.

• Post patient payments accurately and in a timely manner.

• Entered patient medical history and exam results into database, ensuring accurate and timely recordkeeping for improved patient care.
• Coordinated movement and storage of medical records, ensuring compliance with privacy laws and safeguarding patient confidentiality.
• Sorted and scanned incoming parent packets to create comprehensive medical records for each student/patient at Well Child, Inc.

• Executed daily edits for COVID claims, ensuring accuracy and compliance to uphold regulatory standards.
• Collaborated with team members to resolve backlog of edits and complete special projects, enhancing workflow efficiency.
• Assisted with weekly EOB scanning, facilitating timely posting into the system to support financial operations.

• Assisted patients with payment inquiries and insurance questions, establishing payment plans that enhanced financial accessibility.
• Entered and updated insurance information to ensure accurate records and streamline billing process.
• Reviewed accounts for collection status and dispatched collection letters for timely follow-up on outstanding balances.

• Navigated multiple platforms daily to research and finalize claim submissions accurately, ensuring compliance with client standards.
• Processed claims according to client-specific guidelines, resolving exceptions to ensure uninterrupted workflow.
• Collaborated on special claim projects, contributing to improved processing efficiency.