Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Jasmine Mayo

Mooresville,MS

Summary

Friendly Insurance Verification Specialist promoting a background in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.

Overview

17
17
years of professional experience

Work History

Claims Processor Associate

NttData
10.2023 - 04.2024
  • Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
  • Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
  • Processed a high volume of incoming claims in accordance with established policies and procedures.
  • Adhered to all applicable laws, regulations, and company standards while processing claims.
  • Researched discrepancies between submitted documentation and actual records to identify errors or omissions.
  • Applied knowledge of coding systems such as CPT-4 and HCPCS codes for proper reimbursement.
  • Reconciled payment discrepancies between provider statements and remittance advice from payers.

Senior Medical Claims Examiner

Local 164 Fund
07.2015 - 04.2021
  • Assisted with the resolution of complex billing inquiries from providers or third-party payers.
  • Responsible for Medical Coding/ Medical Billing of Claims, along with Processing in and out of network Medicare Claims
  • Provided guidance and training to junior staff members on proper processing techniques for Behavioral Health and Substances Abuse claims.
  • Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
  • Reviewed EOB to determine amount of coverage is accurate according to CPT & ICD 9-10 codes on claims
  • Handled inbound and outbound calls from Payers, and Local 164 Members
  • Reviewed Aged accounts responsible for generating reports and projects for AR department to follow up and sent out appeals

Medical Biller and Coder

Quest Diagnostics
12.2012 - 09.2014
  • Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
  • Verified accuracy of patient information and insurance data in billing system.
  • Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
  • Sorting and filing paperwork, handling insurance claims and performing collections duties
  • Prepared, reviewed, and sent patient statements analyzed, investigated, and resolved denied, unpaid claims involving contact with patients, physicians, and insurance companies

Medical Claim Examiner/QA Analyst

Iron Mountain
08.2007 - 08.2014
  • Responsible for inputting customer medical records, law firm documents into Iron Mountain Database.
  • Trained within the company on different programs to become a QA Specialist for IRM team.
  • Met and Maintained daily productivity goals worked on special projects using Excel spread sheets and Microsoft office, inputted records boxed up
  • Documents, worked in QA inbox, sent and received emails sent and received faxes, handle incoming and outgoing phone calls to customer and multi-line phone processes medical dental and or hospital claims/ processes complex claims independently
  • Provided provider service by responding to and documenting telephone and / or written inquiries
  • Performed pre-authorizations, audits files, request check tracers and stop payments, and assists with researching and preparing appeals to payers
  • Handled special duties and higher level, more complex functions(I.E. third party liability/subrogation, flex, re-insurances, PPO updates, life insurance, ETC) as assigned.

Education

High School Diploma -

Murry Bergtraum High School For Business Careers
New York, NY

Anthem Medical Institute
Jersey City, NJ

Skills

  • Claims Review
  • Transactions reconciliation
  • Payments posting
  • Allocating claims
  • Research & Quality Analyst
  • Ledger Reconcile

References

References available upon request.

Timeline

Claims Processor Associate

NttData
10.2023 - 04.2024

Senior Medical Claims Examiner

Local 164 Fund
07.2015 - 04.2021

Medical Biller and Coder

Quest Diagnostics
12.2012 - 09.2014

Medical Claim Examiner/QA Analyst

Iron Mountain
08.2007 - 08.2014

High School Diploma -

Murry Bergtraum High School For Business Careers

Anthem Medical Institute

Similar Profiles

CREATE PROFILE
Jasmine Mayo