Jasmine Moten
Augusta,GA
Summary
Pursuing a Revenue Cycle Specialist role in an organization where I can apply the skills, knowledge, and experience in the patient accounting department to contribute to the organization's success. Experienced in follow up, collections, self-pay collection, reimbursement, Charge-Master, Contracts, Denials, Rejections, and Appeals.
Overview
12
12
years of professional experience
Work History
Insurance Denials and Appeals rep
Au Medical Center
11.2016 - Current
- Performing reconciliations of all patient balances
- Persistent claim follow-up and working aging accounts receivable
- Completing the process for appeal and reconsideration of claims
- Review and process claims in various stages of the revenue cycle
- Monitor overall client performance, identify potential loss or delay in revenue to ensure maximized reimbursement for assigned clients, seek and suggest solutions to maximize client performance
- Maximize client performance by providing feedback and solutions
- Initiate communication to payers to identify deficiencies and resolve and prevent issues
- Manage correspondence, rejections, denials, appeals, static claims, and all other follow up
- Manage client performance by using big picture analysis and critical thinking
- Build and maintain internal and external relationships to best address client needs
- Rendered decision for non-clinical complaints using sound, fact-based decision making.
- Examined case to initiate clinical review.
- Obtained additional documentation required for case review.
- Completed documentation of final appeals or grievance determination using appropriate templates.
- Submitted verbal and written notification to members and providers.
Authorization specialist
Teleperformance
01.2012 - 11.2016
- Prioritize incoming prior authorization requests according to urgency
- Triage prior authorization rejections to determine validity of the prior authorization
- Communicate with patients regarding clinical information to be used when submitting the prior authorization
- Review patient chart documentation to ensure accuracy of prior authorization submissions
- Request, track and obtain prior authorization from insurance carriers within time allotted for medical and services using my meds, fax or verbal communication
- Follow up on prior authorizations that have been submitted with no response from the insurance carrier in a timely manner.
Education
GED -
Augusta Technical College
Augusta, GA05.2009
Skills
- Knowledge of accounting, including credit, bookkeeping, collections and insurance
- Able to give accurate and detailed information to patients
- Demonstrated ability to complete cash posting
- Functions for bad debt accounts
- Proven record of maintaining professional knowledge of all state and federal regulation for all insurance type
- Office suite, scanning
- Patient system
- Proficient in with Medicare
- DDE system
- Proven abilities to reduce
- RTP’s
Timeline
Insurance Denials and Appeals rep
Au Medical Center
11.2016 - Current
Authorization specialist
Teleperformance
01.2012 - 11.2016
GED -
Augusta Technical College
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