JAYDIA JACKSON
Summary
Medical Billing/AR Specialist with comprehensive expertise in revenue cycle management and accounts receivable, developed through diverse roles in healthcare settings. Excels in optimizing billing accuracy and cash flow through meticulous claims processing and effective collaboration with insurance providers. Eager to leverage skills in medical billing and customer service to advance in the healthcare industry while pursuing a degree.
Overview
7
7
years of professional experience
Work History
Claims Processor
Elevance Health
12.2024 - 08.2025
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
- Enhanced claim processing efficiency by implementing new software and streamlining procedures.
- Developed and implemented quality assurance processes to check accuracy of claims processing.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Collaborated with healthcare providers to ensure accurate billing information was submitted, resulting in fewer denied or delayed payments.
MEDICAL BILLING/AR SPECIALIST
Sutherland Global
04.2024 - 11.2024
- Managed appeals collections via phone and email, enhancing recovery efficiency.
- Collaborated with insurance plans, resolving coverage queries effectively.
- Reviewed contracts to identify billing issues, ensuring accurate re-bills.
- Requested patient and medical records, streamlining information flow.
- Achieved measurable improvements in claims processing accuracy.
- Processed medical claims, ensuring accuracy and compliance with insurance regulations. Resolved billing discrepancies, reducing AR days and improving cash flow.
- Meticulously reviewed and coded medical records for accurate billing. Maintained up-to-date knowledge of coding guidelines and insurance policies.
- Remote
ACCOUNTS RECEIVABLE SPECIALIST
Aspirion
03.2023 - 05.2024
- Monitor and collect accounts receivable by contacting providers via telephone, email, and mail Maintain accounts to ensure claims are aging to date, credits and collections are applied, uncollectible amounts are accounted for, and miscellaneous differences are cleared Medical billing operations, accurate claim submission, account reconciliation, insurance follow up on aged and current denials, as well as appeals. Optimize accounts receivable processes, ensuring timely claim submissions and effective follow-ups on denials. Conduct thorough account reconciliations for financial accuracy.
PROVIDER SERVICE REPRESENTATIVE
UnitedHealth Group
03.2022 - 03.2023
- Provided assistance to providers
- Answered phone and assisted provider with Claims and benefits
- Faxed Eobs
- Provided claim denial information, sent adjustments if needed
- Sent inquiries on benefits and claims for providers who had more specific questions
- Assisted members and providers to get to the right department
- Documented every single call
- Worked on accounts
MEDICAL CLAIMS SPECIALIST
ConnectiveRX
03.2021 - 12.2021
- Processed medical claims ensuring accuracy and timeliness, resolving discrepancies efficiently.
- Reviewed patient records for completeness, enhancing claim approval rates with precise documentation.
- Collaborated with teams to gather necessary information, improving claim processing efficiency.
- Investigated and corrected claims issues, reducing errors and enhancing patient satisfaction.
- Analyzed EOBs to ensure compliance, contributing to improved operational standards.
CASHIER/GUEST SERVICE
Target
08.2018 - 09.2019
- Assisted customers with purchases, enhancing satisfaction and loyalty.
- Processed returns efficiently, ensuring smooth operations.
- Managed phone inquiries, improving communication and service.
- Maintained a clean workspace, contributing to a safe environment.
- Optimized customer transactions, efficiently managed returns, and maintained a pristine store environment, enhancing overall guest satisfaction and operational efficiency.
Education
BACHELOR OF SCIENCE - undefined
Eastwick College-Ramsey
NJ08.2025
Skills
- Customer Service (Expert), Medical Billing (Experienced), Claims Processing, Accounts Receivable (Expert), Data Entry, Phone Support, Cash Handling, Inventory Management, Retail Sales, Microsoft Office, First Aid, Medical Terminology, ICD Coding (Expert), Revenue Cycle Management (Experienced)
- Accuracy and precision
- Payment posting
- Claims review
- CERNER
- Account follow-up
LANGUAGES
English (Native).
Timeline
Claims Processor
Elevance Health
12.2024 - 08.2025
MEDICAL BILLING/AR SPECIALIST
Sutherland Global
04.2024 - 11.2024
ACCOUNTS RECEIVABLE SPECIALIST
Aspirion
03.2023 - 05.2024
PROVIDER SERVICE REPRESENTATIVE
UnitedHealth Group
03.2022 - 03.2023
MEDICAL CLAIMS SPECIALIST
ConnectiveRX
03.2021 - 12.2021
CASHIER/GUEST SERVICE
Target
08.2018 - 09.2019
BACHELOR OF SCIENCE - undefined
Eastwick College-Ramsey
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