Jayla Locks
Phenix City,AL
Summary
Over 10 years’ healthcare and revenue cycle. Extensive years of utilizing various EMR and database systems including but not limited to, PeopleSoft, QNXT, Epic, CISCO, NextGen, Facets and Salesforce,Sabre, ZennApp. Experience with ICD10, UB04, CMS 1500. Proficient in Microsoft Office Suite (Excel, Word, Outlook, and Access)
Overview
12
12
years of professional experience
Work History
Dispute Resolution Analyst 1
J29 Solutions
04.2024 - Current
- Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy.
- Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision.
- Stays abreast of changes in regulations, medical and healthcare practices, policies and procedures.
- Participates in special projects and performs other duties as assigned.
Claims Processor
IKS Healthcare
10.2020 - 03.2024
- Receive inbound calls from patients and work to resolution any concerns or issues they may have regarding billing.
- Task accounts to appropriate department that need specialized handling and follows up within 24-48 hours that requested action has been completed.
- Outbound calls to patients to collect outstanding balances.
- Maintains accurate and complete records concerning account billing activity.
- Communicates escalations with supervisor/manager regarding patient account discrepancies.
Claims Representative
Molina Healthcare
08.2013 - 06.2020
- Provided new and existing members with the best possible service in relation to billing inquiries, service requests, claims status, suggestions, and complaints.
- Resolved member inquiries and complaints fairly and effectively.
- Provided product and service information to members and identifies opportunities to maintain and increase member relationships.
- Accurately recorded all calls in QNXT as applicable.
- Speak with members about their Medicare and Medicaid coverage.
Education
G.E.D -
Lee College
Baytown, TX01.2007
Skills
- Compliance awareness
- Organization skills
- Teamwork
- Teamwork and collaboration
- Customer service
- Attention to detail
Timeline
Dispute Resolution Analyst 1
J29 Solutions
04.2024 - Current
Claims Processor
IKS Healthcare
10.2020 - 03.2024
Claims Representative
Molina Healthcare
08.2013 - 06.2020
G.E.D -
Lee College