Jeanne McAuliffe
Epworth
Summary
Precise, efficient medical billing professional with over 20 years of experience in dental, outpatient, and physician medical billing. Specialize in filing accurate claims, adjusting rejected claims, and understanding insurance contracts, appeals, and EOBs. Highly experienced with reconciling insurance payments and resolving claim disputes. Proficient in a variety of practice management software applications. Dedicated to maintaining strict patient confidentiality.
Overview
20
20
years of professional experience
Work History
AR Follow up 1
R1 Rcm
01.2024 - Current
- Claim denial research for provider identification denials relating to NPI, taxonomy code, license
- Communicate confidentially with insurances to verify provider load issues causing credentialing denials
- Provide credentialing department with detailed information to assist in updating provider information
- Work effectively and efficiently in assigned work queues
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Managed time efficiently in order to complete all tasks within deadlines.
Patient Care Coordinator
Unified Therapy Services, LLC
01.2023 - Current
- Verify insurance benefits and explain to patients their coverage including deductible, coinsurance and copay
- Submit for prior authorization with supporting documentation when required by insurance plan
- Investigate outstanding claims by reaching out to the insurance company via telephone, portal, fax or email
- Correct any claim errors that would be a reason for denial or delay and resubmit Verify that insurance payments and adjustments are done according to payor contracts
Account Manager
Medline Industries
07.2013 - 06.2021
- Placing, tracking and maintenance of orders, providing product information, checking inventory status, and facilitating returns and credits.
- Handle resolutions for customers and escalate concerns to sales when necessary.
- Ensure insurance orders are placed with detailed and accurate information to aid in processing and avoid delays with these orders.
Patient Account Representative
Westside Orthopaedics PC
01.2006 - 11.2011
- Responsible for all aspects of patient accounts from entering charges to entering payments
- Investigate outstanding claims and denials while noting if errors are due to inaccurate information by the clinic or incorrect processing by the insurance company
- Maintain awareness of insurance companies’ rules for claim submission, timely filing, appeal processes
- Keep detailed records of correspondence regarding claim submissions, denials and appeals
- Complete disability and FMLA paperwork for patients
Education
No Degree - General Studies
University of Northern Iowa
Cedar Falls, IASkills
- ICD-10, CPT, & Medical Terminology
- Various Practice Management Software
- Verification of Benefits
- Insurance Denials and Appeals
- HIPAA Compliance
Timeline
AR Follow up 1
R1 Rcm
01.2024 - Current
Patient Care Coordinator
Unified Therapy Services, LLC
01.2023 - Current
Account Manager
Medline Industries
07.2013 - 06.2021
Patient Account Representative
Westside Orthopaedics PC
01.2006 - 11.2011
No Degree - General Studies
University of Northern Iowa