Overview
Work History
Education
Accomplishments
Timeline
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Jenna Cockerham

Portsmouth,NH

Overview

12
12
years of professional experience

Work History

Commercial Denials Specialist II

Novocure, Inc
08.2022 - Current
  • Consistently demonstrates the ability to resolve a larger case load while supporting my teammates
  • Appropriately prioritized work; anticipated and managed work load and other job requirements effectively
  • Designated team Onboard/Mentor for new hires
  • Developed work instructions, letter templates and training guides to assist team members
  • Cross trained to obtain pricing from payers by negotiating Letters of Agreement/Single Case Agreements
  • Drafted and submitted pre-service appeals and post service claim appeals based off denial reason providing all pertinent documentation
  • Reviewed medical records and draft patient summaries to be used in appeals
  • Completed assigned projects timely and thoroughly
  • Aged A/R Resolution Project- Collaborate with Leadership and the Commercial Denials Specialists through once a week roundtable discussions to create and implement action plans to resolve problem accounts, involving 4 or more open dates of service
  • Unapplied Cash Spreadsheet-Update shared Excel spreadsheet with the current outstanding Unapplied Cash on a weekly basis and submitted to assigned Denials Specialists as well as the appropriate Leadership

Commercial Denials Specialist I

Novocure, Inc
05.2020 - 08.2022
  • Followed up on outstanding insurance balances via phone and Provider websites
  • Drafted and submitted post service claim appeals based off denial reason
  • Escalated delinquent accounts to the appropriate payers to collect outstanding balance
  • Initiated claim appeals to payers for erroneous reimbursement (Medical Necessity, UCR, Purchase Price, DME Max, etc.)
  • Worked with Billing to correct and resubmit electronically rejected claims within Change Healthcare
  • Identified and escalated payment issues in regards to payers to Leadership
  • Submitted adjustments and write offs accordingly, including recoupment/offset issues

Reimbursement Specialist

Novocure, Inc.
09.2019 - 05.2020

· Performed Benefit Investigations via Phone Calls and utilization of Online Provider portals

· Conducted initial and ongoing prior authorization requests

· Submitted Out of Network and Single Case Agreement requests

· Assisted with follow-up on pending approvals via phone or Provider Portals

· Reviewed medical records for required supporting documentation

· Streamlined the Benefit Investigation process on the Medicare Advantage and Managed Medicaid team by creating resource and job aid for frequent payers

Long Term Disability Case Manager

Sun Life Financial
08.2018 - 09.2019
  • Managed Long term disability claims by conducting a thorough review and investigation, determining what additional resources are appropriate to be utilized, and deciding initial and ongoing liability.
  • Gathered pertinent claim information, investigated, and decided disability claims by using telephone and written contact with applicable parties, (claimant, client, employer/supervisor, treating physician, etc.)
  • Demonstrated timely and effective utilization of claims support resources, vendors, and tools and understanding the role each plays in the management of claims.
  • Adjudicated claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards
  • Demonstrated mastery of the claims system effectively using online tools to organize, track, prioritize and refer work while maintaining integrity of claims data
  • Documented and communicated claim discussions and decisions

Liability Services Advocate

Advanced Patient Advocacy LLC
03.2015 - 12.2017
  • Worked on behalf of Dignity Healthcare to resolve complex aged Workers Compensation claim denials
  • Filed appeals for underpayments and denials.
  • Disputed claim underpayments
  • Reviewed claim payments against Federal and State Insurance regulations
  • Conducted negotiations with insurers and legal representation regarding medical payments
  • Worked as a U.S Department of Labor claims specialist and point of contact for multiple districts. Underwent claims training conducted by U.S Department of Labor Region 1
  • Performed role utilizing numerous electronic health record systems based on the hospital being worked
  • Investigated accident and insurance data, obtaining injury reports, police reports, medical records, and other documents required to facilitate successful claim resolution.
  • Conducted training for all temporary employees

Tax Exempt Representative II

Fidelity Investments
08.2011 - 10.2013
  • Obtained FINRA Series 6, 7 and, 63 (no longer sponsored)
  • Assisted clients with retirement guidance via the incoming calls in the Call Center (investment fund options, asset allocations, deferrals, reviewing plan health, etc.)
  • Submitted trades for the current markets close
  • Underwent Negotiations training conducted by Black Swan Group, LTD., a negotiation coaching firm
  • Underwent Customer Service training conducted by Disney World
  • Assisted in training process by peer guiding and floor walking to support onboarding new hires
  • Analyzed reports for Customer Experiences and coached peers for improvement

Education

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Hollis Brookline High School

Cross-training

-

RevOps Professional Development Program-May 2023

Accomplishments

Proficient in the following applications:

  • Microsoft, SAP, Emdeon/Change Healthcare, Epic, Cerner, Sorian, MediTech, MS4, NextGen, etc

Awards:

  • Tactical Excellence Award Q2 2022-obtaining reimbursement from complicated payers with balances previously submitted for write off and supporting team by assisting in the onboarding of new hires and ongoing training for current employees

Timeline

Commercial Denials Specialist II

Novocure, Inc
08.2022 - Current

Commercial Denials Specialist I

Novocure, Inc
05.2020 - 08.2022

Reimbursement Specialist

Novocure, Inc.
09.2019 - 05.2020

Long Term Disability Case Manager

Sun Life Financial
08.2018 - 09.2019

Liability Services Advocate

Advanced Patient Advocacy LLC
03.2015 - 12.2017

Tax Exempt Representative II

Fidelity Investments
08.2011 - 10.2013

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Hollis Brookline High School

Cross-training

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RevOps Professional Development Program-May 2023
Jenna Cockerham