Jennifer Grammar
Boerne,TX
Summary
30 + years experience in various aspects of the insurance industry. Experience in Medical billing, coding, collections, appeals, payment posting, verification of benefits, obtaining pre-certifications.
Customer service in Medical, Property & Casualty and General Liability lines of business.
Leadership skills as a Team Leader and office manager for the last 10 years.
Knowledgeable of most commonly used software.
Customer Service and Call Center Skills
Insurance Communication
Cooperative Patient Care Representative well-educated in medical terminology, medical billing and medical coding. Highly skilled in greeting patients and addressing concerns. Hands-on experience explaining charges to patients and assisting each with finding the right financial assistance programs suitable for personal circumstances. Accurate, detailed and hardworking with solid judgment and decision-making abilities.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Medical Billing and Office Manager
Advanced Medical Billing
Boerne, TX
08.2019 - 05.2024
- Made all collection calls and oversaw all collection accounts that were placed with outside agency.
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Resolved complex issues associated with denied or underpaid claims through negotiation with payers.
- Reconciled payment discrepancies between provider statements and remittance advice from payers.
- Applied knowledge of coding systems such as CPT-4 and HCPCS codes for proper reimbursement.
- Supervised staff members, organized schedules and delegated tasks.
- Ordered supplies and equipment to maintain adequate inventory levels.
- Managed, scheduled and coordinated office functions and activities for employees.
Supply Management Team (order Processing)
Medtronic Diabetes
San Antonio, TX
04.2015 - 03.2019
- Accurately entered customer orders into company database system.
- Ensured accuracy of all customer order information prior to processing.
- Obtained authorization from insurance companies if one was required
- Educated patients and healthcare providers on our available products
- Maintained and exceeded our required quotas as set forth by our management.
- Provided customers with tracking numbers and estimated delivery dates.
- Assisted customers via telephone and email regarding their orders or inquiries.
- Analyzed customer feedback and data to identify trends and insights related to diabetes products.
- Provided technical advice and troubleshooting assistance for customers using diabetes products.
Billing Team Lead
Radiology Associates of San Antonio, PA
San Antonio, TX
05.2005 - 07.2010
- Team Leader of 7 other employees
- In the collections and follow up claims department
- Posting incoming Insurance Payments both electronically and manually
- Answering incoming calls on patient accounts
- Verified eligibility and authorizations with all major insurance carriers
- Conducted weekly meetings with billing staff to review performance, discuss challenges, and provide guidance.
- Medical History given to precertification nurses to begin pre-certifications and authorizations
- Monitored overtime and attendance records the employees assigned to my team.
- Submitted electronic claims to various insurance carriers.
- Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
Benefit and Eligibility Associate
Benefit Planners
Boerne, TX
02.2003 - 05.2005
- Answering inbound calls from members, providers, facilities and employers to verify eligibility, confirm benefits, verify network participation and answer questions on processed or denied claims
- Data Entry of Health Care spending account claims information.
- Assisted customers with questions regarding their eligibility status or benefit coverage.
- Worked closely with internal teams such as billing department, utilization management team., to resolve any issues related to benefit verifications.
- Adhered to HIPAA regulations when handling confidential patient information.
- Coordinated benefits processing, including enrollments, terminations and claims.
Property & Casualty Insurance Licensed Agent/Adjuster
USAA
San Antonio, TX
07.1998 - 01.2003
- Quoted, issued, adjusted and cancelled Homeowners, Auto, Boat and Personal Article Floater policies
- Intermediate auto claims adjuster with authority to resolve auto claims up to a limit of $50,000.00 in physical damage
- Assigned appraisers to inspect auto damage, acquire rental vehicles for members
- Evaluate claims file information, prepare and issue payment for all claims related expenses.
- Processed applications for new policies and renewals.
- Advised clients on the most suitable insurance products available.
- Communicated with clients to determine property needs and budget constraints.
- Facilitated closing processes between lender, mortgage companies, buyers and sellers.
- Drafted correspondence related to claim investigations and settlements.
Education
High School Diploma -
Boerne High School
Boerne, TX06-1990
Some College (No Degree) - General Studies
San Antonio College
San Antonio, TXSkills
- Customer Service and Call Center Skills
- Microsoft Office, Excel, Outlook
- Realmed, RIS, PACS, MBS, Greenway, Trizetto
- Medical terminology knowledge
- Electronic Medical Record Software
- Medical coding understanding
- Ten Key by Touch
- Multi Line Phone
- Verification and Authorizations with Insurance Co
- Insurance Communication
Certification
- Property and Casualty License in Texas (license has expired)
Accomplishments
- Employee of the Month several months with Medtronic and USAA
References
References available upon request.
Timeline
Medical Billing and Office Manager
Advanced Medical Billing
08.2019 - 05.2024
Supply Management Team (order Processing)
Medtronic Diabetes
04.2015 - 03.2019
Billing Team Lead
Radiology Associates of San Antonio, PA
05.2005 - 07.2010
Benefit and Eligibility Associate
Benefit Planners
02.2003 - 05.2005
Property & Casualty Insurance Licensed Agent/Adjuster
USAA
07.1998 - 01.2003
High School Diploma -
Boerne High School
Some College (No Degree) - General Studies
San Antonio College
- Property and Casualty License in Texas (license has expired)
Similar Profiles
Jennifer GrammarJennifer Grammar
Office Manager for Billing and Coding Office at Advanced Medical BillingOffice Manager for Billing and Coding Office at Advanced Medical Billing
Michelle BernierMichelle Bernier
Medical Coding and Billing Specialist at Advanced Medical Consulting & BillingMedical Coding and Billing Specialist at Advanced Medical Consulting & Billing
Melissa JohnsonMelissa Johnson
Certified Medical Coder at Advanced Billing ConsultantsCertified Medical Coder at Advanced Billing Consultants