Jennifer Grammar
Medical Billing/Coding
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
30
30
years of professional experience
1
1
Certification
Work History
Office Manager for Billing and Coding Office
Advanced Medical Billing
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
04.2014 - 07.2019
- 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
05.2005 - 03.2014
- 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
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.
Medical Billing Specialist
Stone Oak Pediatrics
10.2001 - 01.2003
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Collected payments and applied to patient accounts.
Property & Casualty Insurance Licensed Agent/Adjuster
USAA
07.1998 - 01.2001
- 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
Some College (No Degree) - General Studies
San Antonio College
San Antonio, TXHigh School Diploma -
Boerne High School
Boerne, TX06-1990
Skills
- Office Manager and Team Leader
- Customer Service and Call Center
- Microsoft Office, Excel, Outlook
- Realmed, RIS, PACS, MBS, Greenway, Trizetto, Modernizing Medicine, Meditech, Athena, ADP, Eclinical
- Medical terminology knowledge and understanding
- Electronic Medical Record Software
- Medical coding understanding and application
- 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
Additional Information
I am currently enrolled and taking AAPC certified Billing and Coding courses in which I will complete and be certified within the next 3-4 months.
Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Work-life balanceWork from home optionCareer advancementTimeline
Office Manager for Billing and Coding Office
Advanced Medical Billing
08.2019 - 05.2024
Supply Management Team (order Processing)
Medtronic Diabetes
04.2014 - 07.2019
Billing Team Lead
Radiology Associates of San Antonio, PA
05.2005 - 03.2014
Benefit and Eligibility Associate
Benefit Planners
02.2003 - 05.2005
Medical Billing Specialist
Stone Oak Pediatrics
10.2001 - 01.2003
Property & Casualty Insurance Licensed Agent/Adjuster
USAA
07.1998 - 01.2001
Some College (No Degree) - General Studies
San Antonio College
High School Diploma -
Boerne High School
- Property and Casualty License in Texas (license has expired)
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