Summary
Overview
Work History
Education
Skills
Key Qualifications
Timeline
Generic

Jennifer Jones

Piscataway

Summary

Revenue management professional prepared to drive success in this role. Proven track record in optimizing revenue cycles, improving financial performance, and implementing efficient processes. Strong focus on team collaboration and achieving results. Adept at adapting to changing needs and fostering reliable work environment. Skilled in financial analysis, strategic planning, and regulatory compliance with keen eye for improving operational efficiencies.

Overview

17
17
years of professional experience

Work History

Billing Department Manager

Carteret Comprehensive Medical Care
09.2018 - Current
  • Company Overview: Multispecialty practice that specializes in Pain management,orthopedic,chiropractic,physical therapy,occupational therapy,acupuncture and some primary care services.
  • responsible for overseeing and managing the entire revenue cycle process within a the organization, which includes everything from the initial patient encounter to the final payment. I ensure that we are properly billing for services provided, managing accounts receivable, and maximizing revenue while maintaining compliance with regulatory standards.
  • Ensure accurate coding for medical procedures, diagnoses, and services based on standards .
  • Supervise the claims submission process, ensuring that claims are submitted timely, accurately, and in compliance with insurance policies and government regulations.
  • Oversee patient billing, ensuring that statements are clear and patients understand their financial obligations. Includes handling patient inquiries related to their accounts.
  • Address and resolve claim denials, working with both the internal team and insurance companies to correct and resubmit claims for payment.
  • Identify areas where revenue can be maximized, whether through process improvements, payer contract negotiation, or reducing claim denials.
  • Track and manage outstanding accounts, ensuring timely follow-up and resolution of unpaid balances. Monitoring AR aging reports and taking appropriate actions to collect payments.
  • Interview staff for all positions, lead and train revenue cycle staff, such as billers, coders, and patient account representatives, ensuring they are following correct procedures and best practices.
  • Analyze financial data and generate reports on key performance indicators (KPIs) like days in accounts receivable, claim denial rates, and collections. Provide insights to improve operational efficiency.
  • create SOPs
  • manage outsourcing team


SR Medical biller and coder-Pediatric specialties and Primary Care

Saint Peters University Hospital
02.2018 - 12.2018
  • Finalize and enter charges for Pediatric Specialty providers such as Neurology, Cardiology, Nephrology, Endo, Neuro Science, Hematology, Behavioral health and primary care physicians participating as a hospitalist for SPUH
  • Refer to patient chart to complete charges and assure accuracy in coding level
  • Assure referring providers are being added to charges and that referrals are being obtained and entered for our NPI number prior to the DOS
  • Call ins on denied claims and trouble shoot any errors pertaining to the denial
  • Correct claims and submit proper documentation supporting coding
  • Enter facility charges corresponding with patients hospitalist visit
  • Finalize facility charges for new borns

Billing Manager/accounts

B.E.S.T Physical Therapy
09.2017 - 12.2018
  • Reconcile daily payments
  • Assist with controlling schedule
  • Pre auth checks for evals and VOB confirmations
  • Post money via ERA or cash
  • Manage front desk and its duties
  • Identify trends and billing errors
  • Educate the therapists on billing

Robert Wood Johnson Physician Enterprise
01.2017 - 01.2018
  • Oversee three individuals under the RCM department
  • Responsible for all deposits on a daily basis, ERA, ACH, onsite deposits, lock box deposits and all other patient payments via credit card and checks
  • Make sure daily deposit reconcile to what was received in the bank
  • Adjust patient accounts accordingly per self-pay and contractual agreements as well as resolve collection issues
  • Responding to Liaison and any other payment questions or issues as well as correcting accounts that were posted incorrectly
  • Obtaining incomplete EOB's and resolving payments that don't belong to our practices yet were received
  • Transfer claims to secondary ins or other responsible party once payments are posted
  • Assist with any projects as needed
  • Assist with monthly close in any way needed

Sr. Accounts Receivable Specialist/Team Lead

McKesson
09.2011 - 01.2017
  • Run daily cash reports for all departments
  • Oversee a group of 5 individuals
  • Assign workflow, projects and identify trends amongst team
  • Build and maintain client relationships
  • Attend training courses offered and participate in international training
  • Insurance follow-up to Medicare, Medicaid, HMO claims 120 accounts a day
  • Posting payments for all insurance such as Medicare, Medicaid, Hmo and Commercial
  • Customer Assistance with taking payments and resolving issues
  • Contact insurance and get denial reasons for claims that should have been processed, submit corrected claims within timely filing period
  • Resolve issues with claims that have been kicked back from the clearing house and not submitted to the ins for various reasons (ins id, last name, first name, gender and cpt code mismatch)
  • Handle all concerns from practice liaison as priority and assist with other projects as giving
  • Train new staff
  • Complete patient refunds and charity care payments

Distribution/payroll specialist

Paychex
10.2007 - 09.2011
  • Payroll specialist is responsible for a set of clients that are assigned by management
  • Daily responsibilities included contacting the clients to remind them of payroll deadlines especially around holidays or bank holidays
  • Efficiently and accurately assure all clients payroll are packaged neatly and together prior to being shipped to the client via fedex or UPS
  • Customer service calls occasionally, mostly from the client themselves requesting special or V.I.P requests
  • Accurately accommodate the client in any way by answering their special payroll requests
  • Maintain a business ethic and appearance for corporate policies

Education

Masters - Business Administration

Strayer University
Piscataway, NJ
07.2019

medical -

Everest medical institute
South Plainfield, NJ
05.2009

Skills

    Knowledge of Healthcare Billing and Coding Claims Management and Denial Resolution
    Accounts Receivable (AR) Management

    Data Analysis and Reporting

    Regulatory Compliance
    Problem-Solving and Critical Thinking
    Communication Skills
    Time Management and Organizational Skills

    Technology Proficiency
    Customer Service Skills
    Negotiation Skills

    excel

    multiple EHR systems

  • Epic
  • IDX
  • RMS
  • RAMS
  • LMR
  • BICS
  • Navinet
  • Epaces
  • Bluelinks
  • Allscripts
  • MMIS
  • Paragon
  • Athena net
  • Onesource
  • Codecorrect
  • Web PT

Key Qualifications

  • Bachelor's Degree business management with health care administration concentration
  • 13 years office/corporate experience industry awareness
  • 3 years in managerial role
  • 10 years medical insurance billing and coding experience
  • Lateral leadership skills
  • Compatible personality
  • Positive attitude
  • Outstanding organizational skills and the ability to handle multiple projects simultaneously while meeting deadlines
  • Proficient with Microsoft Word, Microsoft Outlook, Microsoft PowerPoint and Microsoft Excel
  • Web and tech savvy, require little to no training
  • HIPAA/OSHA Certified
  • Microsoft Excel- Pivot Tables, Spreadsheets, Line Graphs, VLOOKUP
  • Different Databases- Epic, IDX, RMS, RAMS, LMR, BICS, Navinet, Epaces, Bluelinks, Connex, Navinet, Allscripts, MMIS, Paragon, Athena Net, Onesource, Codecorrect, Web PT

Timeline

Billing Department Manager

Carteret Comprehensive Medical Care
09.2018 - Current

SR Medical biller and coder-Pediatric specialties and Primary Care

Saint Peters University Hospital
02.2018 - 12.2018

Billing Manager/accounts

B.E.S.T Physical Therapy
09.2017 - 12.2018

Robert Wood Johnson Physician Enterprise
01.2017 - 01.2018

Sr. Accounts Receivable Specialist/Team Lead

McKesson
09.2011 - 01.2017

Distribution/payroll specialist

Paychex
10.2007 - 09.2011

medical -

Everest medical institute

Masters - Business Administration

Strayer University

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Jennifer Jones