JENNIFER M JONES
Summary
Management professional with over 10 years of experience and an extensive 18 years of knowledge in DMEPOS coverage guidelines and billing for Medicare, Medicaid, and commercial insurance. Proven ability to enhance team performance and customer satisfaction through effective people skills and continuous improvement. Seeking a challenging role as Store Manager 2 to leverage expertise in operations and team leadership.
Overview
19
19
years of professional experience
Work History
Referral Management Supervisor
Denman Services Inc.
Quincy
08.2018 - Current
- Supervised daily operations to ensure service quality and efficiency.
- Trained and mentored staff to improve skills and performance.
- Developed operational procedures to enhance workflow and productivity.
- Facilitated communication between departments for seamless operations.
- Evaluated employee performance and provided constructive feedback regularly.
- Resolved referral and customer concerns by delivering excellent customer service and maintaining a positive attitude.
- Researched and responded to customer and referral inquiries.
- Communicated status of assigned responsibilities to upper management.
- Scheduled team members in remote settings to facilitate appropriate coverage.
- Assisted with recruitment, interviewing and onboarding new employees.
- Identified process improvements that could be made in order to increase productivity and positive outcomes.
- Provided guidance and direction on complex accounts requiring multiple resources.
- Encouraged team-building activities to foster a positive work environment.
- Reviewed employee timesheets for accuracy prior to submitting payroll information.
- Collaborated with other departments to streamline processes and improve efficiency.
- Managed staff of 12 employees, ensuring adherence to company policies and procedures. 11 who work remotely and 1 in an office setting.
- Prepared weekly, monthly and quarterly reports summarizing departmental operations and progress against goals.
- Conducted performance reviews and coaching to enhance employee skills.
- Ensured compliance with all applicable laws and regulations related to employment practices.
- Analyzed denial data to identify areas of improvement in growth opportunity, knowledge and obtain positive future outcomes.
- Established key performance indicators for measuring success within the department.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Verified completed work for consistency, quality, and conformance to standards.
- Reviewed employee performance and provided ongoing feedback and coaching to drive performance improvement.
- Assigned work and monitored performance of project personnel.
- Hold regular one-on-one meetings with employees to review performance, priorities and provide feedback.
- Planned and led team meetings to review business results and communicate new and ongoing priorities.
- Planned and delivered training sessions to improve employee effectiveness and address areas of weakness.
- Organized team activities to build camaraderie and foster a pleasant workplace culture.
- Identified process improvements in the day-to-day functioning of the Monitored write-offs monthly and reported on the findings to educate staff and improve processes.
- Enhanced professional expertise through participation in training sessions and seminars. by attending webinars, seminars, training and workshops.
- Consistently comply with applicable laws and regulations and ensure facility adheres to Medicare and Medicaid regulations.
- Adhered to federal regulations to ensure organizational compliance and integrity., state and local requirements.
- Recommend new methods to improve internal controls and operating efficiency.
- Reviewed processes and implemented changes to enhance Referral Management Specialist workflows.
- Ensure HIPAA compliance.
- Continually improve knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Performed various clerical tasks, including data entry and document management. including copying, faxing and file management.
- Maintain a clean and organized area, including associated areas.
- Assist others when the Director of Reimbursement and/or Billing Supervisor is unavailable or out of the office.
Billing Auditor
Denman Medical Equipment & Supply
Quincy
01.2017 - Current
- Perform compliance and operational audits.
- Ensure compliance with established internal procedures by examining reports, processes, and documentation.
- Identified issues in audit processes and facilitated corrective actions to align business areas with guidelines and compliance standards.
- Investigate discrepancies that are discovered during the auditing process.
- Adhered to federal, state, and local regulations to ensure compliance across operations.
- Consistently comply with applicable laws and regulations and ensure facility adheres to Medicare and Medicaid regulations.
- Identify control gaps in processes, procedures and systems and bring these to the attention of management.
- Recommended methods to enhance internal controls and streamline operations.
- Prepare excel spreadsheets, reports and supporting documentation for audit findings.
- Improved existing audit process to evaluate thoroughness of documentation and maintenance of facility standards.
- Improved billing areas by reviewing processes and implementing targeted changes within workflows.
- Assist in developing, implementing, monitoring and maintaining the Revenue Cycle Worklist within Brightree to improve efficiency and workflow within the Billing department.
- Publish metrics to be incorporated into the monthly and quarterly scorecards.
- Enter and update external audit status in an auditing program to address risks and evaluate regulatory requirements in Cobius.
- Train and mentor new employees on multiple programs, procedures, compliance requirements and collection techniques.
- Maintain professional knowledge by attending webinars, seminars, training and workshops.
- Continually improve knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Executed clerical responsibilities, including copying documents, faxing communications, and organizing files.
- Maintain a clean and organized area, including associated areas.
- Receive, sort and distribute mail correspondence between departments and personnel.
- Oversaw team operations during the Director of Reimbursement's absence.
- Oversaw team operations during the Director of Reimbursement's absence.
Billing Clerk
Denman Medical Equipment & Supply
Quincy
01.2015 - 01.2017
- Monitored outstanding invoices and executed collections efforts, collaborating with customers to establish payment plans and bring accounts current.
- Executed billing tasks and recorded information in company databases.
- Performed account duties including invoicing, researching charges, discrepancies and reconciliations.
- Denial management process appeals to overturn claim denials. When leaving this position denials were posted today and processed tomorrow for Medicare, Medicaid, and Commercial insurances.
- Reviewed customer files to confirm medical necessity and ensure compliance with coverage criteria.
- Answered inquiries and addressed, resolved or escalated issues to management personnel to ensure patient satisfaction.
- Prior Authorization approvals for Medicaid programs for the state of Illinois and Missouri, along with Commercial insurances.
- Mailed monthly invoice statements to patients.
- Performed various clerical tasks, including copying documents, faxing important communications, and managing physical and digital files.
- Trained and mentor new employees on multiple programs, procedures, compliance requirements and collection techniques.
- Ensured HIPAA compliance.
- Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Comply with federal, state and local requirements.
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.
- Maintained professional knowledge by attending webinars, seminars, training and workshops.
- Maintained a clean and organized area, including associated areas.
Billing Supervisor
Denman Medical Equipment & Supply
Quincy
01.2011 - 01.2015
- Oversaw Medicare, Medicaid and Commercial insurance claim submission, Prior authorizations, Denial management, Aged revenue and Patient billing.
- Supervised and managed the daily activities of a billing team consisting of 3 staff members, plus myself.
- Reviewed documentation for compliance with requirements and accuracy of information.
- Coordinated with internal departments to resolve routine and complex issues, ensuring smooth operational flow.
- Performed account reconciliations and resolved variances.
- Developed and implemented billing process improvements, enhancing accuracy and reducing delinquency.
- Identified process improvements in the day-to-day functioning of the department.
- Reviewed customer survey data to identify and address areas for improvement.
- Implemented new assignments based on evaluation of staffing requirements and needs resulting from new business software. After Brightree software went live discussed with upper management the possibility of streamlining billing processes by workflow, rather than splitting job responsibilities by the alphabet and customers' last names, which was approved on a trial basis.
- Developed and achieved financial and growth goals.
- Strategically planned methods to achieve operational goals and targets.
- Processed monthly reports for department performance.
- Monitored write-offs monthly and reported on the findings to educate staff and improve processes.
- Educated staff on state and federal statutes, rules and regulations governing durable medical equipment and supply services.
- Performed job knowledge assessments, annual evaluations and implemented improvement plans when needed.
- Reviewed billing problems, researched issues and resolved concerns.
- Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.
- Trained and mentored new employees on multiple programs, procedures, compliance requirements and collection techniques.
- Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.
- Ensured compliance with federal, state, and local regulations in all operations.
- Monitored and enforced HIPAA standards to safeguard patient information.
- Performed clerical tasks such as copying, faxing, and organizing files.
- Kept work area and surrounding spaces clean and organized for efficiency.
Billing Clerk
Denman Medical Equipment & Supply
Quincy
02.2008 - 01.2011
- Executed billing tasks and accurately recorded information in company databases to ensure data integrity.
- Mailed monthly invoice statements to patients.
- Monitored outstanding invoices and performed collections duties. Worked with customers to develop payment plans and bring accounts current.
- Performed account duties including invoicing, researching charges, discrepancies and reconciliations.
- Denial management process appeals to overturn claim denials.
- Prior Authorization approvals for Medicaid programs for the state of Illinois and Missouri, along with Commercial insurances.
- Reviewed customer files to verify medical necessity and ensure adherence to coverage criteria, facilitating timely claim approvals.
- Addressed and resolved inquiries while escalating complex issues to management, enhancing patient satisfaction and streamlining communication.
- Clerical duties including copying, faxing and file management.
- Trained and mentored new employees on multiple programs, procedures, compliance requirements and collection techniques.
- Monitored processes to maintain HIPAA compliance in all patient interactions.
- Adhered to all federal, state, and local regulations in daily operations.
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.
- Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Maintained professional knowledge by attending webinars, seminars, training and workshops.
- Maintained a clean and organized area, including associated areas.
Temporary Worker
Denman Medical Equipment & Supply
Quincy
11.2007 - 02.2008
- Completed and submitted commercial insurance 1500 claim forms.
- Performed clerical duties such as copying, faxing, and file management to support operational efficiency.
- Organized and filed customers' billing data to streamline access and ensure accuracy.
- Ensured HIPAA compliance.
- Adhered to federal, state, and local requirements to maintain operational integrity.
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.
- Acquired knowledge of durable medical equipment and supplies through targeted webinars and training sessions.
- Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Maintained a clean and organized area, including associated areas.
Education
Associate of Arts - Business Administration
University of Phoenix
Tempe, AZ01-2015
High School Diploma -
Monroe City R-I High School
Monroe City, MO01-1994
High School Diploma -
Cholla Magnet High School
Tucson, AZSkills
- Referral management
- Prior Authorization
- Claim processing - submission to payment decision
- Durable Medical Equipment experience
- Certificate of Medical Necessity
- Documentation requirements for HME
- Regulations and Compliance
- Audit proficiency
- Operational procedures
- Process improvement
- Account management
- Report development
- Employee training and development
- Hiring, onboarding and training
- Performance evaluation
- Cross-departmental collaboration
- Critical thinking
- Problem-solving
- Time management
- Effective communication
Accomplishments
- Brightree Revenue Cycle Worklist Development Team
- ICARE Award
- Patient Navigator Team
Timeline
Referral Management Supervisor
Denman Services Inc.
08.2018 - Current
Billing Auditor
Denman Medical Equipment & Supply
01.2017 - Current
Billing Clerk
Denman Medical Equipment & Supply
01.2015 - 01.2017
Billing Supervisor
Denman Medical Equipment & Supply
01.2011 - 01.2015
Billing Clerk
Denman Medical Equipment & Supply
02.2008 - 01.2011
Temporary Worker
Denman Medical Equipment & Supply
11.2007 - 02.2008
Associate of Arts - Business Administration
University of Phoenix
High School Diploma -
Monroe City R-I High School
High School Diploma -
Cholla Magnet High School