Jennifer Pellegrin
Eaton
Summary
Results-driven business professional with over 15 years of expertise in healthcare ancillary services, specializing in reporting, accounts receivable programs, and auditing. Recognized for a dynamic approach to problem-solving and a strong ability to innovate processes that enhance operational efficiency. Committed to achieving organizational goals through strategic planning and effective collaboration. Proven track record of driving improvements that increase revenue and enhance service delivery.
Overview
18
18
years of professional experience
Work History
Billing Accounting Clerk II
Myriad Genetics Laboratories, Inc.
Mason, OH
12.2018 - Current
- Managed receipt and entry of insurance credit card payments into accounting system, maintaining comprehensive records for all business units.
- Conducted thorough verification of payments against outstanding balances in the system before finalizing postings.
- Analyzed and processed remittance error reports to eliminate obstacles in order fulfillment.
- Supported financial operations by processing and posting electronic fund transfer payments for all business units within company.
- Oversaw documentation of correspondence and detailed explanation of benefits from insurance providers concerning patient testing.
- Ensured compliance with all applicable state and federal regulations to uphold financial integrity and accountability.
- Provided strategic assistance to revenue cycle management teams to optimize workflow processes.
Customer Service Representative
Assurex Health, Inc.
Mason, OH
09.2017 - 12.2018
- Responded to inquiries related to patient statements, insurance billing, and financial assistance, ensuring clarity and resolution for callers.
- Reviewed and validated both electronic and manual patient orders to maintain operational efficiency and quality assurance.
- Conducted thorough manual audits of orders submitted by clients to ensure accuracy and compliance.
- Executed patient eligibility checks by leveraging provider web portals, IVR systems, and telephone interactions with payers to facilitate accurate billing processes.
- Facilitated resolution of intricate customer concerns to enhance satisfaction and maintain open lines of communication.
- Responded to customer inquiries to enhance satisfaction through precise information and tailored solutions.
File Maintenance Coordinator
Assurex Health, Inc.
Mason, OH
05.2015 - 12.2016
- Reviewed and confirmed accuracy of claim submission information for new insurance plans to facilitate proper integration within payer family systems.
- Executed and sustained Assurex credentialing for both new and existing commercial insurance, Medicare, and Medicaid, ensuring seamless integration and adherence to regulatory requirements.
- Optimized system configurations and maintained requirements to ensure accurate claims submission to insurance companies.
- Enhanced claim submission accuracy by 25% through comprehensive billing system analysis.
- Conducted comprehensive analysis for billing department regarding system and claim submissions.
- Facilitated communication with Xifin to troubleshoot and enhance claim submission and processing efficiency.
- Managed and processed enrollments for electronic remittance advices (ERAs) and electronic funds transfers (EFTs) to enhance operational efficiency.
Business Analyst I
Omnicare LLC
Cincinnati, OH
05.2014 - 05.2015
- Managed data processing and analysis of claims rejection reports through Access databases and SQL queries to identify trends and improve accuracy.
- Monitored user error trends and claims rejections, generating ad hoc reports for management review and strategic decision-making.
- Examined and clarified underlying reasons for errors, rejections, and reporting inconsistencies, ensuring comprehensive understanding.
- Engaged with management team in the field to design and produce necessary user-friendly reports.
- Facilitated efficient mass rebilling of claims to ensure accurate billing operations.
Patient Financial Services Specialist
Humana RightSource Specialty Pharmacy
Cincinnati, OH
02.2010 - 05.2014
- Engaged with foundations and manufacturers to streamline access to copayment assistance for specialty medications, ensuring alignment with patient diagnoses and treatment plans.
- Managed submission of direct billing reports and facilitated credit card payment processing for partner foundations.
- Managed and delivered on special projects from management to support strategic initiatives.
- Facilitated knowledge sharing as subject matter expert, enhancing departmental collaboration and external partnerships.
- Facilitated cash posting operations by supporting team with posting duties prior to larger team implementation.
- Facilitated coordination with cash posting team to ensure accurate adjustments and write-offs on patient accounts.
Medicare Consultant Exceptions Department
Walgreens Medicare Part B Support
West Chester, OH
05.2008 - 02.2010
- Assisted with creation of policies and procedures associated with business start-up for Medicare Part B Diabetic Supplies
- Assisted with system testing prior to implementation
- Obtained a basic knowledge of Medicare policies and requirements
Admissions and Reimbursement Specialist
Walgreens Specialty Pharmacy
West Chester, OH
12.2007 - 05.2008
- Verified major medical health insurance coverage, deductibles, out-of-pocket maximums, and patient copayment responsibilities for specialty medications
- Manually determined patient copayment responsibility based on benefits obtained
- Scheduled delivery of specialty medications with patient and coordinated shipment with mail order facility or for pick up at local Walgreens retail store
- Provided medical claims billing for Medicare, Medicaid, and commercial payers
Education
Bachelor of Science - Business Administration And Management
University of Cincinnati-Clermont College
Batavia, OH12.2013
Associates of Applied Science - Criminal Justice
University of Cincinnati-Clermont College
Batavia, OH06.2012
High School Diploma -
Northwest High School
Cincinnati, OH06.2001
Skills
- Financial processing expertise
- Billing document handling
- Office support services
- Clerical assistance
- Insurance expertise
- Medicare knowledge
- Healthcare operations knowledge
- Claims management
- Continuous process refinement
- Proficient in Microsoft Office
- HIPAA compliance knowledge
Accomplishments
- Recognized on Clermont College Dean’s List for four consecutive semesters
- University of Cincinnati Overall GPA 3.339, UC Clermont College GPA 3.614
- Recognized as top performer in quality assurance
Timeline
Billing Accounting Clerk II
Myriad Genetics Laboratories, Inc.
12.2018 - Current
Customer Service Representative
Assurex Health, Inc.
09.2017 - 12.2018
File Maintenance Coordinator
Assurex Health, Inc.
05.2015 - 12.2016
Business Analyst I
Omnicare LLC
05.2014 - 05.2015
Patient Financial Services Specialist
Humana RightSource Specialty Pharmacy
02.2010 - 05.2014
Medicare Consultant Exceptions Department
Walgreens Medicare Part B Support
05.2008 - 02.2010
Admissions and Reimbursement Specialist
Walgreens Specialty Pharmacy
12.2007 - 05.2008
Bachelor of Science - Business Administration And Management
University of Cincinnati-Clermont College
Associates of Applied Science - Criminal Justice
University of Cincinnati-Clermont College
High School Diploma -
Northwest High School