Communication tools/Operating system Windows and Mac OS
Jessica Bomberry
Medical Billing And Coding Specialist
Carmichael,CA
Summary
Results-driven Data Entry Clerk and Medical Claims Analyst with six years of experience. Strong background in error detection and correction.
I have been one of the top producers in the Invoice Department with HealthNet Federal. Scored 100% on Audits in 2016 and trained new employees.
Computer skills and knowledge:
Word, Excel, Power Point, Access, Outlook, Quantum Choice, NPPES, OMNI, Burgess, PC3 Tracker, Fieldglass, DOMA, ABS, PEGA, CenPas, Macess, CBI, Image Operator Console, KDE, Error Box File, Surge and EMedys, ICD-9-CM/PCs, ICD-10-CM/PCS, Medical Terminology, Authorizations, EOB and HIPAA Trained.
Overview
6
6
years of professional experience
4
4
years of post-secondary education
1
1
Language
Work History
Benefit Coordinator/Medical Claims Processor
Healthcare Support Staffing/United Health
Carmichael, CA
08.2021 - 11.2021
- Remote Desktop
- Install benefits to ensure claims are paid and benefits are quoted to members.
- Analyzing benefit documents.
- Building benefits in systems.
- Auditing own work, work of others.
- Respond to inquiries regarding data .
- Tracking received data and source documents.
- Designed, evaluated and modified benefits policies to keep programs current, competitive and in compliance with legal requirements
- Carried out day-day-day duties accurately and efficiently
- Demonstrated respect, friendliness and willingness to help wherever needed
- Used Microsoft Word and other software tools to create documents and other communications
Data Entry Specialist/ Image Operator
Aerotek/DXC Technology/Gainwell
Rancho Cordova, CA
11.2020 - 08.2021
- Data Entered patient information onto professional and or institutional claims.
- Line of business Medicare and Medical claims processed and data entered.
- Worked in mailroom; prepping incoming mail, scan, print and store in Mail room.
- Image Operator Clerk-Monitored operational status of ATAR process, review all rejected fax files from this process, and to initiate provider education on ATAR process.
- Responsibilities for IOC were monitoring operational status of ATAR FAX servers including daily reporting.
- Inbound Processing- Reviewed and processed rejected inbound TAR attachments received via fax, mail or direct upload.
- Outbound Processing- procedures for reviewing and processing rejected Outbound client responses to providers on TARs.
- Adjudication Response Reprint Request- procedures for sending out TAR Response Faxes at program provider's request.
- Entered numerical data into databases with speed and accuracy using 10-key pad
- Compiled data and reviewed information for accuracy prior to input
- Reviewed and updated client correspondence files and database information to maintain accurate records
- Managed workflow scheduling, data entry and accuracy verification for large data projects
- Kept optimal quality levels to prevent critical errors and support team performance targets
- Documents completed work in appropriate logbooks
- Supported multiple departments with special projects
- Outlined appropriate processes and procedures to fulfill and complete inquiries
- Identified data entry errors and reported to necessary departments
- Corrected data entry errors to prevent later issues such as duplication or data degradation
- Reviewed completed work for compliance with regulations
- Completed data entry tasks with accuracy and efficiency
Claims Analyst
Health Net, Centene
Gold River, CA
02.2018 - 11.2020
- Process Health Insurance claims for any individual or families.
- Line of business processed were PPO and HMO.
- Resolved claims issues in timely manner.
- Made sure claims were completed on time and had no errors.
- Process Institutional and Professional claims including Adjustment, Recoupment and stranded claims.
- Priced claims through Burgess.
Claims Examiner
HealthNet Federal Services
Rancho Cordova, CA
09.2016 - 02.2018
- Process institution and professional Veteran claims.
- Audit others work.
- Approve, Deny and escalate claims to its correct department.
- Complete claims in timely manner.
- Work on special projects which were claims that were stranded or on hold for too long.
- Complete online course trainings.
- Assisted with Appeals and Grievances
Claim Examiner/Invoicer
Kelly Services/HealthNet Federal Services
Rancho Cordova, CA
07.2015 - 09.2016
- Processing Health Insurance Veteran claims.
- Processing Appeals, Recoupment and Adjusted claims that are stranded or rejected.
- Approve, Deny or pend (escalate) Facility (Institutional) and Professional claims.
- Completed about 150-200 Invoices day.
- Trained and audit Invoicers work.
Education
Diploma - Medical Billing And Coding Specialist
MTI College
Sacramento, CA 08.2013 - 04.2015
High School Diploma -
Foothill High School
Sacramento, CA 09.2003 - 06.2006
Skills
Excel formulas
Software
Spreadsheets
Timeline
Benefit Coordinator/Medical Claims Processor
Healthcare Support Staffing/United Health
08.2021 - 11.2021
Data Entry Specialist/ Image Operator
Aerotek/DXC Technology/Gainwell
11.2020 - 08.2021
Claims Analyst
Health Net, Centene
02.2018 - 11.2020
Claims Examiner
HealthNet Federal Services
09.2016 - 02.2018
Claim Examiner/Invoicer
Kelly Services/HealthNet Federal Services
07.2015 - 09.2016
Diploma - Medical Billing And Coding Specialist
MTI College
08.2013 - 04.2015
High School Diploma -
Foothill High School
09.2003 - 06.2006
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