Summary
Overview
Work History
Education
Skills
Affiliations
Accomplishments
Certification
Timeline
Generic

Jessica Byrd

Summary

Accomplished Medical Billing/Credentialing Specialist with expertise in insurance credentialing and claim submission management at Milestone Pediatrics. Proven track record in effective communication and conflict resolution, enhancing patient billing processes. Successfully reconciled payments, achieving a 95% accuracy rate. Adept at provider enrollment and documentation compliance, driving operational excellence and customer satisfaction.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Medical Billing/Credentialing Specialist

Milestone Pediatrics
Mesa, AZ
11.2023 - 12.2024
  • Manage insurance credentialing and ensure accurate claim submissions.
  • Ran CAQH, collected all documents needed for providers' CAQH/credentialing, after the onboarding process of providers.
  • Tracked credentialing/CAQH process, created spreadsheets to track process.
  • Track patient visits to ensure correct billing and generate invoices.
  • Monitor account balances and reconcile payments.
  • Receive and sort incoming payments, ensuring proper documentation.
  • Review/audit claim denials on Well Sky.
  • Fix authorization/Service codes on denials and resubmit to Well Sky.
  • Follow up with commercial insurance and or patients to resolve payment discrepancies.
  • Monitor providers' notes/medical records on Clinic Source.
  • Post payments onto Clinic Source, enter in deductible/co-insurance amounts/differences.

Patient Advocate

Elevate PFS
Gilbert, AZ
01.2021 - 09.2023
  • Assist self-pay/uninsured hospital and ER patients in applying for AHCCCS (Arizona Medicaid).
  • Provide education on AHCCCS, Medicare, ALTCS, and Disability services.
  • Certify and bill accounts with approved insurance coverage.
  • Follow up with patients on documentation and re-application requirements for AHCCCS, ALTCS, and Disability.
  • Contact AHCCCS, ALTCS, and Disability Services for resolutions for billing purposes.
  • Educate on/ suggest to patients other affordable insurance options, such as Marketplace if denied for AHCCCS/ALTCS.

BIS

Waterloo Community Schools
Waterloo, IA
08.2013 - 06.2021
  • Responsible for developing individual and family intervention plans to assist in the promotion of strong, cohesive family units.
  • Create environments encouraging the positive behaviors of students while in the classroom.
  • Responsible for communicating with teachers as well as parents on the success of their students.
  • Demonstrate positive behavior strategies to the student on how to remain calm in a stressful situation.
  • Collect and maintain accurate, updated student records.
  • Work with families and students on social issues, problem-solving, and effective communication.
  • Teach students zones of regulation, which assist in how to cope with feelings during times of frustration, anxiety, and anger.
  • Strong interpersonal skills with a demonstrated ability to work collaboratively within diverse groups, including peers, school administrators, faculty, staff, students, and parents.
  • Demonstrated knowledge of school programs, student success, and the school community, parental involvement in the community, and school settings.
  • Actively engage and participate in monthly professional development sessions to remain current on best practices when serving students and families.

Medical Billing Associate

Sunrise Internal Medicine
Queen Creek, AZ
08.2023
  • Performed CPT and ICD-10 coding for provider services.
  • Processed patient billing and insurance claim verification.
  • Checked in patients and facilitated rooming and referrals.
  • Scheduled patient appointments.
  • Resolution with patient insurance regarding billing discrepancies.

Education

Billing & Coding Certificate -

Pima Medical Institute
Mesa, AZ
09.2023

Associates of Arts - General Studies

Hawkeye Community College
Waterloo, IA
05.2011

Skills

  • Insurance credentialing
  • Claim submission management
  • CPT and ICD-10 coding
  • Payment reconciliation
  • Patient billing processes
  • Customer relationship management
  • Conflict resolution strategies
  • Effective communication
  • Documentation compliance
  • Provider enrollment
  • Insurance procedures
  • Credentialing documentation
  • Data management
  • Facility credentialing
  • Document review
  • Credentialing oversight
  • License verifications
  • Procedure compliance

Affiliations

  • Church launch Financial team
  • Director Of Children's Ministry
  • Nursing home Ministry
  • Outreach coordinator

Accomplishments

  • Early Bird Award through my employer
  • Retrived $350,000 of corrected insurance denials

Certification

  • Medical Billing and Coding Certificate, March 2023

Timeline

Medical Billing/Credentialing Specialist

Milestone Pediatrics
11.2023 - 12.2024

Medical Billing Associate

Sunrise Internal Medicine
08.2023

Patient Advocate

Elevate PFS
01.2021 - 09.2023

BIS

Waterloo Community Schools
08.2013 - 06.2021

Billing & Coding Certificate -

Pima Medical Institute

Associates of Arts - General Studies

Hawkeye Community College

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