Jessica Eason

• Responsible for reviewing daily office notes and surgical procedures for accurate coding and adding/editing coding if needed to meet coding and billing guidelines.
• Responsible for posting payments from Insurance/Patients
• Responsible for reading EOB’s and correcting/appealing denials
• Follow up on claim status via Web portals or phone
• Accurately noting accounts when working a claim
• Posting EOB/Payments using DROPBOX, Zelis, Optum RPA, RCM Scans
• Responding to insurance for request of medical records or other needed information required
• Communicating with a team in bi-weekly meetings to ensure understanding of protocols and requirements and communicate trends

Worked on several different teams within Trinity to help where needed when my Workque was low. Knowledge of Professional Coding, Hospital Coding and Audit Review in several different specialties that include: Ortho, Dermatology, Cardiology, OBGYN, ENT and Infusions.

Hospital Billing and Professional Billing Denial Coding Team

• Responsible for reviewing all post-billed denials (inclusive of coding-related denials) for coding accuracy and appealing them based upon coding expertise and coding judgment within the Hospital and/or Medical group revenue operations ($3-5B NPR) of a Patient Business Services Center.
• Serves as part of a team of coding payment resolution colleagues at PBS location responsible for identifying and determining root causes of denials.
• Responsible for leveraging coding knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing of appeals as required by payers, in addition to promoting departmental awareness of coding best practices.
• Provide detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, and CPT -4 procedural codes for HCFA 1500 Professional Billing and UB-04 outpatient or inpatient claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations as directed by supervisors.
• Interprets data, draws conclusions, and reviews findings with all levels of payment resolution specialists for further review.
• Takes initiative to continuously learn all aspects of job
• Maintains a working knowledge of applicable Federal, State and local laws/regulations.
• Maintain high (above 95%) Atlas Productivity and Quality Scores

OUTPATIENT AUDIT Review Team

• Coordinating denials with the Patient Business Service (PBS) center and ensuring compliant clinical documentation.
• Responsible for correspondence from RAC/Insurance companies on Audit Denials/Recoupments
• Investigating denials and root causes through thorough chart reviews and providing education to clinical colleagues.
• Assisting with audits and identifying opportunities for revenue optimization.
• Performing retrospective charge reviews and Outpatient CDI reviews, as well as assisting with third-party charge audits.
• Responsible for leveraging coding knowledge and standard procedures to write appeals through first, second, and subsequent levels, and ensuring timely filing of appeals as required by payers, in addition to promoting departmental awareness of coding best practices.
• Personally Recovered $1,269,003.00 (2024), $529,014.00 (as of April 2025)

• Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
• Translated patient information into alphanumeric and numeric medical codes
• Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation protocols and third-party billing requirements.
• Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
• Read through patient health data, including histories, physician diagnoses and treatments to gain understanding for coding purposes.
• Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
• Communicated with healthcare personnel, including practitioners to promote accuracy
• Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural CPT codes.
• Assigned procedure and diagnoses codes for insurance billing using PrimeSuite and Intergy software.
• Interpreted medical reports to apply appropriate ICD-9 or ICD-10, CPT and HCPCS codes.
• Assigned additional diagnoses codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
• Reviewed account information to confirm patient and insurance information is accurate and complete
• Quickly responded to staff and client inquiries regarding coding questions.
• Sought clarification from physicians and other office/hospital personnel for answers needed for coding interpretations prior to abstracting records.
• Maintained high accuracy rate on daily production of completed reviews.

• Filed and submitted insurance claims.
• Reviewed received payments for accuracy and applied to intended patient accounts.
• Reviewed medical records to meet company requirements.
• Documented and filed patient data and medical records.
• Handled third-party insurance processing tasks to assist patients.
• Maintained up-to-date understanding of insurance payment practices.
• Assessed medical codes on patient records for accuracy.
• Expertly assigned charges and payments for medical procedures.
• Reconciled clinical notes, patient forms, and health information for compliance with HIPAA rules.
• Verified final claims submission by comparing account charges with documentation.
• Performed routine assurance audits to promote data integrity.
• Completed and submitted appeals for denied claims.
• Coordinated communications between patients, billing personnel and insurance carriers.

• Managed daily office operations for clinic, including scheduling staff, oversight of patient scheduling policy, hours of operation
• Oversaw digital patient charting, including data entry and administrative duties regarding insurance, billing and accounts receivable.
• Developed plans to streamline patient flows, increase office and patient care efficiency and generate new revenues.
• Liaised with patients, addressed inquiries, handled meeting requests and answered billing questions to provide outstanding patient care.
• Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
• Performed billing, collection and reporting functions for Orthopedic office generating over $1.1 million annually.
• Filed and submitted insurance claims.
• Reviewed received payments for accuracy and applied to intended patient accounts.
• Reviewed medical records to meet company requirements
• Documented and filed patient data and medical records.
• Handled third-party insurance processing tasks to assist patients.
• Maintained up-to-date understanding of insurance payment practices.
• Assessed medical codes on patient records for accuracy.
• Expertly assigned charges and payments for medical procedures.
• Reconciled clinical notes, patient forms, and health information for compliance with HIPAA rules.
• Verified final claims submission by comparing account charges with documentation
• Performed routine assurance audits to promote data integrity.
• Completed and submitted appeals for denied claims.
• Coordinated communications between patients, billing personnel and insurance carriers.
• Contacted insurance providers to verify insurance information and obtain billing authorization.
• Organized information for past-due accounts and transferred to collection agency