Jessica L. Bates
Tyler
Summary
Highly analytical with a keen eye for detail, possesses the skills to navigate complex claims procedures with ease. Extensive experience in processing and verifying medical claims, well-versed in the rules and coding schemes that govern the healthcare industry. Ability to effectively address claims concerns stems from a comprehensive understanding of medical benefits and a commitment to ensuring accurate and timely payment. Builds strong connections with both patients and providers, motivated by the desire to guarantee precise and prompt reimbursement for medical services. Skilled in processing for many programs such as: Orencia, Eylea, Xeomin, Omidira, and more.
Overview
12
12
years of professional experience
Work History
Claims Analyst
Cencora
10.2022 - Current
- Maintained strict confidentiality with all personal data as per company guidelines.
- Interacted with clients and employees, which helped cultivate positive working relationships.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Examined claims forms and other records to determine insurance coverage.
- Ensuring accurate and efficient processing of transactions
- Investigating and resolving customer-related claims
- Reviewed provider coding information to report services and verify correctness.
- Paid or denied medical claims based upon established claims processing criteria.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, procedures, and HIPAA regulations.
- Managed a large volume of medical claims on a daily basis.
- Verified patient insurance coverage and benefits for medical claims.
- Posted payments to accounts and maintained records.
Benefits Verification Specialist
Cencora
11.2021 - 10.2022
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Updated patient records with accurate, current insurance policy information.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
Criminal Justice and Entrepreneur Teacher
North Forney High School
07.2018 - 05.2020
- Introduce students to professions in law enforcement, protective services, corrections, firefighting, and emergency management services.
- Teach students to understand basic functions of criminal investigations and procedures.
- Teach students how to collect fingerprints, evidence collection, courtroom presentations, crime scene processing, by research and a simulated crime scene
Probation Officer II
Arkansas Community Correction
08.2013 - 01.2017
- Monitor the phone system
- Monitor incoming and outgoing emails
- Serve warrants/make arrests
- Maintain files and keep them current
- Supervise offenders
- Counsel offenders
- Conduct investigations
Office Assistant
Sears
03.2013 - 08.2013
- Prepared daily deposit for store
- Provide exceptional professional and friendly customer service communication over the phone.
- Sent out emails and mail announcements
- Checked for accuracy of nightly Point-of-sale drawers
- File paperwork
Education
Bachelor of Arts - Criminal Justice
University of Arkansas At Pine Bluff
Pine Bluff, AR05.2013
Certified Billing and Coding Specialist - Medical Billing And Coding
Ashworth College
05-2021
Master of Science - Healthcare Administration
University of Arizona Global Campus
Chandler, AZ06-2025
Skills
- Claims analysis
- Proficient in Microsoft Word, Excel, Spreadsheet, TEAMS, Fusion, Renegeron, NextGen
- Interpersonal and written communication
- Workload prioritization
- Multitasking Abilities
- Verify data
- Problem-solving aptitude
- Coaching and mentoring
- Computer skills
- Adaptability and flexibility
- Teamwork and collaboration
- Problem-solving
Timeline
Claims Analyst
Cencora
10.2022 - Current
Benefits Verification Specialist
Cencora
11.2021 - 10.2022
Criminal Justice and Entrepreneur Teacher
North Forney High School
07.2018 - 05.2020
Probation Officer II
Arkansas Community Correction
08.2013 - 01.2017
Office Assistant
Sears
03.2013 - 08.2013
Bachelor of Arts - Criminal Justice
University of Arkansas At Pine Bluff
Certified Billing and Coding Specialist - Medical Billing And Coding
Ashworth College
Master of Science - Healthcare Administration
University of Arizona Global Campus
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