Jessica Ledezma
Fort Worth,TX
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
I am very goal oriented and a quick learner. I have over 20 years of experience in dealing with medical insurances.
Overview
13
13
years of professional experience
Work History
AR Specialist
Ventra Health
1400 International Plaza Suite 800 (Hybrid)
03.2018 - Current
- Researched and resolved customer claims related to shortages, discount violations, and returns.
- Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Managed monthly reconciliation schedules for assigned accounts.
- Performed targeted collections on past due accounts aged over 120 days.
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
- Developed and maintained positive relationships with clients to maximize collections.
- Reconciled accounts receivable ledger to verify payments and resolve variances.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Chased insurance companies to achieve accurate and timely payments.
- Monitored and updated claims status in claims processing system.
- Responded to correspondence from insurance companies.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Managed large volume of medical claims on daily basis.
Medical Biller, Accounts Receivable
Dr Qasim
4819 River Oaks (On-Site)
11.2016 - 03.2018
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Posted payments and collections on regular basis.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
- Followed up overdue payments and payment plans from clients to establish good cash flow.
- Submitted cash and check deposits and generated cash receipts to record money received.
Medical Billing and Collections Specialist
Dr Mosley OBGYN
1001 N Waldrop SR Ste 402
01.2011 - 10.2016
- Compiled and tracked outstanding balances owed to medical facilities.
- Processed billing calls and answered questions from patients and third-party carriers.
- Corrected, completed and processed claims for multiple payer codes.
- Processed online and paper appeal submissions and refund requests.
- Monitored outstanding invoices and performed collections duties.
- Responded to customer concerns and questions on daily basis.
- Assisted in reconciling deposit and patient collections.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Sent daily case confirmations and checked with leadership on daily basis to make emergency changes and routine schedule updates.
- Coded correct procedures for physician and billing purposes.
- Contacted insurance companies to obtain authorizations and gathered all related medical records.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Expertly managed planning, scheduling, and coordination of outpatient procedures.
Education
Associate of Science - Nursing
Tarrant County College District
Fort Worth, TXHigh School Diploma -
North Side High School
Fort Worth, TX05.1992
Skills
- Process Improvement
- Filing Appeals
- Customer Service Support
- Generally Accepted Accounting Principles
- Month-End Closing Procedures
- Data Imports
- Word Processing
- Audit Procedures
- Credit and Collections
- Dispute Resolution
- Payments Posting
- Claim Processing
- Organization and Time Management
- Teambuilding
Languages
Spanish
Native or Bilingual
Timeline
AR Specialist
Ventra Health
03.2018 - Current
Medical Biller, Accounts Receivable
Dr Qasim
11.2016 - 03.2018
Medical Billing and Collections Specialist
Dr Mosley OBGYN
01.2011 - 10.2016
Associate of Science - Nursing
Tarrant County College District
High School Diploma -
North Side High School