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
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
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
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
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