JESSIE FORBUS
Opelika
Summary
Highly skilled Claims Analyst Specialist, Patient Access Specialist II, and prior United States Air Force Senior Airman. Versatile and skilled in insurance and customer service, offering 10+ years of related experience. Looking for a challenging new position with the opportunity to make a positive impact on facility operations and every day lives by applying advanced knowledge and abilities. Well-versed in insurance regulations, terminology, and best practices. Able to handle a high volume of work in fast-paced environments.
Overview
11
11
years of professional experience
Work History
Claims Analyst Specialist
East Alabama Medical Center
02.2022 - Current
- Analyzed, processed, and filed claims to ensure settlements were made according to company practices and procedures
- Verified policies and contracts in regards to correct rates and fee schedules
- Provided effective customer service to communicate claims decisions and technical information directly to internal and external customers
- Served as subject-matter expert on billing, eligibility, and claims
- Developed strong relationships with insurance agents, communicating effectively to reprocess errored and underpaid claims
- Proofread and verified refund requests for correct payment to providers, patients, and insurance companies
- Effectively filed and processed appeals, disputes, and reconsiderations to ensure full reimbursement of coverage’s allowed amounts
Lead Patient Access Specialist II - Access Charge
Monument Health
08.2019 - 09.2021
- Applied strong leadership talents and problem-solving skills to20+ team members to maintain team efficiency and organize workflows
- Created employee schedules and delegated responsibilities to effectively balance department workload and process improvement
- Trained and mentored new hires, resulting in stronger staff development and increased productivity
- Performed patient pre-admission, admission, transfer and discharge activities
- Obtained patient's insurance information and determine eligibility for benefits for specific services to be rendered
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment
- Performed patient scheduling and registration functions to serve as initial contact point for medical office and hospital visits
- Determined patient financial needs and referred eligible patients to proper county, state, or federal agencies to obtain financial assistance
Senior Airman - Aerospace Medicine
U.S. Air Force
07.2014 - 09.2018
- Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus
- Prepared and administered medications to alleviate patient symptoms
- Directed patients to exam rooms, fielded questions and prepared for physician examinations
- Prepared blood, urine, stool and sputum lab specimens for diagnostic evaluation
- Assessed situation severity of emergent medical incidents and provided care accordingly
- Executed well-informed critical decision making in high-pressure situations
- Assisted with routine checks and diagnostic testing by collecting and processing specimens
- Managed quality assurance program, including on-site evaluations, internal audits and patient surveys
Education
Community College of the Air Force
Montgomery, ALHigh School Diploma - undefined
Spring Lake Park Senior High School
Spring Lake Park, MN01.2014
Skills
- Military Treatment Facility (MTF) Expertise
- Patient Registration
- Insurance and Billing
- Medical Records/Sensitive Information Management
- Patient and Family Advocacy
- Program Management
- Claim Investigation and Processing
- Staff Management
- Medical Emergency Response
Certifications/Accomplishments
- NAHAM Certified Healthcare Access Associate
- Aerospace Medical Service and Corpsman Program
- Emergency Medical Technician - Basic
- Mental Health Technician
- Unit Safety Representative
- Advanced Cardiovascular Life Support
- Peer Advocate for Sexual Assault Prevention & Response Program
- Professional Enhancement Course
- Green Belt Academics Course
- 2 Air Force Achievement Medals (First Oak Leaf Cluster)
- Military Secret Security Clearance
Timeline
Claims Analyst Specialist
East Alabama Medical Center
02.2022 - Current
Lead Patient Access Specialist II - Access Charge
Monument Health
08.2019 - 09.2021
Senior Airman - Aerospace Medicine
U.S. Air Force
07.2014 - 09.2018
High School Diploma - undefined
Spring Lake Park Senior High School
Community College of the Air Force
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