Jessy M King
Belleville,MI
Summary
Experienced, professional Revenue Cycle Manager, Intake Manager, Medical Biller & Coder with over 10+ years’ experience in the medical field. Seeking to use my extensive skill set and knowledge base to be a benefit to your company. A leader with values and attributes to show compassion, exhibit resilience with sound judgment in front-end revenue cycle management and appeal management. Skilled in building quality partnerships that involve shareholders in understanding any issues, identifying advanced resolutions and best practice claims and appeal management.
Overview
15
15
years of professional experience
Work History
Senior Revenue Cycle Manager
Strata Oncology
Ann Arbor, MI
12.2021 - Current
- Oversaw team members responsible for claim billing, insurance verification, prior authorization, payer and patient collections, payment posting, appeals, financial assistance program and partnership with other department managers
- Implemented new procedures to streamline billing process and improve accuracy of claims.
- Established key performance indicators for monitoring progress against goals.
- Ensured compliance with all applicable CLIA, CAP and HIPAA regulations, applicable laws and regulations relating to documentation, coding, billing and interactions with HCPs and payers.
- Developed and implemented billing procedures to ensure accurate and timely payment of claims.
- Resolved complex billing issues in a timely manner.
- Analyzed trends in denials, rejections, underpayments., to improve reimbursement rates.
- Oversee the ongoing implementation of the new billing system, and training of team members.
- Built, executed, and oversaw workflow for prior authorization process in coornation with vendors and team members.
Intake Manager
Complete Infusion Services
Livonia, MI
10.2020 - 11.2021
- Directed the intake process by supervising eligibility, authorization, changes in orders, negotiated rates, financial obligation documents and all necessary payor information for all services rendered by the company.
- Managed Intake Reps, both acute and chronic, in performance of their duties ensuring proper training and customer service levels are met, auditing quality of work performed by staff, and ensuring operational flow of department is optimal, monitoring of customer service via telephone calls, fax, email and internet access to improve service and outcomes.
- Collaborated with third party payer administrators, Contract Management Group and Business Development staff on contract issues. Submitted information to Contract Management and Business Development staff regarding contract issues as they affect revenue and sales. Notified appropriate staff of changes in contract arrangements or updates in third party payer guidelines.
- Participated in overall management of location by meeting with General Manager and other department managers to review operations, discuss and formulate resolutions to outstanding issues while maintaining and fostering an atmosphere of cooperation between departments
- Performed management duties including hiring, evaluating, training, development and disciplining of staff.
Intake Coordinator/Supervisor
Complete Infusion Services
Livonia, MI
09.2010 - 08.2020
- Initiated intake process, gathers relevant data from referral sources and completes intake paperwork. Notifies clinical departments of new referral and coordinates information between referral source and clinicians. Provides the necessary intake paperwork to clinical departments.
- Verified insurance eligibility and benefits. Obtains authorization for services and or predetermination of benefits. Confirmed that services to be provided by company are a covered benefit under patient insurance. Determined patient's out of pocket expense for services provided.
- Completed start of care paperwork, Financial Obligation Form, Medicare/Medicaid forms as needed. Contacted patient's prior to start of care to confirm information, notification of financial obligation and arrange any requests for payments.
- Answered telephone utilizing appropriate etiquette and speaks with general public, referral sources, payors, clinician's, patients and their families.
- Provided information and resources to individuals, families, and groups seeking assistance.
- Ensured compliance with relevant regulations pertaining to the provision of services.
- Delegated work to staff, setting priorities and goals.
- Resolved customer/patient complaints or answered customers'/patients' questions.
Reimbursement Representative
Complete Infusion Services
Livonia, MI
08.2008 - 04.2010
- Assured billing processes are compliant with payer requirement for Government, Commercial Health Plans and Medical Group payers. Assures accurate billing of coding and units required by payer and therapy type. Ensured revenue is booked according to appropriate contract allowables.
- Ensured accuracy and completeness of payer requirements prior to timely submission of claims to Health Plans, either electronic or hard copy.
- Reviewed and assured claims are processed and paid in full according to contractual agreements. Commercial Health Plans and Medical Group payers. Analyze and rectify claims issues with payers by timely follow up of claim status/payment
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
- Submitted electronic claims to various insurance carriers.
- Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Performed daily reconciliation of accounts receivable with payment postings on the computer system.
- Collaborated with managers to develop strategies for improving revenue cycle processes.
Pharmacy Lab Technician
Complete Infusion Services
Livonia, MI
08.2010 - 08.2014
- Prescription/order data entry, generate prescription labels, compounding documents and delivery slips under the direct supervision of a pharmacist.
- Compouns and otherwise prepares pharmaceuticals, supplies and equipment under the direct supervision of a pharmacist as allowed by state and federal law and in accordance with USP 797, company policies and accrediting entity standards.
- Clean, test, maintain and track pumps and other infusion equipment as requested. Ensured the clean room suites and related equipment are cleaned and maintained per organizational policy and procedure, USP 797, USP 800 and state and federal regulations.
Education
Associate of Arts - Medical Billing And Coding Certification
Schoolcraft College
Livonia, MI12.2010
BBA - Health Administration
Davenport University
LivoniaSkills
- Revenue Metrics Analysis
- Procedure Optimization
- Billing Cycle Performance
- Account Monitoring
- Team Building Leadership
- Employee Training Oversight
- CPT Coding, ICD-9 & ICD-10, and Medical Terminology,
- Insurance Verification, Prior Authorization, Reimbursement and Collections
- Medical Billing and Coding
- Medical Records and EMR systems
- HIPPA Regulations
- Medicare/Medicaid Reimbursement
- Microsoft Office suite
- EPIC
- Covermymeds, NovaLogics, Carelon (formally AIM), Careviso (Formally CMT) ,Avality, Waystar
References
References available upon request.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Quote
The way to get started is to quit talking and begin doing.
Walt Disney
Timeline
Senior Revenue Cycle Manager
Strata Oncology
12.2021 - Current
Intake Manager
Complete Infusion Services
10.2020 - 11.2021
Intake Coordinator/Supervisor
Complete Infusion Services
09.2010 - 08.2020
Pharmacy Lab Technician
Complete Infusion Services
08.2010 - 08.2014
Reimbursement Representative
Complete Infusion Services
08.2008 - 04.2010
Associate of Arts - Medical Billing And Coding Certification
Schoolcraft College
BBA - Health Administration
Davenport University
Similar Profiles
Mimi PolycarpMimi Polycarp
Clinical Research Associate II at Strata OncologyClinical Research Associate II at Strata Oncology
Shabnam SayedShabnam Sayed
Accountant at M/s. Infinity Strata Management LLC formerly known as M/s. PLACE Strata Management LLC, Owners Association - DAMACAccountant at M/s. Infinity Strata Management LLC formerly known as M/s. PLACE Strata Management LLC, Owners Association - DAMAC
Mary Ann GamboaMary Ann Gamboa
Patient Services Coordinator at US Oncology Network - Virginia Oncology AssociatesPatient Services Coordinator at US Oncology Network - Virginia Oncology Associates
Rebecca OverholtRebecca Overholt
Patient Services Intermediate-Heart Catheterization Scheduler at Michigan MedicinePatient Services Intermediate-Heart Catheterization Scheduler at Michigan Medicine
Gianna RodriguezGianna Rodriguez
Salon Receptionist at Tricho Salon and SpaSalon Receptionist at Tricho Salon and Spa