JILL BOLEN
Mount Gilead,OH
Summary
I am a driven and trained individual that has worked in multiple fields which include retail, insurance, self employed, customer service, training, ROI records, and auditing. I am an analytical thinker and innovative problem solver, driven, honest, dependable, and a hard working individual. My previous career history I have over 25 years in the field of insurance where I was a high lever producer who exceeded quality requirements, communicated through verbal and written correspondence, investigate personal and medical documentation, trained and created training material for new hires. I am self-motivated and customer-focused.
Experienced with managing health information systems and enhancing data accuracy. Utilizes strong analytical skills to ensure compliance with healthcare regulations and improve data management processes. Knowledge of EHR systems and data privacy laws, ensuring efficient and secure patient record handling.
Overview
34
34
years of professional experience
Work History
Health Information Specialist
Datavant. Health
Columbus, OH
02.2018 - Current
- Receive and process requests for patient health information in accordance with Company and Facility policies and procedures.
- Maintain confidentiality and security with all privileged information.
- Maintain working knowledge of Company and facility software.
- Adhere to the Company's and Customer facilities Code of Conduct and policies.
- Inform manager of work, site difficulties, and/or fluctuating volumes.
- Assist with additional work duties or responsibilities as evident or required.
- Consistent application of medical privacy regulations to guard against unauthorized disclosure.
- Responsible for managing patient health records.
- Responsible for safeguarding patient records and ensuring compliance with HIPAA standards.
- Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record.
- Ensures medical records are assembled in standard order and are accurate and complete.
- Creates digital images of paperwork to be stored in the electronic medical record.
- Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately.
- Answering of inbound/outbound calls.
- May assist with patient walk-ins.
- May assist with administrative duties such as handling faxes, opening mail, and data entry.
- Must meet productivity expectations as outlined at specific site.
- Telecommute/remotely
- Managed health information systems to ensure data integrity and compliance with regulations.
- Developed training materials for staff on health information management best practices.
- Analyzed health data for accuracy, identifying discrepancies and implementing corrective actions.
- Streamlined the release of information process for patients, ensuring timely access to their medical records while maintaining strict confidentiality.
- Improved patient data accuracy by meticulously reviewing and updating electronic health records.
- Troubleshot and contacted appropriate areas during system inoperability to reduce downtime.
- Ensured compliance with HIPAA regulations by conducting regular staff training sessions and implementing privacy policies within the organization.
Self Employed
Bolen Graphics
Columbus, OH
06.2017 - Current
- Designed graphics and produced vinyl decals for sale.
- Set up, designed and maintained the company website.
- Maintained and help grow the companies social media platforms.
- Wrote and researched information for blog for company website.
- Manage and maintained photographs and design for all company online platforms which also included logo.
- Problem solved all issues from design to customer satisfaction.
- Telecommute/remotely
Senior Redetermination Specialist
Palmetto GBA LLC
Columbia, SC
02.1997 - 09.2017
- With 20 years of experience I was trained and trained others in all aspects of the redetermination specialist responsibilities.
- I was an asset to the internal customers by backing up and handling day to day processes by reducing pending and executing high quality standards.
- Maintained up-to-date knowledge of Medicare guidelines, policies, and terminology.
- Obtained relevant evidence and information regarding suspicious claims.
- In charge of collection of information, building and researching case files to send on to the Reconsideration department.
- Trained and audited new hires.
- Trained all aspects of Medicare to add my knowledge and expertise to reduce appeals, calls, and reduce errors.
- Closed an average of 80 appeals per day, excelled at production and quality.
- Identified and collected evidence and determined its value to a specific claim.
- Reviewed data to verify the validity of claims.
- Completed required investigations on referred files in a timely manner.
- Kept up-to-date on changes in regulations for deductibles and collections.
- Communicated with insured individuals to explain audit classifications and computations.
- Home office Columbia, SC (worked at home in Ohio)
Medical Claims Processor
RE. Harrington
Columbus, OH
06.1992 - 02.1997
- Reduced loss ratios through fair and prompt processing of claims.
- Obtained relevant evidence and information regarding suspicious claims.
- Investigated any potentially fraudulent claims with a focus on thoroughness, quality and cost control.
- Identified and collected evidence and determined its value to a specific claim.
Builders Square
Columbus, OH
06.1991 - 06.1992
- Customer Service desk.
- Returned items, cash out customers, and maintained cash drawer.
- Audited drawer, stocked shelves and trained new employees.
- Crossed trained in all aspects on the floor of business.
Education
High School Diploma -
Franklin University
Columbus, OHHigh School Diploma -
Watkins Memorial High School
Pataskala, OH05-1990
Skills
- ICD-9 and 10 (International Classification)
- Setting and reaching goals on time
- Healthcare IT systems
- Medical records indexing
- HIPAA compliance
- Electronic health records
- Healthcare analytics
- Insurance verification
- Patient confidentiality maintenance
- Medical office procedures
- Document scanning
- Medical terminology expert
- Managing deadlines
- Establishing own schedule for projects while completing projects timely
- Records maintenance professional
- Cash register
- Cash handling
- HCPCS Coding Guidelines
- Excellent Problem solver
- Resourceful and reliable
- Close attention to detail
- Professional letter writing
- 10 Key
- Typing (100 wpm)
- Healthsource
- Understand Medical claims coding
- Familiar with commercial and private insurance carriers
- Proficient in Excel
- Proficient in Word
- Proficient with Powerpoint
- Office support (phones, faxing, filing)
- Spreadsheets
- Insurance and collections procedures
- Cisco
- Auditing
- Excellent written and verbal communication
- Outlook
- Ultipro
- Problem solver
- Attention to Details
- Critical Thinker
- Epic
- ROI (request of information) records pulling
- Microsoft
- Microsoft Teams
- YouTube
- ICD-10-cM coding
- Health information exchange
PERSONAL INFORMATION
I am a believer in hard work and dependability. Love to learn new things while improving my own skill sets. As a creative person who can think outside of the normal while still being a mother, wife and explorer. I can and will bring my creativity and vest for learning to this position.
Awards
Certification in Dean Vaughn Terminology, Top appeals specialist in quality and production, Medicare training, ICD 10 training and certification, Certificate of honor for production and quality, Acknowledgement and certificate by Medicare President for years of service, quality, production, and contribution to reduction in work.
Timeline
Health Information Specialist
Datavant. Health
02.2018 - Current
Self Employed
Bolen Graphics
06.2017 - Current
Senior Redetermination Specialist
Palmetto GBA LLC
02.1997 - 09.2017
Medical Claims Processor
RE. Harrington
06.1992 - 02.1997
Builders Square
06.1991 - 06.1992
High School Diploma -
Franklin University
High School Diploma -
Watkins Memorial High School