Jolene Pfulmann
Federal Way
Summary
Experienced Medical Billing Specialist with over 25 years in healthcare billing and claims management. Streamlines claims processing and fosters effective communication between patients and insurance providers, ensuring accurate billing and timely resolution of inquiries while complying with HIPAA regulations.
Overview
25
25
years of professional experience
Work History
Medical Billing Specialist
Kelley-Ross and Assoc Inc
Seattle
05.2001 - Current
- Reviewed and verified patient information to ensure correct billing procedures.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Communicated with insurance companies to resolve billing discrepancies effectively.
- Addressed patient inquiries regarding bills and insurance coverage options, enhancing patient understanding and satisfaction.
- Completed appeals and filed and submitted claims.
- Analyzed rejected claims and corrected errors before resubmitting for payment.
- Submitted appeals for denied claims based on insurance company's criteria, improving chances of successful reimbursement.
Lead Pharmacy Technician
Kelley-Ross and Assoc Inc
Seattle
05.2001 - Current
- Operated pharmacy software for prescription processing and patient records.
- Collaborated with healthcare professionals to coordinate patient care effectively.
- Maintained compliance with pharmacy regulations and safety standards.
- Managed inventory levels and ensured pharmaceuticals were stored correctly to maintain quality and accessibility.
- Trained new staff on operational procedures and customer service practices.
- Prepared medications for dispensing by counting, pouring, labeling, and verifying doses.
- Organized and maintained electronic and manual filing systems for prescriptions to ensure easy access and accuracy. of prescriptions, both electronically and manually.
- Resolved customer complaints promptly, enhancing patient satisfaction and trust in pharmacy services.
- Ensured compliance with all federal, state, local laws and company policies related to pharmacy operations.
- Kept accurate records of controlled substances received and dispensed in accordance with DEA regulations.
- Reported any discrepancies or errors in medication ordering or filling processes immediately to the pharmacist on duty.
- Received and verified daily incoming drug inventories, reported discrepancies, and logged items into inventory system.
- Collaborated with colleagues and healthcare professionals to efficiently prioritize and fulfill medication orders; technicians and pharmacists to prioritize and complete orders.
- Transmitted claims to insurance companies for payment and reconciled EOBs.
- Flagged potential side effects and allergies to prescribed medications for patients.
Education
Associate of Science - Medical Billing And Coding
Ultimate Medical Academy
Clearwater, FL01-2021
Pharmacy Technician - Pharmacy
Payless Drugs
01-1995
Skills
- Claims processing
- Insurance verification
- Patient billing
- Appeals management
- Claims reconciliation
- Revenue cycle management
- Medical coding
- ICD-10 proficiency
- CPT knowledge
- HIPAA compliance
- Communication skills
- CPT knowledge
Timeline
Medical Billing Specialist
Kelley-Ross and Assoc Inc
05.2001 - Current
Lead Pharmacy Technician
Kelley-Ross and Assoc Inc
05.2001 - Current
Associate of Science - Medical Billing And Coding
Ultimate Medical Academy
Pharmacy Technician - Pharmacy
Payless Drugs