Jonathan Blanks

▪ Process and manage refund requests for overpayments in accordance with company policies and procedures.

▪ Conducts root analysis for refund trends to identify key improvement areas.

▪ Analyze account discrepancies and resolve complex payment issues in a timely manner

▪ Collaborate with various departments to verify and validate refund eligibility

▪ Analyze and resolve cedi balances on patient and insurance accounts, while processing refunds and adjustments.

▪ Process and track insurance takebacks and recoupments while maintaining detailed documentation for audit purposes.

▪ Perform monthly reconciliation of accounts and prepare detailed reports for senior management.

• Developed and deepened client relationships to cement profitable partnerships.
• Validated overpayments from prior insurance payments, and verify insurance benefits.
• Created refund packets with insurance cards, explanation of benefits, and UB-04s.
• Trained new staff on job duties, company policies, and safety procedures for rapid onboarding.
• Ensured that any discrepancies or problems are resolved quickly before impacting the account.
• Responded to requests for information regarding outstanding payments and reimbursement timelines.
• Ensured the completion of the credit balance and misapplied credit reports by processing insurance and refunds.

• Reviewed clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-9 and ICD-10-CM and CPT-4 codes for billing, internal, and external reporting.
• Accurately coded outpatient conditions and procedures as documented in the ICD-9-CM and ICD-10-CM official guidelines for coding and reporting.
• Audited financial healthcare records to analyze and solve discrepancies made by insurance companies and clients.
• Resolved error reports associated with the billing process while assisting in designing and implementing workflow changes to reduce billing errors.
• Assured overpayment and underpayment discrepancies are resolved timely and accurately/credit balance to allow proper billing.
• Followed up with aged receivables and appeals of denied claims, write-offs, and EOBs.
• Followed insurance carrier guidelines to ensure claims were submitted with proper documentation, consent forms, referral, and authorization as needed.
• Reconciled returned refund checks when a primary payer has overpaid their liability per contract.
• Maintained accurate processing of invoices, expense reports, credit memos, and payment transactions.
• Monitored take-backs, initiated appropriate refunds, performed payment posting and account reconciliation.
• Provided practical training to co-workers to navigate multiple databases and operating systems to research and validate claims.

• Managed the accurate and timely processing of over 10,000 invoices for multiple organizations.
• Updated and reconciled account payables to pay providers, prepared invoices, and requested checks for payments from providers.
• Assisted with setting reimbursement rates while reviewing and settling Medicare cost reports for multiple providers.
• Contacted providers regarding account balances to resolve disputes and collect payments.
• Trained users and served as an internal and external point of contact for all related issues involving various requests on RAC appeals, B2, refund, rebate, PIP, and incarcerated beneficiary payments.
• Implemented new financial software while maintaining diverse databases in various economic systems.
• Processed providers' requests for appeals on claim amounts, denials, Medicare cost reports and maintained detailed analysis of those requests while providing information as needed.