Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

Julie Yenny

Bolivar,USA

Summary

Professional worker with strong background in delivering quality results through effective teamwork and adaptability. Skilled in task management, problem-solving, and ensuring smooth operations. Known for reliability, strong work ethic, and ability to meet changing needs with positive attitude. Focused on achieving goals and contributing to team success.

Overview

25
25
years of professional experience

Work History

Workers' Compensation Insurance Verification Specialist

Kinex Medical
03.2020 - Current
  • Verify Workers' Compensation Coverage:
  • Utilize online state-specific or national databases (e.g., NCCI) and direct communication with insurers to confirm coverage details like policy numbers, dates, and insured names.
  • Confirm patient eligibility and benefits for workers' compensation claims.
  • Communicate with Stakeholders:
  • Serve as a primary point of contact for injured workers, employers, adjusters, case managers, and legal representatives.
  • Respond to inquiries about insurance coverage or pre-authorization requirements.
  • Manage Documentation and Compliance:
  • Obtain and verify authorization for treatments, evaluations, diagnostics, and procedures related to work-related injuries.
  • Maintain accurate documentation of all communications, authorizations, and case activity in Electronic Medical Record (EMR) systems.
  • Ensure compliance with regulatory guidelines (e.g., Ohio Bureau of Workers' Compensation guidelines, HIPAA regulations).
  • Assist with completing and submitting required forms and documentation to relevant parties.
  • Collaborate and Support:
  • Collaborate with billing staff to ensure proper coding and claim submission.
  • Provide support to medical billing and claims teams as needed.

Authorization and Billing Specialist

Ancillary Advantage / Ortho RX
10.2008 - 02.2020
  • Responsible for accurate and timely booking of new accounts and charge orders within the billing system to ensure submission of clean claims per payer filing requirements.
  • Perform quality control on new accounts and charge orders.
  • Maintain off-site accounts for orthopedic surgeons DME and orthotic bracing orders.
  • Data entry in multiple computer systems IDX, Next Gen, Epic, Citrix, Athen all for billing purposes.
  • Verify insurance benefits for Commercial, Medicare, Medicaid, and WC.
  • Obtain insurance authorizations as needed.
  • Negotiate pricing with 3rd party vendors on many WC orders on behalf of physicians.
  • Notify DME on site when the order has been completed for set up.
  • Maintain daily order updates in Microsoft excel.
  • Complete patient claim data entry such as ICD-10 and HCPC codes and insurance to complete the billing process, to print HCFA's and send electronically or mail to insurance.

Payment Application Specialist

Emergency Medicine Physicians
07.2007 - 09.2008
  • Medical billing and payments applications for Emergency Room Doctors.
  • Posting duties included applying commercial, governmental, and private payments to patient accounts.
  • Research electronic money transfers, and bulk checks for patient accounts.
  • Enter insurance EOB applications and denials to patient accounts.
  • Customer Service duties ranged from answering phones, assisting customers in problem resolution, departmental consultation to ensure customer satisfaction.
  • Insurance follow ups on denial issues to obtain appropriate payments.
  • Insurance and provider contract research.
  • Attorney requests for medical claims.
  • HIPAA compliance issues, Data Entry, Spreadsheet maintenance.

Order Intake Team Leader / Customer Service Coordinator

Professional Medical Equipment
05.2000 - 04.2005
  • Supervise the intake personnel, train and coordinate daily tasks and supply ordering and inventory.
  • Processing new and existing customer orders as well as walk in customer orders.
  • Data entry for telephoned and fax orders from Doctors, Nurses, Social workers and patients.
  • Determine insurance requirements for medical equipment qualifications, based upon ICD-9, CPT, HCPC and medical necessity.
  • Document all activity and conversation per order in a database to ensure customer satisfaction and billing accuracy.
  • Dispatch equipment delivery drivers for order delivery and schedule the route time and place for drivers.
  • Upon delivery completion all coding information is uploaded to prepare HCFA and send to insurance.

Education

High School -

Canton South High School
Canton, OH
01.1996

Skills

  • Medical Billing and Insurance Verification (25 years)
  • Problem-solving
  • Attention to detail
  • Teamwork and collaboration
  • Multitasking
  • Decision-making
  • Time management
  • Organizational skills
  • Excellent communication
  • Task prioritization
  • Process improvement
  • Reliability

Additional Information

  • Excellent comprehension, communication and interpersonal skills. 25 years of customer service, insurance calls and Medical billing.
  • Microsoft Word, Excel, PC, Windows, IDX, Centricity, Next Gen, Matrix, Epic, Athens, Citrix, Allscripts, Touchworks
  • Data entry, spreadsheet creating and maintenance.
  • ICD-10, CPT, HCPC coding and referencing.
  • Strong knowledge of Medicare, Medicaid, Commercial and Wc
  • Billing as well as HIPAA laws, regulations and guidelines.
  • Highly developed attention to detail and organizational skills. Ability to manage multiple tasks, and meet deadlines; ability to cross train to other functions as necessary.

Timeline

Workers' Compensation Insurance Verification Specialist

Kinex Medical
03.2020 - Current

Authorization and Billing Specialist

Ancillary Advantage / Ortho RX
10.2008 - 02.2020

Payment Application Specialist

Emergency Medicine Physicians
07.2007 - 09.2008

Order Intake Team Leader / Customer Service Coordinator

Professional Medical Equipment
05.2000 - 04.2005

High School -

Canton South High School

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