Khaliah Jones
Houston
Summary
Detail-oriented Revenue Cycle professional with 5+ years of experience managing patient accounts, insurance follow-up, claims resolution, eligibility verification, and reimbursement processes within healthcare organizations. Experienced working with commercial insurance, Medicare, Medicaid, and managed care payers while ensuring HIPAA compliance and timely account resolution. Skilled at researching denied claims, resolving billing issues, reducing accounts receivable, and delivering excellent patient and provider support in fast-paced healthcare environments.
Overview
8
8
years of professional experience
Work History
Insurance Follow-up Specialist
GetixHealth
Remote
09.2022 - Current
- Follow up with commercial, Medicare, Medicaid, and managed care insurance companies regarding outstanding patient accounts.
- Research denied, rejected, and unpaid claims to identify root causes and secure appropriate reimbursement.
- Resolve claim edits, billing discrepancies, authorization issues, and eligibility errors.
- Review patient accounts to ensure accurate billing and timely payment.
- Document account activity and maintain complete records within billing systems.
- Coordinate with internal billing, coding, and payer teams to resolve claim issues and support operational workflows.
- Document actions thoroughly while meeting productivity, quality, and compliance benchmarks in a remote healthcare environment.
- Maintain HIPAA compliance and protect confidential patient information.
Healthcare Customer Service Representative
Sarnova HC
Remote
01.2020 - 08.2022
- Assisted patients and providers with billing questions, insurance coverage, and account inquiries.
- Processed insurance claims and verified patient demographics for billing accuracy.
- Reviewed medical documentation to support claims processing.
- Coordinated with internal departments to resolve account issues.
- Applied CPT, ICD-10, and HCPCS coding knowledge to support accurate claims submission.
- aintained accurate documentation within electronic health record systems.
Pharmacy Support Representative
Teleperformance USA
Remote
02.2018 - 12.2019
- Assisted members with prescription benefits, insurance questions, and medication orders.
- Coordinated prescription fulfillment and delivery.
Researched member accounts and resolved insurance-related concerns. - Documented all interactions while meeting quality and productivity standards.
- Provided excellent customer service while maintaining HIPAA compliance.
Education
High School Diploma -
Morton Ranch High School
Katy, TX06-2014
Skills
- Revenue Cycle Management
- Accounts Receivable (A/R)
- Payment Resolution
- Claims & Insurance Workflows
- HIPAA & Regulatory Compliance
- Electronic Health Records (EHR/EMR)
- Microsoft Excel & Data Systems
- Attention to Detail & Documentation Accuracy
Timeline
Insurance Follow-up Specialist
GetixHealth
09.2022 - Current
Healthcare Customer Service Representative
Sarnova HC
01.2020 - 08.2022
Pharmacy Support Representative
Teleperformance USA
02.2018 - 12.2019
High School Diploma -
Morton Ranch High School