Lashon Jackson
College Park,Georgia
Summary
Dedicated professional with 20 + years in the Healthcare Revenue Cycle Division. Proven ability to reduce insurance aging and increase organization cash flow. Experience in healthcare billing and collections with knowledge of coding guidelines. Skilled in Medicare, Medicaid/Manage Medicaid and Commercial Payers. Great judgement and problem-solving skills in claims resolution. Reliable Insurance Verification Specialist with excellent insurance organization and interpretation skills. Eager to contribute advanced communication skills toward optimizing the goals of a progressive employer.
Overview
26
26
years of professional experience
1
1
Certification
Work History
A/R Specialist
Wakefield & Associates (formerly RMB)
08.2017 - Current
- Handle billing processes for daily submission of claims depending on the volume of billings
- Identify root causes of insurance denials and rejections
- Report weekly trend finding to management to decrease claim errors
- Submit daily coding issues to coding for re-code resolution
- File appeals to payors and strives to minimize lost revenue
- Work with patients on coordination of benefits and any other patient related denial
- Worked weekly aging and high dollar accounts to increase cash flow and reduce A/R days.
Billing/Collector
American Health Imaging-Atlanta, Georgia
04.2016 - 08.2017
- Manage billing and collections for outpatient radiology services rendered in Georgia, Florida, Alabama and Texas
- Handle all payment reimbursement issues related billing inquires and coding corrections with ICD-10 and CPT
- File appeals for denials
- Follow up with patients for any patient related denials
- Work credit balance report
- Payers of responsibility; Medicaid, Manage Medicaid and Blue Cross.
Accounts Receivable Specialist
United Health Group-Atlanta, Georgia
10.2012 - 05.2013
- Responsible for accounts receivable for multiple health systems throughout the U.S
- Assist business offices in reducing Accounts Receivable and increasing cash flow
- Process billing and collection functions
- Post and reconcile insurance and patient payments
- Research and reconcile incorrect payment for improper reimbursement.
Insurance Biller-Collector and Insurance Verifier
Universal Health Systems- College Park, Georgia
- 05.2013
- Performs daily billing and collection efforts necessary to relieve patient account from a collectable status
- Prepare the daily cash deposits and process daily payment posting to patient account
- Contact insurance carriers to acquire claim status and resolve accounts according to contract rates
- Monitor and process credit balance reports quarterly
- Assist with insurance verification as needed.
Business Office Assistant Manager - Patient Accounting Representative
Acadia (Riverwoods Behavioral Healthcare)-Riverdale, Georgia
01.2010 - 10.2012
- Identified payer problem accounts, investigated and corrected billing errors, followed up on account status with insurance payers and update missing account information, and resolved aging account balances
- Transmit claims daily to clearinghouse
- Chair weekly A/R meeting with Senior Management
- Function as liaison between one or more point of the revenue cycle, i.e., registration, utilization and medical records.
Insurance Recovery Liaison
INOVA HEALTH SYSTEM-Fairfax, Virginia
08.2009 - 12.2009
- Review accounts for pre-bad debt practices
- Follow on account with payers and patient to determine next plan of action
- Review patient financial status to establish payment plans, follow up on delinquent accounts
- Return accounts to follow-up teams that have been improperly assigned for bad debt.
Medicare Billing and Collections
Northside Hospital-Atlanta, Georgia
05.2008 - 07.2009
- Managed and followed up on patient accounts for all payors of Northside Hospitals
- Process billing and collection functions
- Post and reconcile insurance and patient payments
- Research and reconcile incorrect payment for improper reimbursement.
Government Billing and Collections Representative
Piedmont Hospital-Atlanta, Georgia
05.2007 - 05.2008
- Managed all account activity for Medicare and Managed Medicare services rendered to patients for all Piedmont Hospitals in the Atlanta area
- Process billing and collection functions
- Post and reconcile insurance and patient payments
- Research and reconcile incorrect payment for improper reimbursement.
Government Billing and Collections Representative (temporary position)
Northside Hospital-Atlanta, Georgia
01.2007 - 05.2007
- Managed and followed up on patient accounts for all payors of Northside Hospitals
- Process billing and collection functions
- Post and reconcile insurance and patient payments
- Research and reconcile incorrect payment for improper reimbursement.
Government Billing and Collections Representative
DeKalb Medical Center- Decatur, Georgia
05.2005 - 01.2007
- Managed and followed up on Medicare accounts for all payors Dekalb Medical facilities Process all billing and collection functions; post and reconcile insurance payments
- Research and reconcile incorrect payments for improper reimbursement
- Make corrections to billing edits per medical records.
Medicare Specialist (temporary position)
Mariner Healthcare-Atlanta, Georgia
08.2004 - 05.2005
- Processed Medicare billings for 14 skilled nursing facilities throughout the U.S Ensure all claims collected meets government mandated procedures
- Communicate with facilities medical records department and nurse auditors to assure the RUG score and daily census are correct for billing
- Responsible for Medicare collections, reimbursement, adjustments and billing
- Worked with Trail blazers and Mutual of Omaha to quickly resolve any rejects or return to provider claims issues.
Health Insurance Specialist IV
INOVA HEALTH SYSTEM
Fairfax, Virginia
01.2000 - 01.2004
- Performed underpayment reviews for Manage Medicare and Commercial payers
- Underpayment review rebilling and follow-up on claim not paid to contract rate
- Functions included post insurance payment
- Research and reconcile incorrect payment for improper reimbursement.
Financial Counselor/Coordinator
INOVA HEALTH SYSTEM
Falls Church, Virginia
01.2000 - 01.2004
- Support individual Operating Unit and Patient Registration Dept
- Financial goals
- Performed insurance verification online and via telephone inquiry
- Obtained referral and authorizations for services by providing clinical documentation
- Performed pre-registration process via phone for scheduled service to secures copays, coinsurance and deductible.
Insurance Recovery Liaison
INOVA HEALTH SYSTEM
Fairfax, Virginia
01.2000 - 01.2004
- Review accounts for pre-bad debt practices
- Follow on accounts with payers and patients to determine next plan of action
- Review patient financial status to establish payment plans, follow up on delinquent self-pay payments
- Review accounts for improper assignment for bad debt
- Return accounts to follow-up teams for additional review.
Team Lead Patient Representative
INOVA HEALTH SYSTEM
Springfield, Virginia
01.2000 - 01.2004
- Managed and followed up on all line of business on patient accounts for Small Balance Division
- Post and reconcile insurance and patient payments
- Research and reconcile incorrect payment for improper reimbursement
- Train new employees and assist manager with additional duties as assigned.
Government Patient Representative III for Medicare
INOVA HEALTH SYSTEM
Fairfax, Virginia
01.2000 - 01.2004
- Managed and followed on patient accounts to ensure proper account status
- Specialized in Medicare, billed Medicare inpatient and outpatient claims and corrected claim in DDE Responsible for completing Medicare request for additional information letters
- Work Medicare remittance denials and analyze patient accounts and review EOB'S work rejections and perform proper reimbursement analysis.
Medicare Collector
Memorial Health University Medical Center-Savannah, Georgia
12.1998 - 05.2000
- Managed and followed up on patient accounts
- Specialized in Medicare billed inpatient, and outpatient claims and corrected claim in FSS Responsible for completing Medicare request for additional information letters
- Work Medicare remittance denials and analyze patient accounts and review EOB'S work rejections
- And perform proper reimbursement analysis.
Insurance Verification and Precertification Representative
DeKalb Medical Center- Decatur, Georgia
05.2013
- Contact insurance companies and third-party payers to verify patient benefit coverage, for deductibles, copays, coinsurance and outer pocket expenses
- Review for Authorization, referral and pre-determination
- Provide clinical documentation to insurance companies and third parties to obtain authorizations for all requires services
- Complete registration of patient accounts prior to service
- Calculate patient responsibilities to be collected during the preregistration process via telephone or at the point of service.
Education
Healthcare Management
Clayton State University
Morrow, Georgia01.2007
Medical Assistant Course
Savannah Technical College
Savannah, Georgia01.1992
Health Information Technology
Northern Virginia Community College
Annandale, VirginiaSkills
- Insurance knowledge
- Insurance Verification
- Payment posting
- Insurance terminology
- Claims Processing
Certification
- CPAT-Certified Patient Account Technician
- CCAT-Certified Clinical Account Technician
- AAPC- AMERICAN ACADEMY OF PROFESSIONAL CODERS. In progress
References
Available upon request
Timeline
A/R Specialist
Wakefield & Associates (formerly RMB)
08.2017 - Current
Billing/Collector
American Health Imaging-Atlanta, Georgia
04.2016 - 08.2017
Insurance Verification and Precertification Representative
DeKalb Medical Center- Decatur, Georgia
05.2013
Accounts Receivable Specialist
United Health Group-Atlanta, Georgia
10.2012 - 05.2013
Business Office Assistant Manager - Patient Accounting Representative
Acadia (Riverwoods Behavioral Healthcare)-Riverdale, Georgia
01.2010 - 10.2012
Insurance Recovery Liaison
INOVA HEALTH SYSTEM-Fairfax, Virginia
08.2009 - 12.2009
Medicare Billing and Collections
Northside Hospital-Atlanta, Georgia
05.2008 - 07.2009
Government Billing and Collections Representative
Piedmont Hospital-Atlanta, Georgia
05.2007 - 05.2008
Government Billing and Collections Representative (temporary position)
Northside Hospital-Atlanta, Georgia
01.2007 - 05.2007
Government Billing and Collections Representative
DeKalb Medical Center- Decatur, Georgia
05.2005 - 01.2007
Medicare Specialist (temporary position)
Mariner Healthcare-Atlanta, Georgia
08.2004 - 05.2005
Health Insurance Specialist IV
INOVA HEALTH SYSTEM
01.2000 - 01.2004
Financial Counselor/Coordinator
INOVA HEALTH SYSTEM
01.2000 - 01.2004
Insurance Recovery Liaison
INOVA HEALTH SYSTEM
01.2000 - 01.2004
Team Lead Patient Representative
INOVA HEALTH SYSTEM
01.2000 - 01.2004
Government Patient Representative III for Medicare
INOVA HEALTH SYSTEM
01.2000 - 01.2004
Medicare Collector
Memorial Health University Medical Center-Savannah, Georgia
12.1998 - 05.2000
Insurance Biller-Collector and Insurance Verifier
Universal Health Systems- College Park, Georgia
- 05.2013
Healthcare Management
Clayton State University
Medical Assistant Course
Savannah Technical College
Health Information Technology
Northern Virginia Community College
- CPAT-Certified Patient Account Technician
- CCAT-Certified Clinical Account Technician
- AAPC- AMERICAN ACADEMY OF PROFESSIONAL CODERS. In progress
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