La Tanya Jones

• Communicates with Emergency Room Providers about missing documentation to complete coding and billing information
• Develops, coordinates, and distributes reports containing billing, coding, and transaction data
• Analyzes and reviews all data entry submissions for errors, inaccuracies, and completeness; and implements corrections as needed
• Responsible for maintaining and managing patient files, records, and data, and precise uploading files into designated confidential databases
• Utilizes various hospital systems and record databases to obtain patient information, make necessary updates, and minimize errors.

• Assist the California Employment Development Department, Auditing claimant certification weeks for potential discrepancies and benefit overpayments
• Review and audit a claimant’s potential overpayment status based on complex financial information by evaluating wages and earnings
• Process claims with confirmed eligibility issues for potential adjudication/determination by the EDD
• Document findings, along with actions taken to supplement case notes
• Collaborate with subject matter experts to address unique issues
• Analyzing claim information to determine the cause of outstanding issues
• Assessing eligibility requirements based on UI Code, Policies, and Procedures
• Evaluating wage and earnings
• Communicating with claimants and employers by phone to obtain missing information
• Working closely with subject matter experts to gain further understanding of unique issues and how to address them
• Referring more complex issues to the supervisor or tenured staff
• Notating all contacts and actions taken on a claim clearly and thoroughly
• Demonstrating the ability to make a timeline and logical decisions
• All other duties as assigned by management to support claim processing.

• Provides and ensures the delivery of accurate and timely administrative support for the department
• Oversees all office operations by coordinating with colleagues, senior leaders, and facilities teams on processes
• Supports the nursing staff by greeting patients and verifying paperwork for correct documentation prior to patients proceeding to the clinical area
• Manages and maintains department inventory and supply levels, and coordinates department equipment and supply acquisitions
• Coordinates, gathers and analyzes data to determine efficient cost-effective time practices for the department
• Analyzes operational trends and metrics and submits recommendations regarding improvement for office operations.

• Provided a wide range of complex office administrative and support functions for department leadership and staff members
• Managed multiple projects in a fast-paced and vigorous work environment and adhered to a demanding schedule to meet deadlines
• Managed the daily operations of 3 specialty departments for Executive Directors and Managers
• Cultivated professionalism in handling multiple tasks in a complex medical setting with high- volume patient contact
• Developed and managed multiple projects, enhancing skills in the execution of supporting three high-volume departments
• Coordinated, led, and executed monthly departmental and house-wide meetings
• Supervised and reviewed chart analytics to ensure coding and medical documentation met billing standards
• Successfully managed communications and correspondence to ensure patient care staff members received all information and updates in a timely manner
• Emergency and In & Outpatient service representatives are responsible for coordinating, collecting, and inputting all patient information and new patient set-ups into a customer information system
• Developed a working knowledge of current Medicare, Medicaid, insurance regulations, products and services offered by the organization they represent, CMS & JCAHO, and all applicable governmental guidelines and regulations.

I received my certificate in coding & billing which required 240 hours of training on the following subjects.

• Medical Office Etiquette & Ethics.
• Career Management & Communication Skills.
• Medisoft and other computer programs.
• Coding Techniques for CPT.
• Coding Techniques for ICD-9 & ICD-10.
• Completion of the HCFA 1500 form.