Microsoft Excel, Microsoft Word
LUECENDOR JONES
BILLING SPECIALIST
Summerville,SC
Summary
Efficient billing professional with 23 years of experience. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.
Overview
32
32
years of professional experience
3
3
years of post-secondary education
1
1
Language
Work History
Refund Representative
MUSC
North Charleston, SC
06.2022 - Current
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Compiled department-specific reports to help senior managers identify trends and improve progress.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Prevented delays and claim denials by correcting information prior to submission.
- Reconciled accounts receivable to general ledger.
Medical Biller
Beaufort Memorial Hospital
Beaufort, SC
01.2021 - 12.2022
- Delivered timely and accurate charge submissions.
- Liaised between patients, insurance companies, and billing office.
- Collected payments and applied to patient accounts.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Filed and updated patient information and medical records.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Training Specialist
DSN
Beaufort, SC
08.2014 - 12.2020
- Conducted orientation sessions to assess skill levels and areas of strength and weakness.
- Trained and mentored 12 new personnel hired to fulfill various roles.
- Collected data on program effectiveness to develop modifications and improvements to curricula.
- Developed lesson plans, instructional materials and written practice tests for consumers and education training courses.
- Provided constant training to staff on newly developed training programs used in classrooms, new language labs and computer systems.
- Utilized cross-training techniques to boost productivity and develop each team member's individual skills set.
Teacher's Assistant
Beaufort County School District
Beaufort , SC
02.2011 - 08.2014
- Oversaw students in classroom and common areas to monitor, enforce rules, and support lead teacher.
- Handed out classroom materials, like pencils, paper, and crayons.
- Kept classrooms clean, neat, and properly sanitized for student health and classroom efficiency.
- Supported student learning objectives through personalized and small group assistance.
- Tutored struggling students individually and in small groups to reinforce learning concepts.
Medical Billing Specialist
HCA Virginia Health System
Richmond, VA
01.2006 - 08.2008
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Collected payments and applied to patient accounts.
- Liaised between patients, insurance companies, and billing office.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prepared billing correspondence and maintained database to organize billing information.
- Precisely evaluated and verified benefits and eligibility.
- Communicated effectively and extensively with other departments to resolve claims issues.
Account Payable Specialist
CLEVELAND CLINIC FOUNDATION
Cleveland, OH
07.1990 - 03.2001
- Investigated daily variances and corrected errors to resolve discrepancies.
- Reached out to vendors and customers to verify information and follow up on client issues.
- Produced month-end closing reports and provided actionable suggestions on remittance for quick resolution.
- Applied proper codes to invoices, files, and receipts to keep records organized and easily searchable.
- Used advanced software skills to produce high-quality documents, reports and presentations.
- Updated accounting ledgers and journals to balance statements and maintain consistent records.
- Assisted manager in conducting internal audits to analyze findings.
Claim Processing Specialist
BlueCross BlueShield Of SC
Florence, SC
01.1983 - 02.1989
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Utilized appropriate cost containment techniques to reduce overall claim costs.
- Followed up with customers on unresolved issues.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Calculated adjustments, premiums and refunds.
- Verified client information by analyzing existing evidence on file.
Education
High School Diploma -
Timmonsville High School
Timmonsville, SC 06.1984 - 08.1987
No Degree - Medical Biller Coder Specialist
Florence Darlington Technical College
Florence, SC 05.2001 -
Skills
Sheet balancing
Quickbooks mastery
Invoicing prowess
A/P and A/R expertise
Customer service support
Financial Management
Database Management
Billing statement review
Cash Flow analysis
Tax reporting
Financial report creation
Financial statement analysis
Vendor invoice processing
Accounting remittances
Accomplishments
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Achieved 100% through effectively helping with monthly reports.
- Achieved 100% by completing daily reports with accuracy and efficiency.
Affiliations
- International Customer Service Association
- Society of Human Resource Management
- International Association of Administrative Professionals
Software
HTML5
EPIC
Software Development
Timeline
Refund Representative
MUSC
06.2022 - Current
Medical Biller
Beaufort Memorial Hospital
01.2021 - 12.2022
Training Specialist
DSN
08.2014 - 12.2020
Teacher's Assistant
Beaufort County School District
02.2011 - 08.2014
Medical Billing Specialist
HCA Virginia Health System
01.2006 - 08.2008
No Degree - Medical Biller Coder Specialist
Florence Darlington Technical College
05.2001 -
Account Payable Specialist
CLEVELAND CLINIC FOUNDATION
07.1990 - 03.2001
High School Diploma -
Timmonsville High School
06.1984 - 08.1987
Claim Processing Specialist
BlueCross BlueShield Of SC
01.1983 - 02.1989