Michelle M. Jackson

Obtain initial visit authorization Receive periodic clinical reports to support subsequent visit authorizations.

• Worked with clinical and operations teams to facilitate client placement and obtain appropriate services for clients.
• Answer20-30 phone calls and manage approximately 30-40 incoming faxes daily for new clients required paperwork to initiate service.
• Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
• Explained eligibility requirements, application details, payment methods, and applicants' legal rights during intake assessment.
• Assessed clients' needs and determined eligibility for intake services.

• Filed and updated patient information and medical records.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Printed and reviewed monthly patient aging report and solicited overdue payments.
• Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
• Liaised between patients, insurance companies, and billing office.
• Collected payments and applied to patient accounts.
• Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
• Identified and resolved patient billing and payment issues.
• Located errors and promptly refiled rejected claims.
• Communicated effectively and extensively with other departments to resolve claims issues.
• Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
• Posted and adjusted payments from insurance companies.
• Precisely evaluated and verified benefits and eligibility.
• Precisely completed appropriate claims paperwork, documentation and system entry.
• Identified, researched, and resolved billing variances to maintain system accuracy and currency.
• Researched and resolved billing discrepancies to enable accurate billing.
• Developed and maintained billing procedures to make timely payments.

• Collected information about rejected claims and developed effective solutions.
• Generated monthly billing and posting reports for management review.
• Monitored outstanding invoices and performed collections duties.
• Handled account payments and provided information regarding outstanding balances.
• Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
• Followed up on overdue payments
• Processed adjustments and posted refunds.

• Worked effectively with medical payers such as Medicare, Medicaid, and commercial insurances to obtain timely and accurate payments.
• Reviewed and solved account and billing discrepancies.
• Identified, researched, and resolved billing variances to maintain system accuracy and currency.
• Received incoming information and entered into database system.
• Researched and resolved billing discrepancies to enable accurate billing.
• Handled account payments and provided information regarding outstanding balances.
• Used data entry skills to accurately document and input statements.
• Confidently and adeptly handled claim denials and/or appeals.
• Posted and adjusted payments from insurance companies.
• Diligently filed and followed up on third party claims.
• Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements regarding billing.
• Verified insurance of patients to determine eligibility.
• Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.