Peggy Jackson
Taylor,MI
Summary
Patient billing and claims specialist with 15+ years of experience in insurance claims processing, EHR data entry, and HIPAA-compliant account support, known for accurate denial review, patient-focused communication, and effective revenue cycle problem solving.
Overview
14
14
years of professional experience
Work History
Patient Account Representative
Up Health Systems
Marquette, Michigan
01.2010 - 01.2018
- Processed insurance claims, payments, and patient account adjustments.
- Verified coverage details and updated patient demographic records.
- Reviewed patient account inquiries to provide accurate billing support for UP Health Systems.
- Provided customer service to patients regarding billing inquiries and account information.
- Documented account activity in health system billing systems.
- Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
- Resolved inquiries from patients, families, and external payers.
- Resolved patient complaints regarding account balances, insurance coverage, and payment plans to enhance patient satisfaction.
- Conducted follow-up calls with patients to verify account accuracy and resolve outstanding issues. with patients to ensure that accounts were up to date and properly documented.
- Filed patient appeals to contest denied claims, ensuring proper documentation supported each case. following thorough research of denied claims.
- Submitted electronic bills following facility and legal compliance standards.
- Researched discrepancies in patient accounts to determine appropriate resolution.
- Collected, counted and disbursed money to complete basic bookkeeping and banking transactions.
- Inventoried and ordered materials, supplies and services.
- Trained staff members to perform work activities and use computer applications.
- Monitored office supply stock levels and placed timely orders for replenishment.
- Maintained confidentiality of patient information in compliance with HIPAA regulations.
- Answered telephones, directed calls, and took messages.
- Reviewed files, records and other documents to obtain information or respond to requests.
- Organized and maintained office supplies to promote team productivity.
- Responded promptly to customer inquiries via telephone or email in a professional manner.
ROI Specialist
Chart One
Kirkland, Washington
09.2008 - 10.2009
- Processed medical record requests using ROI workflows and HIPAA guidelines at Chart One.
- Reviewed authorization forms for completeness and compliance before releasing protected health information.
- Verified patient identity and request details through chart review and document checks.
- Reviewed and updated medical records for completeness and accuracy, ensuring compliance with standards.
- Accurately entered patient information into electronic health record systems.
- Retrieved medical records upon request from healthcare professionals.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Conducted regular training sessions for new staff on medical records management systems and procedures
- Facilitated urgent communications by sending faxes to attorneys and law enforcement regarding elder abuse cases, ensuring timely information delivery.
Patient Service Representative
Group Health/Kaiser Permanente
Seattle, Washington
08.2003 - 04.2008
- Verified check amounts, signatures, and endorsements to ensure compliance and accuracy in account records.
- Processed incoming checks for a financial services organization using check-processing systems.
- Built relationships with external parties, such as carriers, vendors, and regulators.
- Prepared 1099 tax and supporting schedules for corporate compliance reviews.
- Created reports summarizing the results of tax research projects.
- Supplied detailed tax documentation needed to submit accurate corporate and individual returns.
- Collected vendor details to enable timely check runs, ensuring compliance with executive approval processes for large transactions.
Education
Graduate Certificate - Certificate For Medical Billing & Coding
Everett Community College
Everett, WA08-2003
Associate Degree in Nursing - Preq For Nursing
Shoreline Community College
Seattle, WA01-1991
GED -
Highline College
Seattle, WA01-1979
Skills
- Insurance claims processing
- Claims processing systems
- Claims appeal submission
- Billing inquiry resolution
- EHR data entry
- Revenue cycle management
- HIPPAA compliance
Timeline
Patient Account Representative
Up Health Systems
01.2010 - 01.2018
ROI Specialist
Chart One
09.2008 - 10.2009
Patient Service Representative
Group Health/Kaiser Permanente
08.2003 - 04.2008
Graduate Certificate - Certificate For Medical Billing & Coding
Everett Community College
Associate Degree in Nursing - Preq For Nursing
Shoreline Community College
GED -
Highline College