Rachel Jamail
Crosby,TX
Summary
Results-driven professional with 20 years of office experience, showcasing strong communication and organizational skills. Demonstrated ability to manage tasks independently while building effective relationships with clients and team members. Adaptable and proactive, focusing on problem-solving and team success. Committed to leveraging expertise for organizational growth and efficiency.
Overview
18
18
years of professional experience
Work History
Patient Accounting Specialist
St. Joseph Medical Center
Houston, TX
12.2012 - 03.2019
- Processed Medicare, Medicaid, and Commercial claims using ePremis electronic billing system.
- Resolved all Secondary and Workers' Comp held claims in the billing editor daily.
- Managed electronic rejects, rebills, and late charges to ensure compliance with billing procedures.
- Coordinated with Billing Manager to address coding issues and modifiers through Health Information Management.
- Generated invoices for client billing efficiently.
- Operated with minimal supervision to maintain workflow.
- Performed additional duties as assigned by the Billing department.
Medicare Billing and Follow Up
The Methodist Hospital
Houston, TX
07.2012 - 12.2012
- Reconcile Medicare accounts by resolving denial issues.
- Bill claims to Medicare and ensure claims are billed in a timely manner with the correct information.
- Review claim processing procedures to ensure all sources are utilized in a cost efficient manner.
- Review Medicare Return to Provider claims and correct via Medicare online system (FSS)
- Verify patient eligibility within Medicare FISS systems.
- Review claim processing procedures to ensure all sources are utilized in a cost efficient manner.Worked with little to no Supervision.
Patient Accounting Specialist III
San Jacinto Methodist Hospital
Baytown, TX
12.2000 - 07.2012
- Coordinates and consolidates payer-specific reimbursement data according to assigned protocol.
- Create policies and procedure according to departmental protocol.
- Attend payer meetings with Medicare Replacements to remain current with payer issues and updates.
- Post Medicare Cash via PostPro Software to post adjustment and payments to patient accounts.
- File 3619 forms on TMHP website for Skilled Nursing claims
- Review Medicaid R&S and appeal Medicaid claims denied for other insurance, invalid program type, and Medicare eligibility not on file.
- Review Medicare Stat report. Correct and rebill claim via FISS.
- Review Medicaid Rejection Report, correct patient's date of birth, other insurance and rebill claim via TMHP website.Follow up with patient's group employer and insurance to update coordination of benefit file to help to expedite clam process.
- Cross trained on Aetna and Blue Cross contract, to ensure MCBP claims are reimbursed per contract.
Education
College -
San Jacinto College
Houston, Tx01.2010
High School -
Robert E. Lee
Houston, TxSkills
- Problem resolution
- Claim processing
- Insurance verification
- Effective communication
- Team collaboration
- Attention to detail
- Data analysis
- Medical billing
- Customer service
- Electronic claims submission
- Payer relations
- Time management
Affiliations
- I
Timeline
Patient Accounting Specialist
St. Joseph Medical Center
12.2012 - 03.2019
Medicare Billing and Follow Up
The Methodist Hospital
07.2012 - 12.2012
Patient Accounting Specialist III
San Jacinto Methodist Hospital
12.2000 - 07.2012
College -
San Jacinto College
High School -
Robert E. Lee
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