Ricadonna Jones
Dallas,TX
Summary
Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level NCT Radiologic Technician position. Ready to enhance my knowledge and help team achieve company goals.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Medical A/R Specialist II
Methodist Health Systems
01.2022 - Current
- Facility claims processing and denial management to ensure proper reimbursement per contract agreements between facilities and payer
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt
- Submit electronic/paper claims documentation for timely filing
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Checked documentation for accuracy and validity on updated systems.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Maintained confidentiality of patient finances, records, and health statuses.
- Enhanced organizational skills through effective multitasking and prioritization of daily responsibilities.
- Calculated adjustments
- Managed a high volume of insurance claims, ensuring accurate documentation and prompt processing.
Patient Account Representative
Fresenius Medical Care
09.2020 - 01.2022
- Insurance claims follow up for government & commercial payers
- Submit Claims/Corrected Claims
- Appeal claims/Submit medical records as needed or requested
- Utilize insurance provider portals & call provider line inquiry
- Verify patient coverage, coordination of benefits
- Send patient letters and statements
Medical A/R Specialist II
Methodist Health Systems
01.2019 - 07.2019
- Submitted electronic/paper claims documentation for timely filing
- Monitored and updated claims status in claims processing system
- Verified patient insurance coverage and benefits for medical claims
- Managed large volume of medical claims on daily basis
- Evaluated medical claims for accuracy and completeness and researched missing data
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations
- Researched and resolved complex medical claims issues to support timely processing
- Made contact with insurance carriers to discuss policies and individual patient benefits
Patient Account Specialist
Cook Children's Physician Network
01.2018 - 01.2019
- Insurance claims follow up
- Appeal denied claims, submit medical records
- Analysis & resolution of insurance payment issues (underpayments & overpayments)
- Verify patient coverage, coordination of benefits
- Access insurance provider websites & call provider line inquiry
- Send statements to patients/Answer patient calls regarding bills or claims
- Submit claims/corrected claims within timely manner
Medical Claims A/R Specialist
Family Healthcare Associates
06.2017 - 01.2018
- Review insurance claims processing/payments
- Appeal denied claims, submit medical records
- Verify patient coverage, coordination of benefits
- Send statements to patients/Take patient credit card payments via phone
- Payment posting of insurance checks to providers
Medical Claims A/R Specialist
Alliance Family Of Companies
09.2016 - 06.2017
- Identified payment trends and adjusted billing processes accordingly
- Insurance claim follow ups for group of in-network doctors
- Appeal denied claims, submit medical records
- Verify patient coverage
- Access provider websites & call provider line inquiry
- Submit claims/corrected claims within timely manner
Medical Claims A/R Specialist
Texas Health Care PLLC
08.2014 - 09.2016
- Identified payment trends and adjusted billing processes accordingly
- Insurance claims follow up
- Appeal denied claims, submit medical records
- Verify patient coverage, coordination of benefits
- Access insurance provider websites & call provider line inquiry
- Submit claims/corrected claims within timely manner
- Send statements to patients
- Take patient credit card payments via phone
- Answer patient calls regarding bills or claims
Insurance Collections Specialist
Dr. Dolar Patolia OBGYN TX Womens
01.2010 - 08.2014
- Verified patient eligibility/coordination of benefits
- Obtained insurance authorizations prior to patient visits/procedures
- Communicated with patient their financial responsibility prior to scheduling
- Contacted patients/set up payment arrangements regarding outstanding balances
- Utilized online provider portals & provider inquiry line for benefits and claims
- Appealed denied claims, submitted medical records for claim processing
- Send statements to patients
- Take patient credit card payments via phone
- Answer patient calls regarding bills or claims
Education
Certificate - NCT Radiologic Technologist
The X-Ray Academy of Texas
Fort Worth, TX03.2024
Certificate - Medical Administrative Assistant
Everest Institute - Houston Hobby
Houston, TX2010
High School Diploma -
Deer Park High School
Deer Park, TX1998
Skills
- Organizational skills, Task Prioritization
- Time Management, Analytical Thinking
- Maintaining confidentiality
- HIPAA Compliance
- Account Management
- Insurance Verification
- Insurance Claims
- Billing and Invoicing
- Account Reconciliation
- 10-Key Data Entry
- Medical Billing
- Accounts Receivable
- Collections & Denial Management
- Deadline Adherence
- Insurance Billing, Claim Submission
- CMS-1500 & UB-04
- CPT Knowledge
- ICD-10 Coding
- Billing and Collection Procedures
- Account Management Software
- Conflict Resolution
- 10-Key Touch
- Information Verification
- Billing Software
- Insurance Coverage Verification
- Insurance Claim Forms Review
Certification
- TMB Licensed NCT Radiologic Technician
Timeline
Medical A/R Specialist II
Methodist Health Systems
01.2022 - Current
Patient Account Representative
Fresenius Medical Care
09.2020 - 01.2022
Medical A/R Specialist II
Methodist Health Systems
01.2019 - 07.2019
Patient Account Specialist
Cook Children's Physician Network
01.2018 - 01.2019
Medical Claims A/R Specialist
Family Healthcare Associates
06.2017 - 01.2018
Medical Claims A/R Specialist
Alliance Family Of Companies
09.2016 - 06.2017
Medical Claims A/R Specialist
Texas Health Care PLLC
08.2014 - 09.2016
Insurance Collections Specialist
Dr. Dolar Patolia OBGYN TX Womens
01.2010 - 08.2014
Certificate - NCT Radiologic Technologist
The X-Ray Academy of Texas
Certificate - Medical Administrative Assistant
Everest Institute - Houston Hobby
High School Diploma -
Deer Park High School
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