Shydeja Jones
El Paso,TX
Summary
Well-versed detail-oriented team player with strong organizational skills. Driven Medical Claims Processor with a strong background in building rapport with providers to discuss claim status or claim denials. Ready to handle multiple administrative tasks effectively with highly investigative skills when processing claims.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Medical Claims Coordinator
William Beaumont Army Medical Center
02.2022 - 09.2023
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
- Researched and resolved complex medical claims issues to support timely processing.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Identified and resolved discrepancies between patient information and claims data.
Medical Support Assistant
William Beaumont Army Medical Center, William Beaumont
01.2021 - 02.2022
- Provided backup support to medical staff by completing billing and filing tasks, answering phones and scheduling appointments.
- Organized patient records to research records, extract medical information and review records for completeness and accuracy.
- Determined nature and urgency of patient requests to refer patients to appropriate medical staff.
- Verified patient insurance coverage and collected required co-payments.
- Called and faxed pharmacies to submit prescriptions and refills.
- Liaised with patients and addressed inquiries, appointment requests and billing questions.
Medical Support Assistant
United States Army Europe
03.2019 - 01.2021
- Provided backup support to office staff by completing billing and filing tasks, answering phones and scheduling appointments.
- Determined nature and urgency of patient requests to refer patients to appropriate medical staff.
- Organized patient records to research records, extract medical information and review records for completeness and accuracy.
- Used CDA & ALTHA, to maintain and record patient data and generate reports.
- Interviewed patients to verify and update clinical and demographic records.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Performed medical records management, including filing, organizing and scanning documents.
Dental Assistant
United States Army Europe
01.2017 - 01.2019
- Cleaned and sanitized dental tools and equipment, straightened treatment rooms, and restocked supplies to prep for next patient and maintain health and safety practices.
- Sanitized trays, instruments, and surfaces for clean dental office setting and patient safety.
- Successfully assisted dentist by performing four-handed dentistry and other chair-side duties.
- Performed general chair-side duties for general dentistry, endo procedures, and oral surgery.
- Prepared patient x-rays and images for dentist review.
- Maintained dental supply inventory by checking stock to determine inventory levels and placing and expediting orders for supplies.
- Explained treatment procedures and instructed patients on home care guidelines.
- Prepared and arranged instruments, medications, and required materials for dental procedures.
- Documented patient dental health information, medical history, and vital signs for future reference.
- Created dental impressions used for diagnostics, opposing models and study casts to make crowns, bridges, and other dental prosthetics.
- Recorded patients' health histories, documented current symptoms, and pulled up records from prior visits for dentists to view and evaluate.
Education
Resilience Trainer Assistant Course November 2018 - Dec 2018 Self-Development Course -
Dental Clinic Kaiserslautern
Basic Skills Course -
US Army
Ft Sill, OKHigh Point Central High School
Carolina, NorthBachelor of Science - Health Administration
University of Phoenix
Tempe, AZ05.2026
Skills
- Coverage Assessments
- Information Verification
- Claims Auditing
- Customer Communication
- Carrier Coordination
- Loss Documentation
- Compliance Management
- Documentation Review
- Composite Health Care System
- Corporate Dental System
- Medical Billing and Coding
- AHLTA
- Essentris
- Microsoft Word
- Microsoft Excel
- Adobe Acrobat
Certification
Patient Services Admin Training, Germany December 2018 - January 2019
Additional Information
- HONORS AND AWARDS , Military Certificate of Appreciation
Timeline
Medical Claims Coordinator
William Beaumont Army Medical Center
02.2022 - 09.2023
Medical Support Assistant
William Beaumont Army Medical Center, William Beaumont
01.2021 - 02.2022
Medical Support Assistant
United States Army Europe
03.2019 - 01.2021
Dental Assistant
United States Army Europe
01.2017 - 01.2019
Resilience Trainer Assistant Course November 2018 - Dec 2018 Self-Development Course -
Dental Clinic Kaiserslautern
Basic Skills Course -
US Army
High Point Central High School
Bachelor of Science - Health Administration
University of Phoenix
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