Sophia Jones
Fort Lauderdale,FL
Summary
To obtain a position that will enable me to use my strong organizational skills. I have the ability to prioritize tasks, meet time sensitive deadlines and work effectively in a group or independently to achieve goals. I am a highly motivated, growth-oriented professional.
Overview
25
25
years of professional experience
1
1
Certification
Work History
IRISE Spine and Joint
- Revenue Cycle/Accounts Receivable
- Trainer of payment posting
- PIP payment poster
- Request Demand / PIPSUIT letters for payments.
- LOP payments
- Time management of batches and Cycles EOB’s ERA’s
- Workmen Comp Payment posting
- Attorney Settlement research
- TMS-January 2020-March 2021
- Medical Billing Specialist Insurance
- MentalHealth Accounts Receivable
- Payment Posting
- CPT/ICD-10 coding
Medical Billing Specialist
Florida Spine Associates Boca Raton FL
Boca Raton, FL
02.2024 - Current
- Processed medical claims efficiently using advanced billing software solutions.
- Ensured accuracy of patient information and insurance details for timely reimbursements.
- Reviewed and resolved claim denials through effective communication with insurance providers.
- Maintained up-to-date knowledge of coding regulations and compliance requirements.
Payment Specialist
Irise Spine Associates
Boca Raton, FL
02.2022 - 02.2024
- Processed patient payments and insurance claims accurately within established timelines.
- Resolved billing inquiries by collaborating with patients and insurance representatives.
- Maintained up-to-date knowledge of payment processing software and systems.
- Generated detailed reports on payment trends to identify discrepancies.
Medical Billing and Coding
Polaris Rx Long Term Care Pharmacy
02.2018 - 12.2019
- Medical Billing/ALF (Assisted Living Facility)
- Medicaid Verification/Following up with case workers regarding coverage eligibility.
- Insurance processor/ EOB
- Census/entering A/R information and verifying Responsible parties for financial coverage
- Customer Service/follow up calls to Nurse/Social worker regarding medication and any changes in cover.
- Adjudication/calling insurance to process paying claims, denied claims to the benefit or coverage requirement.
- Data Entry, Entering New ALF Homes and Patient information
- Retro Quick Orders to process them through insurance to be paid.
Pharmacy Technician
1800 Pet- Meds
Pompano Beach, Florida
01.2006 - 02.2018
- Customer service, data entry.
- Sales
- Entering new prescriptions and creating order.
- Contacting referring physicians’ offices to verify and receive prescription approvals.
- Maintaining inventory and processing mailed prescriptions.
- Packaging meds and maintain packaging records.
- Processes invoices, credits and backorders.
- Training of new employees.
Pharmacy Technician
First Choice Pharmacy
Pompano Beach, Florida
05.2001 - 01.2006
- Process incoming prescription requests.
- Counting and packaging medication
- Data entry and customer service
- Process incoming prescription request
- Communicate with physicians to gain prescription approvals
- Training of new employees.
Education
Associates Degree - Medical Insurance Billing and Coding
Skills
- Customer Service
- Strong communications and interpersonal skills
- Detail-oriented
- Medicaid Verification
- Comprehensive knowledge of Microsoft Office, Excel, PDF and Power Point Frameworks, ECM, Point Click Care System and Matrix
- Kareo Software, Eclinic, NewMed
- Trainable and quick learner
- Knowledge of, HIPPA and OSHA policies
- Data Entry Skills
- Coding experience, CPT and ICD-10
- Revenue Cycle experience, Payment posting Healthcare and Auto PIP payments
Certification
- Registered Pharmacy Technician
- Certificate CBCS (Certificate Billing & Coding Specialist.)
Timeline
Medical Billing Specialist
Florida Spine Associates Boca Raton FL
02.2024 - Current
Payment Specialist
Irise Spine Associates
02.2022 - 02.2024
Medical Billing and Coding
Polaris Rx Long Term Care Pharmacy
02.2018 - 12.2019
Pharmacy Technician
1800 Pet- Meds
01.2006 - 02.2018
Pharmacy Technician
First Choice Pharmacy
05.2001 - 01.2006
IRISE Spine and Joint