Jenessa DeRosa
Billings,MT
Summary
Medical Billing and Coding Specialist with 10 years providing administrative and patient support in (Emergency Department) hospital and family practice medical office settings. Advanced knowledge of private insurance processes and codes.
Positive, upbeat, hardworking professional that welcomes challenges and excels under pressure.
Overview
10
10
years of professional experience
Work History
Owner/Budget Analysis & Payroll
Construction Specialties (with Ex-husband)
01.2007 - 08.2015
- Managed day-to-day business operations.
- Consulted with customers to assess needs and propose optimal solutions.
- Trained and motivated employees to perform daily business functions.
- Established foundational processes for business operations.
- Enhanced operational efficiency and productivity by managing budgets, accounts, and costs.
- Evaluated suppliers to maintain cost controls and improve operations.
- Organized and attended trade shows and special events to showcase products, network with other businesses and attract new customers.
- Generated revenues yearly and effectively capitalized on industry growth.
- Prepared bank deposits and handled business sales, returns and transaction reports.
- Oversaw business budget planning and administration, accounting functions, purchasing, and bi-weekly payroll to handle financial needs.
- Introduced new methods, practices, and systems to reduce turnaround time.
Charge Entry/Patient Service Representative
Providence, St. Patrick Hospital
12.2008 - 06.2012
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Verified insurance eligibility and coverage for patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Built and maintained positive working relationships with patients and staff.
- Managed patient registration process, confirming data accuracy and completeness.
- Took copayments and compiled daily financial records.
- Used Epic and Centricity Business to schedule appointments.
- Balanced deposits and credit card payments each day.
- Investigated insurance claims denials and appeals.
- Verified patient insurance eligibility and entered patient information into system.
- Answered incoming calls, scheduled appointments and filed medical records.
- Greeted and assisted patients with check-in procedures.
- Facilitated communication between patients and various departments and staff.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
Claims Examiner/Stop Loss
Allegiance Benefit Plan Management
05.2005 - 08.2007
- Examined statements and adjudicated claims based on ICD-9 coding received on claims.
- Investigated and processed health and vision insurance claims for policyholders and sent out EOB daily.
- Researched claims and incident information to deliver solutions and resolve problems.
- Reviewed documentation on HCPCS and HCPC ensuring correct documentation and billing.
- Worked with the clinic or hospital to ensure correct CPT codes to properly classify claims.
- Examined claims forms and other records to determine insurance coverage.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Education
Associate of Applied Science - Health Information Technology
Northland College
East Grand ForksNo Degree - Pre-Nursing - Did Not Finish Due To Illness.
University of Montana
Missoula, MTSkills
- Administrative Oversight
- Budget Administration
- Business Management
- Business & Strategic Planning
- Customer Relations & Patient Check-In
- Human Resource Management & training
- Medical & Office Procedures Scheduling
- Patient Registration & Insurance Eligibility and Verification
- EMR Software
- Attention to Detail & Effective Multitasking
- Reception Management
- Team Supervision & Strong Work Ethic
- Medical Practice Operations
Timeline
Charge Entry/Patient Service Representative
Providence, St. Patrick Hospital
12.2008 - 06.2012
Owner/Budget Analysis & Payroll
Construction Specialties (with Ex-husband)
01.2007 - 08.2015
Claims Examiner/Stop Loss
Allegiance Benefit Plan Management
05.2005 - 08.2007
Associate of Applied Science - Health Information Technology
Northland College
No Degree - Pre-Nursing - Did Not Finish Due To Illness.
University of Montana
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