Theresa Jacob
Philadelphia,PA
Summary
Passionate and hardworking leader offering 15 years of experience in project management, process improvement, financial analysis, problem-solving, and system implementation. Proficient in overseeing team operations, dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.
Overview
27
27
years of professional experience
Work History
Senior AR Specialist
Simpson Senior Services
12.2022 - Current
- Assigned to two communities sites (Simpson House & Simpson Meadows) to handle all AR services for Independent Living, Assisted Living, Skilled Nursing & Long-Term Care Facilities.
- Create monthly invoices with Salesforce for rent, salon, meals, transportations, pharmacy, labs, general store and medical supplies services to bill the residents. Assigned as the Cash Banker using the RFMS system to give residents monthly allowances and check cashing services.
- Currently implementing configuration and data with troubleshooting to create the new service of procedures and controls in MatrixCare. Conducted independent technical reviews of current processes and records to proactively identify and correct process and system issues.
- Process month-end close to close out all financial activity for assigned facilities for the preceding month using M&T online commercial treasury center, MatrixCare and Sharepoint.
Medical Billing Manager
Philadelphia Mental Health Center
07.2021 - 12.2022
- Worked cooperatively with the CEO, managers, administration and billing team for reporting and patient account management. Reviewed and finalized all services for IBHS, Psychiatry, Telehealth, Mobile Mental, Pediatric claims for CBH, Magellan and TPAs to ensure accurate revenues.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques. Created KPIs and holding weekly supervision meetings in-person or through the Zoom platform. Conducted performance reviews and implemented improvement plans.
- Responsible for system configurations inclusive of Care Authorization setup, claims processing, billing, developing alerts/triggers, forms and reports
- Completed insurance credentialing for providers and clinics with PECOS, CAQH and all other insurance portals including Medicare and Medicaid. Implemented and updated all insurance changes, contracts, and pricing in the Credible software system. Reviewed billing problems, researched issues, and resolved concerns. Performed testing for billing modules, enhancing new functionality and process improvements.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies. Evaluated and negotiated contracts to procure favorable financial terms. Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports. Improved overall financial reporting by streamlining control processes and reporting structures.
Director of Revenue Cycle
Advanced Diagnostics/Injury Rehabilitation Center of PA
11.2017 - 03.2022
- Responsible for overseeing the entire billing process of the company. In charge of setting, implementing, and enforcing billing policies and staff disciplinary actions. Supervised all billing shifts along with managing & monitoring all accounts receivable, collections, credentialing and insurance contracting ensuring that all billing-related tasks are completed on time and were accurately assigned to the daily KPI reporting for the staff.
- Posted jobs, conducted interviews, hired, trained and completed onboarding, offboarding and payroll for all the billing staff.
- Handled all system implementation for EHR & billing model of services with adding new software(s), or configurations with troubleshooting and data revision to update the service of procedures, pricing and controls. Handled credentialing, contracting and pricing negotiations with all insurance companies.
- Negotiated with attorneys for settlements on outstanding cases and represented the company in all court case proceedings for workers comp, motor vehicle, & slip and falls accidents to authenticate the billing cost of treatment & tests.
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency. Monitored and guided revenue cycle operations. Supported clinical team members with revenue cycle procedures and addressed issues. Completed financial reporting and analysis for billing revenue cycle.
- Identified discrepancies between budgetary targets and actual revenue and expenses. Analyzed business processes to identify cost savings and operational efficiencies. Worked closely with the CEO/Founder to manage and prepare the sellable AR invoices for purchase with the AR Factoring Buyers.
Medical Billing and Coding Instructor
All-State Career School
02.2020 - 06.2021
- Created instructional powerpoint presentations, lectures, & curriculum documentations for hospitals and all medical specialty forums for medical billing and coding unitizing EHR and RCM systems, 1500 and UB04 claim forms.
- Supervised all student learning experiences in the classroom and online through Zoom and Canvas settings. Recorded attendance and graded all assignments and exams on the Canvas platform application. Actively promoted student retention and served as a professional role model for students
- Mentored students in the development of their medical billing knowledge and skills, including ICD-10 coding. Kept updated with developments in subject area curriculum, technical and career trends and teaching resources and methods.
Account Receivable Specialist
Soleo Health
05.2016 - 04.2018
- Performed all related functions regarding prior authorizations, collection of charges entered in an electronic posting and/or filing system with Allscripts, ZirMed/Waystar & CPR+.
- Reconciled accounts receivable ledger to verify payments and resolve variances. Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Maintained medical health records and insurances to support consistent and accurate AR revenues for home infusion and pharmaceutical services.
Senior Account Receivable Specialist
Vascular Access Centers (Medical Practice)
12.2015 - 11.2017
- Completed all assigned billing including TPA billing. Reviewed accounts on monthly basis to assess aging and pursue collection of funds. Posted payments and adjustments and ran weekly and monthly AR reports for meetings with the supervisors.
- Worked daily on AR follow-up, denials and appeal for comprehensive interventional services such as dialysis, access maintenance services, limb salvage, venous and arterial disease treatments.
Independent Contracted Freelancer
TRJ Consultant Services
05.2009 - 05.2016
- Provided multiple freelancing services for ePA authorizations, billing system integrations, medical billing services, and provider credentialing with all medical insurances to a variety of specialty providers such as pain management, physical therapy, MRI, home infusion, DME, pharmacy, labs, orthopedics and cardiology.
- Also provided public services for quarterly and yearly tax filing, W2, 1099 and general accounting.
- Sold injury care, homecare & hospice supplies and devices independently and through contracted specialist providers.
Medical Billing Manager
Body Solutions, Inc.
07.2007 - 05.2016
- Responsible for overseeing the day-to-day operations of a medical billing department and intake process
- Completed all authorization requests and checked eligibility and benefits. Negotiated and obtained insurance contracts. Posted payments, completed all credentialing, billing and collection.
- Supervised and scheduled all billing staff and billing school interns. Conducted performance reviews and implemented improvement plans.
Adults/Adolescents IOP Care Manager/QA Specialist
NET (Northeast Treatment Center)
12.2013 - 12.2015
- Assisted intake team with clients Compass enrollments for insurance activations for the Opioid & Alcohol Treatment Outpatient Programs for CBH and Magellan
- Accessed community-based resources, housing, and employment databases services to help clients to re-establish or start with new beginnings. Created appropriate referrals and performed general case management and counseling
- Checked all insurance packets for errors and accuracy prior to delivery of the packets to the Philadelphia DPW offices and to the CBH ( Community Behavioral Health) office.
- Established and maintained relationships with clients, families and community partners to coordinate services to meet client's needs.
- Monitored clients' progress and tracked client services using Credible to provide crisis interventions, insurance changes and client's demographic updates.
Medical Billing & Coding Instructor
CHUBB Institute
09.2006 - 09.2009
- Instructed students in a classroom setting on all of the required curriculum and syllabus courses. Recorded attendance and graded all assignments and exams.
- Kept updated with developments in subject area curriculum, technical and career trends and teaching resources and methods. Met training needs with well-organized, factual programs based on contemporary requirements.
- Engaged students in academic and practical conversations that elicited critical thinking, creativity, collaboration and communication. Observed and evaluated students' work to determine progress, provide feedback, and make suggestions for improvement.
AR Appeal & Denial Specialist
SIEMENS Medical Solutions
10.2002 - 08.2005
- Wrote appeal letters to all of the insurance companies to resolve denial issues & called the insurances for updates. Documented all transactions into the patient accounts using the Envision system.
- Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes. Identified root cause of denials to provide plans for denial resolution.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Certified Claim Processor/Group Benefits & QA Specialist
Independence Blue Cross
03.1997 - 03.2001
- Conducted research to find the root causes to resolve the customer benefit issues. Q/C and completed benefit packages. Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
- Created goals for recommendation and implementation for new processes on how to have the solutions to resolve internal/external issues
- Resolved issues and improved operational performance on a cross-functional/departmental basis.
- Utilized specialized software to process incoming claims, enter data and generate reports. Managed workload and priorities to meet claims processing meet deadlines.
Education
Diploma -
BOK AVT HIGH SCHOOL
06.1989
Skills
- All Microsoft Office 365
- Leadership
- Business Operations
- Reconciliation, Cash Application and Deposits
- Vendor Management
- Project Management
- Training and Instructing
- Implementation and Troubleshooting
- Compliance and Policy Development
- Aging Report Analysis
- Investigative Research
- Superior Attention to Details
References
AVAILABLE UPON REQUEST
Timeline
Senior AR Specialist
Simpson Senior Services
12.2022 - Current
Medical Billing Manager
Philadelphia Mental Health Center
07.2021 - 12.2022
Medical Billing and Coding Instructor
All-State Career School
02.2020 - 06.2021
Director of Revenue Cycle
Advanced Diagnostics/Injury Rehabilitation Center of PA
11.2017 - 03.2022
Account Receivable Specialist
Soleo Health
05.2016 - 04.2018
Senior Account Receivable Specialist
Vascular Access Centers (Medical Practice)
12.2015 - 11.2017
Adults/Adolescents IOP Care Manager/QA Specialist
NET (Northeast Treatment Center)
12.2013 - 12.2015
Independent Contracted Freelancer
TRJ Consultant Services
05.2009 - 05.2016
Medical Billing Manager
Body Solutions, Inc.
07.2007 - 05.2016
Medical Billing & Coding Instructor
CHUBB Institute
09.2006 - 09.2009
AR Appeal & Denial Specialist
SIEMENS Medical Solutions
10.2002 - 08.2005
Certified Claim Processor/Group Benefits & QA Specialist
Independence Blue Cross
03.1997 - 03.2001
Diploma -
BOK AVT HIGH SCHOOL
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