Tracey Jones
Baltimore,MD
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
20
20
years of professional experience
Work History
Insurance Verfication Specialist
Kennedy Krieger Institute
05.2022 - Current
- Monitored changes in government regulations affecting healthcare reimbursement systems
- Ensured that the most current version of provider contracts were stored in the database
- Provided timely follow up with payers regarding payment status of claims
- Conducted regular audits of patient accounts for accuracy of demographic data
- Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information
- Responded promptly to customer inquiries regarding their benefits and eligibility status
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements
- Interpreted Explanation of Benefits statements from various insurers and communicated relevant information with other departments as needed
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers
- Participated in training sessions on new software programs used for verification purposes
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
- Updated patient and insurance data and input changes into company computer system
- Analyzed and interpreted insurance coverage policies to determine patient eligibility for services
- Resolved insurance-related issues and discrepancies to prevent claim denials
- Collaborated with healthcare providers to communicate insurance coverage and authorization details
- Contacted patients to confirm demographic information and communicate financial responsibilities
- Managed multiple tasks and priorities in a high-volume, fast-paced environment.
Security Officer /Front Desk
Kennedy Krieger Institute
09.2012 - 05.2022
- Answered phone with positive attitude and asked questions to better understand customer needs
- Monitored security cameras and fire, building and alarm systems
- Triaged problems quickly and provided precise and clear information while working under minimum supervision
- Scheduled and confirmed appointments
- Provided friendly and professional assistance to employees, visitors and customers
- Communicated with team members and building management via radio, telephones, computers and proprietary outlook software
- Provided excellent service and attention to customers when face-to-face or through phone conversations
- Sanitized work area and sterilized equipment and instruments to comply with protocols
- Offered protective masks and face shields to guests
- Communicated professionally to explain COVID-19 screening procedures to staff members and visitors
- Screened employees and visitors using specific protocol and non-contact infrared thermometers.
Correctional Officer
State of Maryland
05.2004 - 06.2011
- Inspected cells and conducted random searches of common areas
- Monitored daily activities to identify and manage suspicious behavior, improper conduct and signs of conflict
- Detected potential threats and quickly defused conflicts
- Informed inmates and visitors of rules, safety and security procedures and responsibilities
- Supervised residents during meal distribution and intake, recreation time and work-site performance
- Received property from incoming inmates, provided receipts and inspected items for contraband
- Transported inmates to and from medical and dental appointments, funerals, work details and court hearings
- Processed inmate intake and re-assignment by completing paperwork, conducting searches and recording fingerprints
- Provided friendly and professional assistance to employees, visitors and customers
- Communicated with team members and building management via radio, telephones, computers.
Education
High School Diploma -
Habor City High School
Baltimore, MD06.1998
Skills
- First aid certified
- MS Office
- People skills
- Inbound and Outbound Calling
- Customer Service
- Office equipment proficiency
- Problem-solving abilities
- Security procedures knowledge
- Premises surveillance
- Vigilant and watchful
- CPR certified
- Crisis Prevention and Intervention training (CPI)
- Proficient in [Software]
- Medical Terminology
- Insurance terminology
- Attention to Detail
- Insurance Coverage Verification
- Coverage and Authorizations
Timeline
Insurance Verfication Specialist
Kennedy Krieger Institute
05.2022 - Current
Security Officer /Front Desk
Kennedy Krieger Institute
09.2012 - 05.2022
Correctional Officer
State of Maryland
05.2004 - 06.2011
High School Diploma -
Habor City High School
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