Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Helpful Patient Service Representative with 10+ years of experience. Adept at collecting patient information, maintaining efficient office and coordinating with medical professionals. Extensive knowledge of insurance authorizations and commitment to patient happiness.

  • Administrative and Office Support
  • Database Search and Data Entry Skills
  • Patient Confidentiality and Data Security
  • Quality Standards and Protocols
  • Organized and Efficient
  • Comfort with Technology and Databases
  • 50 WPM Typing Speed
  • Clerical and Filing Support
  • Medical Services Administration
  • Multi-Line Telephone Systems
  • Records Management
  • Collections Management
  • Technical Troubleshooting
  • Claims Handling and Coverage Verification
  • Payment Calculation
  • Spanish Fluency
  • Insurance Authorizations
  • Benefits Explanation
  • Bilingual Spanish and English
  • Patient Registration
Work History
Access Service Representative II, 04/2008 to Current
Moffitt Cancer CenterTampa, FL,
  • Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance-related instructions.
  • Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Resolved patient financial and authorization/referral problems with guidance from documented guidelines and procedures.
  • Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
  • Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
  • Received patient deductibles, co-pay amounts and self pay estimates and discussed options to satisfy remainder of patient financial obligations.
  • Contributed to reduction of accounts receivables by adhering to predetermined policies and procedures to recover amounts due from patients.
  • Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.
  • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
  • Took copayments and compiled daily financial records.
  • Reviewed and corrected claim errors to facilitate smooth processing.
  • Balanced deposits and credit card payments each day.
  • Generated monthly statements to check outstanding balances.
  • Explained plans for treatment and payment options.
  • Initiated Inpatient, Outpatient, Observation authorizations.
  • Worked flexible hours; night, weekend, and holiday shifts
Medicare Billing Specialist, 10/2001 to 10/2006
Austin Heart PACity, STATE,
  • Reviewed patient records, identified medical codes and created invoices for billing purposes.
  • Liaised between patients, insurance companies and billing office.
  • Adhered to established standards to safeguard all patients' health information.
  • Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
  • Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
  • Reviewed services rendered and completed to reconcile codes.
  • Communicated with insurance providers to resolve any denied claims and resubmit.
  • Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Posted payments and collections on regular basis.
  • Researched and followed up on denied insurance claims.
  • Verified proper ICD-9 coding on claims.
  • Reviewed outgoing bills for eligibility and accurateness.
  • Completed client requests and advised supervisors of special needs.
  • Trained new employees on multiple medical billing programs and data entry software.
  • Transferred balances to correct payers.
Certificate: Medical Coding And Billing, Expected in 05/2020
Austin Community College - Austin, TX
High School Diploma: , Expected in 04/1996
Plainview High School - Plainview, TX

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Resume Overview

School Attended

  • Austin Community College
  • Plainview High School

Job Titles Held:

  • Access Service Representative II
  • Medicare Billing Specialist


  • Certificate
  • High School Diploma

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