Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary
Procure a key position as a Healthcare / Business Analyst, applying my discriminating analysis and medical coding skills to the achievement of greater profitability within a dynamic organization.
Skill Highlights
  • Medical, HCC, & RXHCC Coding Analysis & Educatio
  • Medical Credentialing & Contracting Training Documentation & Instructio
  • Medical Claims Review Technical / Computer/ MS Office Proficiency Financial Accounting & Analysis Insurance Savvy Written / Oral / Technical Communications Budget Preparation, Forecasting, and Management Medical & Business Billing & Collections
  • Engineering Software AClaire, Westinghouse
  • Graduated Magna Cum Laude 3.7 / 4.0 GPA. Completed eight-semester course load in seven semesters
  • Created and implemented business office processes for a start-up ASC. Studied and customized AdvantX practice management software. Results: 6- figure profitability within the first 3 months of operations
  • Improved management of client data at a medical practice management company. Successfully enrolled clients with insurance carriers, electronic filing, and electronic remittance. Investigated proper coding, negotiated fee schedules, and secured contracted codes payments. Results: Ensured payment and compliance with proper coding, education, and contracting
  • Excelled in medical biller position with no experience and no on-the-job direction: learned Medical Manager, established electronic billing, formulated human resources documents and policies, interviewed applicants, analyzed & upgraded computer network. Results: Billed 10 times what previous person did in just first month. Promoted to Office Manager after 6 weeks
  • Established accounting procedures and workflow processes for a small company by implementing an accounting software package and spread sheeting major status points. Results: Seamless project management of 118 and 91 location billing audits, and 5-year increase in revenues of 130-fold
  • Enhanced an Excel spreadsheet to be an elaborate summary of people costs. As this was 70% of the annual budget, it was eminently important in preparation and forecasting. Results: Variances in pay or benefits easily reflected. Invaluable as failsafe tool throughout the year
  • Standardized open backbone network access interfaces and usage procedures for PC users in an 18,000 employee, 15-building campus by programming user interfaces, co-writing a network user's manual and system administrator's guideline, and providing training sessions as needed. Results: Increased productivity of all users, and freed time of lead network support personnel
  • Computerized capital budget forecasting and asset management, after upgrading the department's computer network. Results: Increased budget data availability to an on-demand status rather than monthly. Department asset database more complete and than corporate mainframe. Stopped write-off of $511K
  • United States Secret Clearance 1985- 1992
Professional Experience
CARETAKER, 01/2012 - 01/2012
Addus Homecare Corporation Turner, ME, and MRA Coding at Matrix Medical Network in Clearwater, FL. Personal grief and recovery work since my husband passed away. Excited to be ready to rejoin the workforce at this time.
BUSINESS OFFICE MANAGER, 01/2010 - 01/2011
Augustana Care Corporation Saint Paul, MN, Formulated computer network structure and created processes to effectively run the business aspects of a new Ambulatory Surgery Center. Customized AdvantX practice management software. Performed onsite accounting responsibilities, coding, billing, and reimbursement management. Daily and weekly financial reporting and cash flow analysis for partners. Assisted with AHCA & AAAHC certifications and Medicare enrollment. Supervised front desk, insurance verification, billing and coding activities: 4 direct reports.
Department Of Defense Fort Wainwright, AK, Created data base elements, data base structure, input screens, output to credentialing forms, and custom reports. Coordinated 5 member international team efforts. Ensured correct coding and provided education via proper CPT/ICD-9 matching, NCCI edits, NDC evaluations, online research, carrier guidance, and vendor outreach. Created client management tools. Brought new practices onboard: completing electronic filing, remittance, and contracting & credentialing actions. Verified proper fee schedule payments. Developed process documentation of key operational methodologies.
Paper Transport, Inc. Sanford, FL, 2004-2005 Positions in private medical offices, developing processes and implementing billing and A/R systems. Analyzed CPT procedure codes, ICD-9 diagnostic codes, EOB statements, denials, insurance benefits, and provider contracting and credentialing to optimize work and cash flow. Florida Eye Centers, P.A., St. Petersburg, Florida - Office Manager St. Petersburg Chiropractic Clinic, St. Petersburg, Florida - Insurance Verification St. Mary's Family Practice Center, St. Petersburg, Florida - Billing and Office Manager
BUDGET OFFICER, 01/2001 - 01/2002
City Of St. Pete Beach City, STATE, Coordinated budget process for the City of St. Pete Beach, compiled all department information, authored executive summary, and published the City's operating and capital budgets. Performed extensive management analysis: revenue enhancement, contract review, cost allocation and containment.
OWNER, 01/1995 - 01/2001
Rewarding Audits, Inc City, STATE, Performed detailed audit investigations of telephone and utility bills to secure refunds of overcharges for clients. Fulfilled billing & collections, computer technology, accounting, and payroll functions. Avg annual sales $221K.
ANALYST/PROGRAMMER, 01/1985 - 01/1992
Westinghouse Electric Corporation City, STATE, Personal computer network design, peripheral integration, training, and support. Technical writing: network manual and administrator guides Responsible for computer equipment procurement, capital facilities expenditures, monthly cash flow forecasts, and renovations coordination. Created and maintained asset inventory database.

Effectively managed a multi-line phone system and greeted all patients.

Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.

Reviewed medical record information to identify all appropriate coding based on CMS HCC categories.

Verified and abstracted all medical data from the record to assign appropriate codes for hospital inpatient records.

Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.

Recorded and filed patient data and medical records.

Acquired insurance authorizations for procedures and tests ordered by the attending physician.

Wrote detailed clinical phone messages for physicians.

Entered orders into the EMR system efficiently and without errors.

Participated in revenue cycle processes.

Career Chronology
entery, 11/2012 - 01/2013
avb town, state
Education and Training
Bachelor of Science: Business Administration/Data Processing, Expected in
Shepherd College - Shepherdstown, WV
Bachelor of Science - Business Administration/Data Processing, Shepherd College, Shepherdstown, WV. Graduated Magna Cum Laude 3.7 / 4.0 GPA. Completed eight-semester course load in seven semesters.
: Medical Coding & Billing, St, Expected in
Career Institute of Florida - St. Petersburg, FL
Career Institute of Florida - Medical Coding & Billing, St. Petersburg, FL. Nationally Accredited by ACCSCT. Completed program in less than half the scheduled time with a 4.0 / 4.0 GPA.
CPC Certified Professional Coder MEDICAL BILLING P.A American Academy of Professional Coders, Certified Professional Coder.
Professional Affiliations
Advisory Council, Career Institute of Florida Allied Health Department
Cash, Billing, Accounting, Asset Inventory, Database, Forecasts, Integration, Integrator, Inventory, Network Design, Optimization, Procurement, Training, Coding, Cpt, Icd, Icd-9, Annual Sales, Audit, Clients, Collections, Credit, Payroll, Sales, Telephone, Office Manager, Client Management, Documentation, Filing, Payments, Process Documentation, Remittance, Ahca, Financial Reporting, Front Desk, Medicare, A/r, Benefits, Medical Billing, Medical Invoicing, Office Management, Budget, Budgets, Contract Review, Access, Asc, Asset Management, Audits, AClaire, Backbone, Budget Preparation, Claims, Electronic Billing, Excel, Financial Accounting, Forecasting, Human Resources, Increase, Mainframe, Medical Claims, Ms Office, Operations, Project Management, Training Documentation, Workflow, Medical Coding

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School Attended

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  • Career Institute of Florida

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