Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000,
Professional Summary

Driven and Passionate Health Care Service professional with 12 years hands-on experience in fast-paced Medical Billing and Customers Service environment. Accountable and responsible with a strong focus on client, insurance and patients accounts needs.

Skill Highlights
  • Professional Integrity 
  • Team Player
  • Self-Directed 
  • Strong Communication


  •  Detailed-oriented
  • Strong analytical skills
  • Strong Research Skills
  • Strong Interpersonal skills
Professional Experience
09/2016 to Current Customer Service Firstservice Residential | Silver Spring, MD,
  • Promptly responded to general inquiries from members, staff, and clients via mail, e-mail and fax. Placed Orthotic orders for Doctor's office and Nursing Facilities daily
  • Verified that information in the computer system was up-to-date and accurate.
  • Created, organized, updated and maintained over 200 patient charts weekly.
  • Promptly responded to general inquiries from members, staff, and clients via mail, e-mail and fax.
  • Communicate with Doctor's office and Nursing Facilities Daily regarding coding of patient charts
  • Communicate with Sales Reps daily regarding patient orders
  • Verify patient insurance eligibility and benefits for multiple payors
  • Request Insurance Authorization for patient orders
  • Enter new patient demographics in system software
  • Verified Doctor Credentials for all orders
  • Created new facility locations in system
  • Created daily reports of Sales Reps orders for follow-up
  • Communicated daily with Sales Reps regarding issues/concerns regarding patient orders received
  • Created Certificates of Medical Necessity for patients and faxed to doctor's office and nursing facility for signatures
  • Created Assignment of Benefit letters for patients and mailed out
  • Handled In and Out bound calls
  • Posted insurance and patient payments in system as requested
  • Verified and tracked patient orders via UPS for daily reporting 
  • Handled replacement and exchanges orders as needed
  • Managed Insurance websites used
09/2011 to 08/2016 Accounts Receivable Rep / Team Support Sika Corporation | Chino, CA,
  • New Hire On Boarding, orientation of staff providing Company compliance policy education and training courses.
  • Ensured all New Hires Compliance documents are signed.
  • Communicated with HR/IT Support Team on behalf of New Hired Employee regarding compliance requirement issues/concerns
  • Processed and distributed all credit card payments for patients & insurance.
  • Monitored reports for patient and insurance credit card payments to improve performance
  • Maintained credit card Inventory Spread sheets monthly for multiple clients to support company compliance policy.
  • Established and maintained positive relationships with government payers, clients, office staff and multiple health care providers.
  • Maintained Excel spread sheet for multiple Client website portal access logs for insurance payers and electronic data interchange.
  • Managed over 200 websites ensuring smooth cash flow allowing over 5 million dollars of in-coming revenue monthly.
  • Provided update to Management Team with websites concerns and/or issues for clients and office staff.
  • Prepared and update Office Policy and Procedure Manual for Management Office Team.
  • Provided Support to office and client staff regarding website access.
  • Provided Quick Reference Guides and/or Helpful Hints user guides
  • Trained office staff to use website portals to improve quality of work production.
  • Timely follow-up and communication with insurance payers for claims appeals, corrections and re-adjudication of denied claims.
  • Responsible for reducing AR for 120 days> to less than 15%
  • Identified, corrected any billing and coding issues for conflict resolution.
  • Provided Customer Service Team Staff support with patient calls and account resolution.
  • Worked Patient Collection Report, reviewing patient accounts to determine accounts to be sent to collection.
  • Reviewed Patient Account Credits balances for payment reallocation to reflect true patient account balance.
  • Support Customer Service Team with Spanish Speaking calls.  
09/2009 to 09/2011 System Software Trainer/Support McKesson | City, STATE,
  • Worked with IT Support Team members regarding test and upgrade requirements
  • Researched and update of ANSI carrier codes for system software
  • Maintained and distributed updated system analysis to all Management Team weekly.
  • Identified and Report potential problems for system software with resolution to Management Team Weekly.
  • Maintained Multiple Client website access logs for insurance and electronic data interchange
  • Provided Team Leaders with carrier news/changes for current and/or future events.
  • Performed 50 Employee Audits monthly to ensure accuracy of greater than 86% and compliance of company and client policies.
  • Reported Employee Audit results to Management Team, while focusing on failing audits of less than 86%.
2007 to 09/2009 Accounts Receivable & Customer Service Supervisor McKesson | City, STATE,
  • Managed multi state client site in central business office.
  • Monitored Clients A/R cash receipts to ensure 25% weekly income.
  • Monitored all cash discrepancies for corrections weekly.
  • Monitored Client refund and over payment for both Insurance and Patient accounts weekly.
  • Reviewed patient account for client authorized small balance write offs monthly.
  • Monitored Clients A/R aging weekly.
  • Reviewed employee daily/weekly production and report discrepancies to Management Team.
  • Created employee work plans based on existing aging focusing on timely filing limits & payer amounts outstanding.
  • Analysis and correct all errors related to Pre-bill & WebMD billing reports; report all trends to Manager and Clients for efficient resolution process.
  • Monitor Denial Module and Collections Module to ensure resolution of patient accounts daily.
  • Monitor Collections Agency Reports.
  • Perform daily/monthly closes for multiple client sites.
  • Monitor Payroll, Approve overtime/make up time for all employees assigned as well as resolving all employee discrepancies.
11/2003 to 2007 Team Leader McKesson | City, STATE,
  • Conducted audits of A/R, call center collection staff Maintain the internal processes that will allow the company to meet and exceed the needs of the client.
  • Assisted in determining action plan when audits do not meet standards of the company.
  • Communicated with management team to provide feedback on quality of work, status of training programs, and the implementation/maintenance of new/current processes.
  • Provided one-on-one training to individuals or provide training in group environment.
  • Worked in conjunction with corporate training team to deliver training on any software upgrades and/or changes, Implementation of effective billing and follow up procedures.
  • Reviewed collection, denial module and corrective action module for update.
  • Reported clients with trending of current denial rejections.
  • Maintained EDI folders and ensure timely follow up and return to the appropriate departments.
  • Reviewed refunds and credit balances.
  • Communicated with clients on software errors and billing procedures.
  • Analysis system errors and ensure correct process is being used by employee and for timely billing and filing of insurance claims.
  • Researched on government rules for billing on procedures, diagnosis and report to management and clients.
  • Assisted cash posters with posting errors and ensure employees have clear explanation of insurance explanation of benefits to ensure better processes for insurance billing and posting.
  • Assist on posting of insurance and patient payments for multiple clients.
  • Assist collection representative with patient calls and letters.
  • Assist on special projects requested by Manager.
  • Perform other duties requested by supervisor and manager.

Microsoft Office 2013 - Microsoft Excel 2015 - Outlook 365 - eSolutions - ADP-ezLabor Manager - AR Express Billing System - Healthcare software system - NextGen EPX - Electronic Payment Exchange Chase Credit Card Software - Avality Emdeon-Claims tracker /Payment Manager - Medical Manager - Website System Support - A/R & Patient cash posting skills - Staffing management and development ability - Creative Problem Solving - Personal and professional integrity - Relationship and team building - Spread Sheet - Customer Service - Critical thinking - Multi-Task Management - Sound judgment and decision making skills - Time Management - Written and Telephone Communication Skills - Hard Worker - Team Player- Self-Directed - Detailed-oriented - Strong analytical skills - Strong Research Skills - Strong Interpersonal skills

Education and Training
Expected in 1997 GED | , Philadelphia, PA GPA:

Expected in 1998 Graduate Diploma | Computerized Business & Accounting DPT Business School, Philadelphia, PA GPA:
Create Fund Raisers to raise money and collections of items for multiple different organizations and an Active member of community Church

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Resume Overview

School Attended

  • DPT Business School

Job Titles Held:

  • Customer Service
  • Accounts Receivable Rep / Team Support
  • System Software Trainer/Support
  • Accounts Receivable & Customer Service Supervisor
  • Team Leader


  • GED
  • Graduate Diploma

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