Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000,
Professional Summary
Seeking to obtain a position as a Medical Billing Representative/ Patient Account Rep. I have extensive knowledge in the area of claims resolution. Well developed written and oral communication skills. Area of expertise is government health coverage products such as traditional Medicaid, CMO plans and Avesis Vision. Also experienced with some commercial health plans. Trained to maintain a high level of service to patients and operate according to HIPAA guidelines.
Skill Highlights
EEMR, Epic Web, Avesis, Medical Manager, Mega West, Microsoft Word, Excel, all CMO web portals, Availity, Cactus, IDX, I-Suite, GE Centricity
  • Employee of the month
  • High claim payment record
  • Complimentary feedback from patients
  • High claim payment outcomes
  • Exceed production and quality assurance standards.
  • Medical Billing Specialist Certification April 2006.
Professional Experience
08/2008 to Current Denial Resolution Specialist William Demant Holding A/S | Glenwood Springs, CO,
  • Identify trends in denials and implement resolution measures
  • Create and maintain the Medicaid portal accounts for provider profiles throughout the Emory Healthcare system
  • Review and update provider credentialing status
  • Review and submit medical notes to government payers to support CPT billing reasoning
  • Correct and resubmit claims via paper and electronic filing
  • Provide input for company training manuals
  • Directly communicate with senior management to address claim issues
10/2005 to 08/2008 Medical Billing Clerk Dover Corporation | Salisbury, MD,
  • Submit physician fee charges electronically and hardcopy using HCFA 1500 Form
  • Check eligibility and claim status via web portal and telephone
  • Investigate denials and resubmit for payment Adhere to ICD-9 and CPT-4 coding standards
  • Post charges to billing software
  • Communicate with patients to resolve outstanding balances
  • Collect and display data crucial to revenue increase.
05/1998 to 04/2005 Supervisor Home Depot | City, STATE,
  • Lead in the effort of exceptional customer service among staff
  • Provide resolutions to customer complaints
  • Assess and collect on outstanding balances
  • Monitor and provide assistance to incoming customer calls
  • Aid to train new cashiers with daily store functions, policy, and procedure
  • Maintain customer orders and purchase accounts.
Education and Training
Expected in 2003 Certification | Medical Billing Everest Institute, Atlanta, GA GPA:

10 years denial resolution experience for government payers, exceptional customer service skills, professional telephone etiquette, proficient Excel and Microsoft Word skills, confidently navigate health plan web portals

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School Attended

  • Everest Institute

Job Titles Held:

  • Denial Resolution Specialist
  • Medical Billing Clerk
  • Supervisor


  • Certification

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