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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Experience
PSA / Dental Biller, 06/2011 - Current
Lifepoint Hospitals Vernal, UT,
  • Carefully reviewed dental records for accuracy and completion and ensured proper coding, sequencing of diagnoses and procedures as required by insurance companies to submit claims.
  • Acquired insurance authorizations for procedures and tests ordered by the attending physician as well performed insurance verification and pre-certification.
  • Performed quality control of reconciliation report to verify that claims and payments were posted correctly for 5 different sites (Brooklyn Chinese, Park Slope, Park Ridge, and Caribbean and Main site).
  • Appropriately and correctly identified errors and re-filed denied/rejected claims and submitted refund requests for claims paid in error as they were received from the Patient Account Representatives.
  • Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology, restorative, endodontics, prosthodontics (removable and fixed), and implant services reports as well as clinical studies) in support of existing diagnoses.
  • Posted and Applied charges, payments, adjustments and denials into Dental Manager System for 3 different sites (Brooklyn Chinese, Park Slope, and Main site).
  • Consistently informed patients of their financial responsibilities prior to services being rendered.
  • Coordinated appointment schedules for both the dentist and oral surgeon.
Medical Billing Associate, 03/2003 - 09/2010
Unite / BTQ Financial City, STATE,
  • Worked closely with Clinical Directors from seven clients with multiple programs such as, ADHC, Mental Health, Oasis, Dental, Foster Boarding Home, Family Based Treatment, COBRA Case Management and a Multi Specialty Clinic
  • Created excel tracking system to monitor percentage of billings received from clients
  • Responsible for billing, voids, adjustments payments for all originations sites including Medicaid, Medicare and Vida care
  • Generated weekly accurate Denial reports, monthly Billing reports, and Income reports on a monthly and annual basis for the Director of Billing
  • Processed client billing and third party reimbursement claims, maintain supporting documentation and files, and verify the accuracy of input to reports generated
  • Reviewed all weekly clients billing for missing information and adjust by utilizing Epaces or correspond with the sites to obtain client initial data form
  • Posted medical billing payments, charges, clinic co pays
  • Posted payments of insurances checks with write-offs or allowance for doubtful amounts, provide weekly billing submission reports
  • Followed up with the insurance companies on claims submitted, monitor outstanding claims, intake tracers and workers compensation issues
Education
Associate: Medical Billing / Office Technology, Expected in 2004
-
Computer Career Center, INC - Brooklyn, NY
GPA:

High School Diploma: , Expected in 2002
-
Manhattan Comprehensive Day / Night H.S. - New York, NY
GPA:
Certifications

Evaluation and Management, HCFA1500, CPT-4 Procedure Codes, ICD-9 Diagnoses Codes, Fraud & Abuse

Skills

Proficient in Dentrix Logon, Smart ID, Office Manager, ADS (Advance Data System)/Medics Premier, Medisoft, Fun EZ, Epaces/Ecentral/Healthplex/Denta Quest, HCPCS, Med-Manager, Microsoft Works Studio/Word/Excel/Power Point/Outlook, Front Office, Citrix, Adobe Reader Acrobat

Languages

Native Spanish speaker, English

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School Attended

  • Computer Career Center, INC
  • Manhattan Comprehensive Day / Night H.S.

Job Titles Held:

  • PSA / Dental Biller
  • Medical Billing Associate

Degrees

  • Associate
  • High School Diploma

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