Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
Professional Summary
Detail-oriented Billing A/R Specialist who keeps entries up-to-date daily. Dedicated to providing current state-of-accounts reports to inform cash flow management decisions.
Core Qualifications
  • Over 10 years of Healthcare consulting experience including hospital and physician Excel in  collections, denial management, appeals, payment posting, charge entry, insurance verification, policy and procedure updates, and registration.
  • Electronic and manual Medicare, Commercial, and Third-party claim submissions-extensive UB04 and CMS 1500 knowledge.
  • Able to identify and solve problems and to coach others; provided training and direction to new PFS staff.
  • Updated and implemented policies and standard operational procedures for best practices regarding billing and collections.
  • Review payment denials and discrepancies and re-bill for reimbursement. Systems/Skills Overview:
  • Keyboarding-70 wpm
  • Microsoft Word, Excel, Outlook, Access, PowerPoint, and Publisher.
  • MediSoft, DoctorsPartner, Dairyland/Healthland, HCS, Epic, Quickbooks Pro, Meditech, DDE, NextGen, Misys, Allscripts, MS4, DSG, SMS, AS400, Cerner, Citrix-Cirius, Emdeon, CPSI and Image silo

Accounts receivable professional
Adobe software
Complex problem solving
Strong communication skills
Traveling Medical Billing Specialist, 01/1 to Current
Healthcare Resource GroupCity, STATE,
  • Cash Payment posting policies and procedures implemented and updated for posting department. Training on how to balance days and months. Financial reporting. Medicare-DDE Billing and follow-up/Medicaid Billing and Direct entry billing/adjustments.
  • Hospital follow-up on Commercial payers all financial classes. (March 2014-August 2014)
  • Hospital and Clinic billing and follow-up all Government and Commercial payers.
  • Medicare DDE billing and follow-up/Medicaid billing and direct data entry/adjustments. Turning Point Resources-CA Travel Billing Specialist January 2014-March 201 St Joseph's Hospital-IL
  • Billing and follow-up Illinois Medicaid using Meditech Mammoth Hospital, Mammoth Lakes, CA - Managed Care Collector
  • Billing and follow-up of Workers Compensation
  • Follow-up of Blue Cross claims Ferry County, Republic, WA -Medical Billing Representative
  • Billing and follow-up of all commercial payers
  • Provider One Adjustments Skyline Hospital, White Salmon, WA - Provider One Trainer and Account Recovery
  • Provider One Adjustments and Employee training
  • Medicaid Account Recovery Lincoln Hospital District 3, Davenport, WA - Consultant
  • Charge Entry in Provider One Portal
  • Account Recovery in all Commercial payers
  • Secondary billing Holy Rosary Hospital, Miles City, MT - Medical Biller/Consultant
  • Hospital and Physician Credits & Refunds/Admission Department/Medical Billing/Collections
  • Payment Posting and Charge Entry using Dairyland/Healthland software St. Patrick's Hospital, Missoula, MT - Consultant
  • Medical Billing and Admissions Department
  • Auditing credits and issuing refunds for commercial insurance, Medicare, Medicaid and Self Pay accounts
  • Auditing Veterans Administration for overpayments and turning in findings to hospital management
  • Worked on the proration holds and unbilled reports to obtain missing demographic information and NPI numbers to complete billing process
  • DDE (Medicare) - Inpatient auditing for any inpatient and ER admissions; Systems: Meditech
Chambers Hospital, Anahuac, TX-Remote Analyst/consultant, 02/2012 to 01/2014
ResolutionsCity, STATE,
  • Louisville, CO-Remote Assignments for following hospitals: February 2012-January 2014 Chambers Hospital, Anahuac, TX-Remote Analyst/consultant
  • Commercial/Medicare/Government follow-up using CPSI and Healthland systems. South Lyon Medical Center, Yerington, NV-Consultant onsite and remote analyst
  • Commercial/Medicare/Government follow-up using CPSI systems/healthland conversion accounts.
  • Medicaid billing using CPSI and Nevada Medicaid billing guidelines. NYE Regional Medical Center, Tonopah NV-Remote analyst/consultant
  • Medicare/Commercial follow-up using CPSI billing system.
MBA: Accounting, Expected in 2014
Colorado Technical University - Colorado Springs, CO
Colorado Technical University 1/1/2013- graduation date 9/2014 Colorado Springs, CO Master of Business Administration (Accounting) (MBA) GPA 3.81
Bachelor of Science: Accounting, Expected in 2012
Colorado Technical Universtiy - Colorado Springs, CO
Bachelor of Science in Accounting 1/2011-8/2012 GPA 3.8
: , Expected in 2010-11-10
Cheryl Fell's School of Business - Niagara Falls, NY
High School Diploma: , Expected in
- ,
Billing, Medicaid, Medicare, Adjustments, Meditech, Posting, Training, And Account, Auditing, Billing/collections, Blue Cross, Claims, Collections, Commercial Insurance, Compensation, Credit, Davenport, Managed Care, Medical Billing, Medical Invoicing, New Product Introduction, Npi, Workers Compensation, Accounting, Hr Generalist, Hrg, Data Entry, 70 Wpm, Access, As400, Best Practices, Cerner, Citrix, Cms, Content Management System, Epic, Excel, Healthcare, Keyboarding, Medisoft, Microsoft Word, Outlook, Pfs, Powerpoint, Publisher, Quickbooks, Quickbooks Pro, Sms, Typing, Word, Cash, Financial Reporting, Mba, Secretarial

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School Attended

  • Colorado Technical University
  • Colorado Technical Universtiy
  • Cheryl Fell's School of Business

Job Titles Held:

  • Traveling Medical Billing Specialist
  • Chambers Hospital, Anahuac, TX-Remote Analyst/consultant


  • MBA
  • Bachelor of Science
  • High School Diploma

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