Insurance Manager
Resume:
Ethel L. Jones
Houston, Texas 77082
281-***-**** Cell
Experienced Medical Professional with knowledge in billing and collections willing to obtain and share skills.
SUMMARY OF QUALIFICATIONS
* More than 10 years of billing/collections * History of increasing profitability
* Hard working able to multi-task * Proven ability to lead effectively.
* Outstanding training, leadership, and communication
* Familiar with aspects of business
* Knowledge of ICD-9 and CPT Coding
PROFESSIONAL EXPERIENCE
RediClinic, LLC Revenue Cycle Supervisor
Central Billing Office 08/11-10/12
Houston, Texas
*Supervise Staff of 5
*Verify weekly time
*Submitt bi-weekly time for payroll
*Review requested employee time off/vacation
*Run monthly A/R report
*Run Daily Coders Report/Activity Report
*Submitt Employee Invoice for Payment
*Attend weekly, bi-weekly managers meeting/via web-ex
*Review/Approve Patient-Insurance Refund Requests
*Verify current insurance coverage
*Enter patient and billing information
*Review/Verify accuracy of billing codes (EMR)
*Review patient information for accurate billing to insurance company
*Enter patient billed charges into EMR (Athena)
*Follow-up with insurance companies on claim payment status
*Print Itemized statements
*Post insurance and patient adjustments/write-off (EMR)
*Answer patient concerns that request supervisor
Greenway Family Practice Billing Manager
Dr. JoAnne Rogers 2009-2011
Houston, TX
*Validate end of day balance
*Verify current insurance coverage
*Enter patient and billing information
*Review/Verify accuracy of billing codes (EMR)
*Review patient information for accurate billing to insurance company
*Enter patient billed charges into EMR (eClinical Works)
*Electronic Claims Submission/Denial Reports
*Print HCFA
*Follow-up with insurance companies on claim payment status
*Appeal all denied claims
*Follow-up with patients on balance
*Process end of month reports
*Mail patient statement/letters
*Print Itemized statements
*Post insurance and patient adjustments/write-off (EMR)
*Provider Credentialing
*Front Desk Receptionist/Scheduled Ancillary Test
* Referral Coordinator
*Office Manager
ParrishShaw + Co Recovery Coordinator
Houston, TX 2005-2008
*Maintained all collections process on insurance balance for several accounts.
*Produced monthly AR reports on all delinquent accounts.
*Gathered payments status information from medical insurance companies
*Submission of letters of appeal on denied claims
*Completing adjustments
Synergy Business Services, Inc Recovery Coordinator
Houston, TX 2004 - 2005
*Maintained all collections process on insurance balance for several accounts.
*Produced monthly AR reports on all delinquent accounts.
*Gathered payments status information from medical insurance companies
*Submit letters of appeal on denied claims
*Completing adjustments
*Maintained accurate patient and insurance data, i.e., medical records,
explanation of benefits, demographics, etc.
*Secured medical documentation required or requested to ensure account
resolution.
*Maintained confidentiality of all information in accordance with HIPPA.
Special Kids Care Billing Supervisor
Houston, TX 2002 - 2004
*Responsible for all billing and collections for two Home Health Locations.
*Downloaded all billing and payroll via internet (WINZIP).
*Data Entered 50 plus patients into billing accounts for electronic processing.
*Consistently achieved or exceeded all billing processes for the week.
*Prepared, presented, and arranged billing and payroll reports.
*Created and designed new collections process for accounts.
*Supervised and scheduled job assignments for other departments.
Patient Accounting Services Center Lead Collector
Houston, TX 2001- 2002
*Maintained all collections process on bad-debt accounts for Laredo Pediatric,
Texas Children, Baylor College of Medicine and New Mexico Hospitals.
*Met all collections objectives, recognized for leading one of companies
highest-rated territories.
HEALTHSOUTH Billing/Collections
Houston, TX 2000 - 2001
*Managed daily operations for data entry, billing and collections.
*Maintained collections system, monitored and notated all developments.
*Arranged payment schedules with insurance companies and patients.
EDUCATION
Houston Community College, Houston Texas 2009-2010
Continuing Education
Medical Billing and Coding
San Antonio College of Medical and Dental Assistants, San Antonio, TX
Medical Administrative Assistant, concentration in Billing and Collections 1997
San Antonio Community College 1995
Computer Science
Our Lady of the Lake University, San Antonio Texas 1991-1992
Computer Science
Thomas Jefferson High School, San Antonio, TX 1988-1991
General Diploma-Graduated
Ethel L. Jones
3131 Hayes Rd #101
Houston, Texas 77082
281-***-**** Cell
REFERRANCES
PROFESSIONAL:
Arlene Monroe
Human Resources of RediClinic, LLC
9 Greenway Plaza, Suite 2950
Houston, Texas 77089
832-***-**** Cell
Dr. JoAnne L. Rogers Dr. Robin M. Moore
Greenway Family Practice Elite Family Health & Wellness
4126 Southwest Freeway, Suite 600F 1200 Binz Street Suite 1198
Houston, Texas 77027 Houston, Texas 77004
713-***-**** Office 713-***-**** Office
713-***-**** Fax 713-***-**** Fax
Carmen Gonzalez Mrs. Lerneisha McKinnley
HealthSouth-Office Manager Greenway Family Practice
PERSONAL:
Mrs. Dana Gibson
Mrs. Guy Green, Pastor
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