Medical Biller, Collector
Julie A. Jackson
700 E. Washington St. #188
Colton, Ca. 92824
Medical Collector, Medical Biller
A seasoned Medical Collector/ Biller with over 20 yrs. experience providing thorough and skillful resolution of
accounts receivable for hospitals and physicians, using CMS 1500 and UBO4 claim forms.
Proficient in Microsoft Office, IDX, Epic, Medi-Tech, Medi-Soft, EZ-Cap, Sieman’s, AS400 and Versys
Adept at accomplishing tasks simultaneously and working well under pressure.
Highly organized, analytical thinker with strong communication skills.
Knowledgeable in medical terminology and all insurance products: HMO, PPO, POS, EPO, Managed Care and Government payers: straight Medi-Cal, Managed Care Medi-Cal and Managed Care Medicare.
Per diem Contractor
Working in medical billing, collections, auditing and revenue cycle for several 2008-2014
- facilities: Loma Linda Medical Center, San Bernadino and Murrieta, Ca. Regional Medical Center, Moreno Valley, Ca
Private, Riverside, CA
Following the care plan as directed by CHF (Congestive Heart Failure) clinic physicians Medication reminders, run errands, drop off/pick (prescriptions) escort to Dr. appointments. Plan prepares meals followed by clean up, housekeeping, laundry and companionship.
Patient Account Liaison
Wayne Perry & Associates, Grand Prairie, TX
(Temporary Assignment) 2013-2013
Financial assessment of vendors accounts receivables and report back to management. Printed CMS1500 and UB04 claim forms for submission to insurance companies
Submitted request for medical records for claims to be rebilled to health plan for payment\ Verified month to month eligibility for medi-cal through AEVS systems.
Knowledge in medical terminology and insurance products, HMO, PPO, POS, EPO and Managed Care, Commercial
Medi-Cal Collector/ Biller 2013-2013
Sherman Oaks, CA (Temporary Assignment)
Accounts receivable assigned by payer average 25 accounts daily with aging at 90 days or less through excel spread sheet.
Verify month to month medi-cal eligibility through AEVS systems
Review and bill CMS 1500 claim forms and 304 drug claims
Knowledge of medical terminology and insurance products; HMO, PPO EPO and Medi-Cal
Requested TAR and SARS for services rendered, responded to RAD request for claims processing
Submission of appeals for denied claims.
Medi-cal Collector/ Biller 2012-2013
Medix Staffing, Irvine, CA (Temporary Assignment
Accounts receivable assigned by alpha numeric split, average 300 claims as a biller, average 40 accounts daily as a collector, aging to be 60 days or less
Submission of UB04 claims to ensure clean and timely claims to be processed and paid Verify month to month eligibility
for medi-cal members through AEVS systems.
Knowledge of medical terminology and insurance payer products for government payers.
Review EOBS for payments posted on accounts to submit claim on appeal for underpayment.
Medi-Cal Biller/ Auditor
Office Works, Inc., Riverside, CA (Temporary Assignment) 2011-2011
Audited physicians patient billing records to determine what claims have not been submitted to payers
Verified patient health information was entered from patient chart into Medi-Soft billing systems
Knowledge of medical terminology and insurance payer products, HMO, PPO, EPO, POS, Commercial and Managed Care
Medical Biller 1 2011-2011
QTC Management Inc., Diamond Bar, CA
Accounts Receivable assigned by alpha numeric split, average 225 claims as a biller, aging to be 60 days or less
Review and analyze new business for pre/post discharge of military personnel from United States forces.
Submission of claims to all Veteran’s Administration facilities, once services are approved they are forwarded by invoice to the medical groups for processing.
Knowledge of medical terminology and insurance payer products; HMO, PPO, POS, EPO, Managed Care and Commercial policies.
Patient Account Analyst 2009-2010
Sequetor, Inc., Costa Mesa, Ca.
Successfully appealed claims denied for timely filing to Blue Cross/ Blue Shield for reimbursement
Accounts receivable assigned by insurance payer, average 50 claims daily, aging to be 90 days or less.
EOB review and follow up on denied/no pay claims, submit adjustments on balances to bill members for coinsurance and deductibles.
Knowledge of medical terminology and insurance payer products; Managed Care, Commercial and Government payers,
Claims Representative 1/ Data Entry 2009-2009
WellPoint, Anthem Blue Cross
Claims processed for Inter-Plan teleprocessing limit for electronically received claims for out of state providers. Average 300 claims processed daily.
Applying group benefits or contract matrices for claims to adjudicate for payment.
Knowledge of medical terminology and insurance payer products
DDE/ Direct Data Entry, edit and correct claims based on CPT and ICD-9 for UBO4 and CMS 1500 claims prior to sending for processing,
Patient Account Representative 2008-2008
Comforce Staffing, Irvine, Ca (Temporary Assignment)
- Assigned to work in CBO for physician billing, average 40 accounts daily, aging to be 120 days or less
Review claims for submission of adjustments to bill members for coinsurance and deductibles
EOB review, submission of appeals for denied or underpaid claims sent to: DMHC (Department Of Managed Health Care) for reporting and tracking on non-compliant payers.
Patient Account Representative 2006-2008
Aurora Behavioral Healthcare, Corona, Ca
Accounts receivable split by state, average 40 accounts daily, aging to be at 90 days or less
Verification of insurance eligibility, submission of authorization and retro authorization for services.
Submission of UB04 claims, EOB review to submit appeals for additional payment
Weekly client meetings for stats on outstanding accounts receivable
Submit adjustments to bill members for coinsurance and deductibles.
Knowledge of medical terminology and insurance payer products; PPO, EPO, POS, Managed Care, Commercial and
Senior Patient Account Representative 1999-2005
Pediatrix Medical Group, Inc. Orange, Ca
- Team Lead, supervision of 7 employees, accounts assigned by payer, working $30k +, average 38 accounts daily, aging to be 60 days or less.
Successfully resolved $250k for claims aged 200 days from multiple medical groups
Request for authorization and retro authorization, knowledge of medical terminology and insurance payer products; HMO, PPO, POS, EPO, Managed Care and Commercial insurances
EOB review for underpaid and denied claims. Submit appeals for underpaid claims per contract.
Consistent telephone and written contact with payers for payment and resolution.
Fullerton Junior College,
Fullerton, Ca, AA-Healthcare Administration, Business Finance 1998-2000
Santa Ana High School-Santa Ana,
General Education 1982-1986
Certified Patient Account
Technical-AAHAM Americas Associates Healthcare Administrative Management
UEI College-Medical Billing/
Insurance Coding- Presently attending