Medical Biller, Collector

Julie A. Jackson

700 E. Washington St. #188

Colton, Ca. 92824

(951)534-6202, (951)547-9500

Kanoelani25@yahoo.com

OBJECTIVE:

Medical Collector, Medical Biller

HIGHLIGHTS:


  • 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.          

WORK HISTORY:

 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

Caregiver                                                                                                                                                              2008-2014

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
    insurance companies.

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
    plans.

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
    Government payers.


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.

EDUCATION:


  • 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









  • ID#: 88427
  • Location: Colton, CA , 92324

Don't Be Fooled

  • When selling, do not put your home address in your ad.
  • To avoid scams, buy and sell with people you can meet locally, in person.
  • When meeting with someone you don't know, meet in a public place. If that's not possible, have a buddy with you. Also, carry a cell phone; if you feel unsafe, you can call a trusted friend, and stay on the line.
  • Never give out financial or private information like account numbers, PayPal login, or social security number.
  • If an offer sounds too good to be true, it is. Walk away!

Look Who's Hiring!

Medical Biller
Beverly Hills, CA Randstad
Medical Biller
Anaheim, CA Kforce
Biller/Collector Specialist
Torrance, CA Cedars Sinai
Medical Biller
Indio, CA Robert Half
Medical Biller Needed for Psych Treatment Center
San Francisco, CA Robert Half
Medical Biller / Coder
Newport Beach, CA Kforce