Jacqueline Gresham, Rhit, Cuc Email & Phone Number

Atlanta, GA, US

Alpharetta, Georgia, United States

• Onsite/Remote application training and go live support.
• End user training for efficiencies of the EMR systems.
• Works with support staff and management to identify workflow issues and/or system enhancement needs.
• Document and communicate project status with department representatives and Athena/Allscripts project teams.
• Troubleshoot issues and submit tickets.

Knoxville, Tennessee Area

• Accurately assign CPT, ICD-10 HCPCS and modifiers codes for procedural and Surgical procedures. Reviews clinical documentation and associated codes; provides feedback concerning documentation audits and monitors..
• Initiates of clinical documentation improvement through daily/subsequent documentation reviews. Identify and correct coding issues.
• Assist with development of training on coding (ICD-10 and CPT), health record quality documentation requirements and provides education to clinical and administrative staff.
• Tracks and trends quality of clinical documentation, educates providers on documentation requirements, diagnostic and procedure code selections as necessary for encounter and PTF completion.

Villa Rica, Georgia, United States

• Provide onsite application training and go live support.
• Train end users on the efficiencies of the EMR systems.
• Works with support staff and management to identify workflow issues and/or system enhancement needs.
• Document and communicate project status with department representatives and Athena/Allscripts project teams.
• Troubleshoot issues and submit tickets.

Irving, Texas, United States

• Assigned codes for diagnoses, treatments, and procedures according to the appropriate classification system for complex inpatient or outpatient encounters. for several specialties. Maintained an accuracy and quality.
• Responded to inquiries, questions, or requests and effectively resolved complex conflicts or complaints. Ensured timely resolution of patient billing issues.
• Utilized technical coding principals and APC reimbursement expertise to assign appropriate ICD-9-CM diagnoses, ICD-10-CM diagnoses and ICD-9-CM/CPT-4 procedures.
• Provides verbal and written communication that is thorough and correct, using clear and precise communication methods.

Greater Atlanta Area

• Responsible for abstracting patient operative reports and accurately assigning CPT,ICD-10 HCPCS and appropriate modifiers codes for outpatient surgical procedures
• TES (Transaction Editing System) deleting duplicate invoices, appending appropriate modifiers to CPT codes, correcting diagnosis codes, research unbundled CPT relationships via CMS NCCI edit Guidelines
• Determine and initiates actions to resolve rejected claim issues, corresponding with Physicians and Clinical staff to ensure information is accurate and timely
• Performed medical coding and billing functions using CPT and ICD-9 Codes
• Analyze outstanding accounts receivable for Medicare, Medicaid and Commercial Healthcare Plans
• Escalate delinquent accounts to management of appropriate course of action

Greater Atlanta Area

• Identify denial patterns and escalate to management as appropriate with sufficient information for additional follow-up, and/or root cause resolution
• Make recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency and reduce denials.
• Assist with complex, specialized billing and follow-up workflows including but not limited to transplant billing and reconciliation including global billing and billing procedures requiring extensive communication with.

Greater Atlanta Area

• Apply Medicare Part B, Medicaid and commercial insurance and credit card payments refunds and contractual adjustments to patient accounts under industry rules and guidelines, balancing patient accounts
• Apply denials from insurance companies in accurate and timely fashion and handle special accounts via Ryan White and Employee payment program accounts
• Identify with all components of explanation of benefits (eobs), process return checks and prepare and balance batches to be keyed
• Maintaining a.99 percent keying rate and a.68 error rate

Baltimore, Maryland Area

• Processing claims to insurance carriers, researching payment status, follow up on Un-paid and under paid claims
• Managing patient invoicing posting payments and refunds, generating payment and charge entry batches, reviewing A/R reports for accuracy of records understanding of CPT and ICD-9 codes
• Filing of Medicare part B payments and explanation of benefits, communicating with health insurance companies for Explanation of Benefits confirmation
• Mailing out insurance claims for payment of secondary insurance claims

Baltimore, Maryland Area

• Processing medical claims, filing explanation of benefits and retrieving medical records for insurance purposes
• Documenting process of claims in IDX and epic system for review
• Filing TES, payment and charge entry batches.
• Communicating with insurance companies to ensure payments of patient billing process, preparing claims for proper mail out directions
• Batching of Medicare part B vouchers, and entering data for patient billing information.
• Correcting and submitting and re-submitting HCFA 1500 primary and secondary insurance claims

Licensed Practical/Vocational Nurse Training

Associate Degree, Health Information Technology

Licensed Practical/Vocational Nurse Training