Janette Thomas Email & Phone Number

SUMMARY OF QUALIFICATION:Experience of more than 20 plus years in-depth knowledge of medical insurance claims, procedures and documents, as well as 15 plus years of experience as a supervisor. Thorough knowledge of coding, medical billing procedures, ICD10, revenue cycle, denials, reconsiderations, rejections and with exceptional communication skills both verbally and written. Knowledge of customer service skills and medical terminology with the knowledge of computer skills like MS excel, MS word, MS outlook. Have worked on several different Practice Management systems, such as Epic, Cerner and Centricity. WORK EXPERIENCE:Revenue Cycle Insurance Follow-upChi St Alexius – BismarckSept 2020 to presentFollows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive. Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. Resubmits claims with necessary information when requested through paper or electronic methods. Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. Assists with unusual, complex or escalated issues as necessary. Work special projects when the need arises. Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. Accurately documents patient accounts of all actions taken in billing system. Other duties as assigned by leadership

Listed skills include Microsoft Office, Windows, Microsoft Word, Microsoft Excel, and 19 others.