Jessica Hampton Email & Phone Number

Specializing in revenue cycle management with a focus on claims adjudication, payment integrity, and government business. Proficient in utilizing EPIC and advanced billing software to resolve complex insurance claims while ensuring compliance with CMS, Medicare, Medicaid, and regulatory requirements. Skilled in analyzing payer policies, identifying claim delays, and implementing process improvements to achieve operational excellence.Experienced in managing account resolutions for Medicare, Medicaid, and other government payers across multiple states. Expertise in re-filing UB-04 and CMS-1500 claims using EPIC and payer systems, consistently achieving timely resolutions and maintaining a clean claim rate exceeding 95%. Proven ability to conduct detailed claim audits, ensuring accuracy and adherence to CMS, NCCI, and payer-specific regulations.Highly collaborative, with a track record of working across cross-functional teams to address payer issues, negotiate payments, and optimize billing workflows.

Fort Worth, Texas, United States

Specialized in managing and resolving high-volume government and commercial insurance claims for the state of California, ensuring strict adherence to state-specific regulations and payer requirements. Demonstrated in-depth knowledge of Medicare, Medi-Cal (California Medicaid), and private insurance policies, navigating complex billing scenarios while maintaining full regulatory compliance. Analyzed and corrected claim rejections, denials, and edits, ensuring all submissions met clean claim standards and minimizing delays in reimbursement.Utilized advanced understanding of California-specific billing requirements, including Medi-Cal coding guidelines, payment methodologies, and state regulations, to resolve claims efficiently and accurately. Applied expertise in claims adjudication processes to identify recurring issues, develop corrective actions, and achieve timely resolutions for both inpatient and outpatient claims.In addition to technical responsibilities, mentored and trained new staff members on Medicare, Medi-Cal, and private insurance billing protocols specific to California. Delivered tailored training sessions and ongoing support, equipping team members to navigate the unique challenges of billing within the state. This hands-on approach improved team productivity and accuracy, contributing to a more efficient and effective billing process for California providers.

Pittsburgh Pa

Acted as the primary liaison for healthcare providers, serving as the central point of contact for resolving complex Medicare Part B claims, benefit issues, and payment discrepancies. Leveraged in-depth knowledge of CMS policies and payer-specific guidelines to investigate, analyze, and resolve claim denials, ensuring timely and accurate reimbursement. Provided personalized support and proactive communication to providers, addressing their concerns and delivering clear guidance on claims adjudication processes.Consistently delivered exceptional customer service by educating providers on reimbursement policies, claims submission best practices, and compliance requirements. Facilitated training and ongoing support to help providers navigate billing complexities and reduce future claim rejections, contributing to improved operational efficiency and enhanced provider satisfaction.