Erica Jones

Assisted patients in understanding their financial obligations and facilitated payment arrangements to ensure timely and accurate billing. Conducted comprehensive financial assessments to determine patient eligibility for financial assistance programs and provided guidance on available options within EPIC.

Maintains the integrity of insurance member data through systematic updates in CRM and Advalent platforms. Reviews and reconciles member demographic changes and TRR/MMR reports weekly, utilizing Microsoft Access for accuracy.

Investigated and resolved denied insurance claims, ensuring compliance with organizational policies by adapting adjustments in the Epic system. Liaised with insurance representatives to confirm and correct claim details, showcasing expertise in decoding and addressing coding denials.

Verified insurance coverage for prescription drugs, securing patient access to essential medications. Handled inbound and outbound communications, efficiently resolving member inquiries and concerns.

Monitored and maintained aging reports to secure on-time filing of claims, enhancing the efficiency of accounts receivable collections. Handled the processing of various claims, including Medicare, Medicaid, and federal, adhering to healthcare regulations and payer protocols.

Audited and processed insurance claims in compliance with Medicare, Medicaid, and Durable Medical Equipment billing protocols. Managed patient accounting and facilitated insurance collections, ensuring precision in financial transactions within the patient accounting system.

Liaised with insurance providers to obtain remittance and claims updates, maintaining precise anesthesia claim processing. Resolved denial issues through telephonic appeals and detailed analysis of Explanation of Benefits (EOBs) to pinpoint and correct discrepancies.

Oversaw account reviews and reconciliations, maintaining precise customer records by updating insurance and demographic details. Conducted data entry and managed payment postings, processed insurance claims, and recorded transactions from credit card and check payments.

Digitized and categorized medical documents, facilitating their accurate incorporation into the billing system, which enhanced workflow management. Managed anesthesia records and updated relevant spreadsheets, contributing to the maintenance of daily operational efficiency.

Completed an Associate's Degree focusing on Marketing and Business principles. Gained foundational knowledge in business operations and marketing strategies.