Jessica Fleming

Performs clinical and medical reviews, data collection, and database entry. Provides supporting reference documentation to the reviewer and applies state laws during the Quality Assurance process.

Oversaw the care of residents, including medication administration, wound care, and supervision of labs. Communicated resident needs and concerns to the Director of Nursing, resident assistant staff, and family members.

Managed health insurance, dental, vision, life insurance, disability, retirement plans, and wellness programs. Ensured benefit plans complied with federal and state laws such as ERISA, ACA, COBRA, and HIPAA.

Operated passenger vehicles while adhering to all safety procedures and performed pre-trip inspections. Assisted passengers, including elderly or disabled individuals, on and off the bus.

Reviewed remittance advice and explanation of benefits, contacting payors to resolve inappropriate denials. Collaborated with other departments to appeal legitimate denials and advised supervisors of contractual problems.

Generated, reviewed, and processed complex or high-volume invoices, ensuring accuracy and compliance with company policies. Reconciled billing records with accounting and payment data, resolving discrepancies.

Currently pursuing studies in Medical Coding & Data Quality, focusing on the principles and practices of medical data management and quality assurance. Developing expertise in coding systems and data integrity within healthcare.

Completed a comprehensive program to become a Licensed Practical Nurse, acquiring essential skills in patient care, medication administration, and clinical procedures. Obtained PA PN# 319980 and Multistate Licensed Practical Nurse- PN #319980.