Jennifer Thomas

Education

Education
Aug 2002 - Aug 2003

Grayson County College

Objective

Health Claims Specialist with several years experience. Special leadership strengths in infusion collection projects and hospital based radiologist.Excellent oral and written communication skills. Enjoy being a team player as well as taking a leadership role.

Work History

Work History
Jun 2009 - May 2012

Client Manager

Zotec Partners
Jun 2009 - May 2012

Client Manager

Zotec Partners

·        Proactively evaluate revenue cycle processes and performance for assigned clients on an ongoing basis, interacting with Operations Management to ensure timely workflow and optimized collection performance. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>

·        Regularly conduct client meetings to review accounts receivable performance, practice trends, payor performance and advise practice on business/ industry issues impacting the practice. <o:p></o:p>

·        Oversees and or conducts regular audits of the practice to ensure appropriate charge capture, charge flow, report dictation, contract management, electronic claims filing etc.<o:p></o:p>

·        Schedules and oversees coding audits for the practice and provides feedback to provide practice with feedback to optimize coding quality.<o:p></o:p>

·        Schedule coding education meetings for the practice to provide feedback to optimize physician dictation.<o:p></o:p>

·        Establish Key Performance Indicators (KPIs) for clients and regularly review to ensure consistent performance; communicating with Operations regarding any exceptions, inconsistencies, etc.<o:p></o:p>

·        Interacts with Operations Management to communicate any changes in the practice and plan for appropriate operational impacts (i.e. new sites, new physicians, managed care contracts, etc).<o:p></o:p>

·        Deliver client reporting, assuring standard and specialty reports are delivered accurately and timely to client to evidence and illustrate performance.<o:p></o:p>

·        Serve as direct liaison between client and company to communicate process changes affecting the client in an effective and timely manner.<o:p></o:p>

·        Respond timely to client inquiries (including but not limited to) benchmark comparisons, reimbursement changes, internal processes, patient issues, etc.<o:p></o:p>

·        Serve as the intermediary between Operations and the client’s facilities to obtain charge, demographic and audit files.<o:p></o:p>

·        Managed Care Contracting support for clients to analyze and provide information to clients and/or assist in contract negotiations.<o:p></o:p>

·        Gain a strong working knowledge of client needs and expectations and provide proactive recommendations to improve AR management and collection performance.<o:p></o:p>

·        Provide ongoing communication regarding client satisfaction and work collaboratively with Operations, support, etc. to promptly address issues.<o:p></o:p>

·        Routinely assess client satisfaction and complete the Client Management Subjective Assessment on a monthly basis to report satisfaction levels.<o:p></o:p>

·        Maintain current working knowledge of the local market trends, payor practices, state and national reimbursement trends impact the practice specialty.<o:p></o:p>

·        Knowledgeable and proficient in the company’s billing system and decision support.<o:p></o:p>

·        Knowledgeable of medical coding and reimbursement.<o:p></o:p>

·        Knowledgeable of Medical Billing Compliance.<o:p></o:p>

·        Knowledgeable in third party reimbursement processes to include managed care contracting.<o:p></o:p>

Jun 2009 - May 2012

Client Manager

Zotec Partners

·        Proactively evaluate revenue cycle processes and performance for assigned clients on an ongoing basis, interacting with Operations Management to ensure timely workflow and optimized collection performance. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>

·        Regularly conduct client meetings to review accounts receivable performance, practice trends, payor performance and advise practice on business/ industry issues impacting the practice. <o:p></o:p>

·        Oversees and or conducts regular audits of the practice to ensure appropriate charge capture, charge flow, report dictation, contract management, electronic claims filing etc.<o:p></o:p>

·        Schedules and oversees coding audits for the practice and provides feedback to provide practice with feedback to optimize coding quality.<o:p></o:p>

·        Schedule coding education meetings for the practice to provide feedback to optimize physician dictation.<o:p></o:p>

·        Establish Key Performance Indicators (KPIs) for clients and regularly review to ensure consistent performance; communicating with Operations regarding any exceptions, inconsistencies, etc.<o:p></o:p>

·        Interacts with Operations Management to communicate any changes in the practice and plan for appropriate operational impacts (i.e. new sites, new physicians, managed care contracts, etc).<o:p></o:p>

·        Deliver client reporting, assuring standard and specialty reports are delivered accurately and timely to client to evidence and illustrate performance.<o:p></o:p>

·        Serve as direct liaison between client and company to communicate process changes affecting the client in an effective and timely manner.<o:p></o:p>

·        Respond timely to client inquiries (including but not limited to) benchmark comparisons, reimbursement changes, internal processes, patient issues, etc.<o:p></o:p>

·        Serve as the intermediary between Operations and the client’s facilities to obtain charge, demographic and audit files.<o:p></o:p>

·        Managed Care Contracting support for clients to analyze and provide information to clients and/or assist in contract negotiations.<o:p></o:p>

·        Gain a strong working knowledge of client needs and expectations and provide proactive recommendations to improve AR management and collection performance.<o:p></o:p>

·        Provide ongoing communication regarding client satisfaction and work collaboratively with Operations, support, etc. to promptly address issues.<o:p></o:p>

·        Routinely assess client satisfaction and complete the Client Management Subjective Assessment on a monthly basis to report satisfaction levels.<o:p></o:p>

·        Maintain current working knowledge of the local market trends, payor practices, state and national reimbursement trends impact the practice specialty.<o:p></o:p>

·        Knowledgeable and proficient in the company’s billing system and decision support.<o:p></o:p>

·        Knowledgeable of medical coding and reimbursement.<o:p></o:p>

·        Knowledgeable of Medical Billing Compliance.<o:p></o:p>

·        Knowledgeable in third party reimbursement processes to include managed care contracting.<o:p></o:p>

Jun 2009 - May 2012

Client Manager

Zotec Partners

·        Proactively evaluate revenue cycle processes and performance for assigned clients on an ongoing basis, interacting with Operations Management to ensure timely workflow and optimized collection performance. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>

·        Regularly conduct client meetings to review accounts receivable performance, practice trends, payor performance and advise practice on business/ industry issues impacting the practice. <o:p></o:p>

·        Oversees and or conducts regular audits of the practice to ensure appropriate charge capture, charge flow, report dictation, contract management, electronic claims filing etc.<o:p></o:p>

·        Schedules and oversees coding audits for the practice and provides feedback to provide practice with feedback to optimize coding quality.<o:p></o:p>

·        Schedule coding education meetings for the practice to provide feedback to optimize physician dictation.<o:p></o:p>

·        Establish Key Performance Indicators (KPIs) for clients and regularly review to ensure consistent performance; communicating with Operations regarding any exceptions, inconsistencies, etc.<o:p></o:p>

·        Interacts with Operations Management to communicate any changes in the practice and plan for appropriate operational impacts (i.e. new sites, new physicians, managed care contracts, etc).<o:p></o:p>

·        Deliver client reporting, assuring standard and specialty reports are delivered accurately and timely to client to evidence and illustrate performance.<o:p></o:p>

·        Serve as direct liaison between client and company to communicate process changes affecting the client in an effective and timely manner.<o:p></o:p>

·        Respond timely to client inquiries (including but not limited to) benchmark comparisons, reimbursement changes, internal processes, patient issues, etc.<o:p></o:p>

·        Serve as the intermediary between Operations and the client’s facilities to obtain charge, demographic and audit files.<o:p></o:p>

·        Managed Care Contracting support for clients to analyze and provide information to clients and/or assist in contract negotiations.<o:p></o:p>

·        Gain a strong working knowledge of client needs and expectations and provide proactive recommendations to improve AR management and collection performance.<o:p></o:p>

·        Provide ongoing communication regarding client satisfaction and work collaboratively with Operations, support, etc. to promptly address issues.<o:p></o:p>

·        Routinely assess client satisfaction and complete the Client Management Subjective Assessment on a monthly basis to report satisfaction levels.<o:p></o:p>

·        Maintain current working knowledge of the local market trends, payor practices, state and national reimbursement trends impact the practice specialty.<o:p></o:p>

·        Knowledgeable and proficient in the company’s billing system and decision support.<o:p></o:p>

·        Knowledgeable of medical coding and reimbursement.<o:p></o:p>

·        Knowledgeable of Medical Billing Compliance.<o:p></o:p>

·        Knowledgeable in third party reimbursement processes to include managed care contracting.<o:p></o:p>

Jun 2009 - May 2012

Client Manager

Zotec Partners

·        Proactively evaluate revenue cycle processes and performance for assigned clients on an ongoing basis, interacting with Operations Management to ensure timely workflow and optimized collection performance. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>

·        Regularly conduct client meetings to review accounts receivable performance, practice trends, payor performance and advise practice on business/ industry issues impacting the practice. <o:p></o:p>

·        Oversees and or conducts regular audits of the practice to ensure appropriate charge capture, charge flow, report dictation, contract management, electronic claims filing etc.<o:p></o:p>

·        Schedules and oversees coding audits for the practice and provides feedback to provide practice with feedback to optimize coding quality.<o:p></o:p>

·        Schedule coding education meetings for the practice to provide feedback to optimize physician dictation.<o:p></o:p>

·        Establish Key Performance Indicators (KPIs) for clients and regularly review to ensure consistent performance; communicating with Operations regarding any exceptions, inconsistencies, etc.<o:p></o:p>

·        Interacts with Operations Management to communicate any changes in the practice and plan for appropriate operational impacts (i.e. new sites, new physicians, managed care contracts, etc).<o:p></o:p>

·        Deliver client reporting, assuring standard and specialty reports are delivered accurately and timely to client to evidence and illustrate performance.<o:p></o:p>

·        Serve as direct liaison between client and company to communicate process changes affecting the client in an effective and timely manner.<o:p></o:p>

·        Respond timely to client inquiries (including but not limited to) benchmark comparisons, reimbursement changes, internal processes, patient issues, etc.<o:p></o:p>

·        Serve as the intermediary between Operations and the client’s facilities to obtain charge, demographic and audit files.<o:p></o:p>

·        Managed Care Contracting support for clients to analyze and provide information to clients and/or assist in contract negotiations.<o:p></o:p>

·        Gain a strong working knowledge of client needs and expectations and provide proactive recommendations to improve AR management and collection performance.<o:p></o:p>

·        Provide ongoing communication regarding client satisfaction and work collaboratively with Operations, support, etc. to promptly address issues.<o:p></o:p>

·        Routinely assess client satisfaction and complete the Client Management Subjective Assessment on a monthly basis to report satisfaction levels.<o:p></o:p>

·        Maintain current working knowledge of the local market trends, payor practices, state and national reimbursement trends impact the practice specialty.<o:p></o:p>

·        Knowledgeable and proficient in the company’s billing system and decision support.<o:p></o:p>

·        Knowledgeable of medical coding and reimbursement.<o:p></o:p>

·        Knowledgeable of Medical Billing Compliance.<o:p></o:p>

·        Knowledgeable in third party reimbursement processes to include managed care contracting.<o:p></o:p>

Feb 2008 - Mar 2009

Account Manager

McKesson Corporation

McKesson Corporation, Dallas TX February 2008-March 2009

Account Manager- Radiology

  • Serving as an Account Manager for clients of medium to large size, independently providing high level client management services as well as ensuring client access and exposure to specialized financial reimbursement strategic and information management services.
  • Develop and maintain positive customer relations and coordinates with various functions within the company to ensure customer request are handled appropriately and in a timely manner.
  • Ensures that all appropriate resources are available and utilized to effectively and consistently provide clients with business management and strategic planning services of the highest caliber.
  • Regularly conducts client meetings to review accounts receivable performance, payor issues and trends, client’s business strategies, and physician compensation plans.
  • Maintains day-to-day relationships with existing clients, collecting and clarifying information with the client, communicating project or program plans and progress, and answering client questions.
  • Performs periodic billing audits for assigned clients to ensure that utility files, billing parameters, electronic transmissions, demographic interface tapes, and billing and payment tapes, insurance verification interfaces are utilized appropriately.
  • Ensures preparation, analysis and presentation of all Account Management deliverables (including A/R measurement statistics and payor trends, fee schedules, ad hoc financial reports) ensuring their relevancy, accuracy and overall quality while requiring interaction with operations management and third party payors.
Oct 2004 - Oct 2008

Account Receivable Manager

Genezen Healthcare

Genezen Healthcare, Addison TX October 2004-February 2008

Accounts Receivable Manager – Infusion services

  • Responsible for managing up to 16 collectors at one time.
  • Implemented major collection project for $4.5 million in old account receivables.
  • Created collection policies and procedures.
  • Act as an independent lead on all collection projects.
  • Audit and monitor all collectors for productivity and quality of work.
  • Monitor and report payment trends to the Insurance Verification Department and Finance Department from commercial and government payors.
  • Identify and report overpayments from physicians and insurance carriers for the physician’s retention reports.
  • Stay abreast of all Lash Groups’ reimbursement updates and policies.
  • Assist and train the Payment and Collection Department regarding policies and procedures for auditing super bills, reconciling, posting payments and adjustment procedures.
  • Coordinate patient payment plans.
  • Reconcile end of month reports as well as old accounts for reporting purposes to the physicians  and Finance Department.
  • Monitor all uncollectible, high balances and aging reports to track industry trends.
  • Responsible for end of month posting of all adjustments and payments.
  • Identify high and low adjustment reports.
  • Negotiate settlement offers with the physician offices.

Insurance Specialist

  • Trained new employees in all aspects/functions of collections.
  • Implemented electronic claim filing for all physicians.
  • Collected, reconciled, transferred and posted insurance payments made to physicians in various states.
  • Identified and appealed denied claims.
  • Identified and applied adjustments.
  • Maintained and disseminated weekly collection reports to Finance Department.
  • Researched formatting errors and claim form requirements for commercial and government carriers while coordinating with internal billing company to ensure that such errors were resolved.
  • Identified and processed refunds to patients, providers and all insurance carriers.
  • Credentialed physicians with Medicare and Medicaid carriers while maintaining company reports of provider updates.
  • Performed customer service duties and special projects as needed.
Sep 2000 - Oct 2004

Technical Specialist

TrailBlazer Health Enterprises

TrailBlazer Health Enterprises, Dallas TXSeptember 2000- Oct 2004

Technical Specialist

  • Assisted customer service representatives regarding benefit information, review processes and Medicare requirements.
  • Monitored and audited Customer Service Representatives to assure quality while maintaining CMS requirements.
  • Reported all changes in Medicare guidelines and requirements in weekly QC meetings.

Appeals Representative II

  • Served as Lead Auditor for the Appeals Department which consisted of 16 auditors.
  • Supervised and monitored auditors with problems or questions to ensure process was completed in a timely manner.
  • Tracked and monitored audit interactions and provided feedback with other Customer Service Departments.
  • Processed telephone appeals for the providers and beneficiaries pertaining to all denials including utililization review.
  • Researched and acquired planning and data gathering skills.
  • Worked closely with external and internal departments including the processing and recording of overpayments and recoupments.
  • Gathered data to record and compile monthly audit reports.
Aug 1989 - Oct 1997

Customer Service Representative II

Blue Cross Blue Shield of Texas

Blue Cross Blue Shield of Texas, Bonham Texas1989-1997 Customer Service Representative II

  • Processed written and incoming telephone appeals for the providers and beneficiaries.
  • Assisted providers and beneficiaries with claim status, claim denials, claim form requirements, provider enrollment requirements, eligibility information and updates, benefit information, coverage issues and general questions.
  • Kept abreast of Medicare rules and guidelines mandated by CMS.

Senior Claims Examiner

  • Processed Medicare claims including all specialties such as anesthesiology and physical therapy while maintaining a high level of production and accuracy.
  • Participated in extensive training for CPT, ICD-9 coding and HCFA 1500 requirements.
  • Performed special projects as needed.

References

References

Bill Keys