1. Jeanette McDow
1119 Park VistaDr. #503 Arlington,Texas 76012 Cell:(713) 301-0823 Email: nettiemcdow@gmail.com
Education
Strayer University Currently Enrolled
Associates Degree in Applied Sciences
Academy of Healthcare Professions Sept 2001-June 2002
Certificateof Completion Obtained for Medical Billingand Coding
Experience
Senior Care Centers Dallas, Texas
Insurance Billing Specialist of Revenue Cycling July 2014-present
Create, edit, process and bill claim from AHT for long term care
Follow up on all insurance claims for 50 facilities
Resolves all electronic claims rejection and EOB denials
Performed all aspects of outstanding A/Rincluding appeals
Oversees the implementation of revenue cycling process.
Primary point of contact for the facilities regarding account balances and follow-up
Post all payments for Ins., Medicaid as required, move co-pays,ded., and adjustments per the EOB’s
Analyze and resolved revenue cycle issues associated with all professional accounts
receivable while insuring annual cash flow and appropriate collection ratios .
Meets and exceeded all goals and operation objectives, while making corrective improvements
where needed.
Provides business insight regarding all aspects of the revenue cycle to the Hospital Administrator.
Ensuring excellence in the delivery of the revenue cycle with focus on improved operational efficiencies,
patient satisfaction and cash flow collection procedures.
Responsible for the daily operation of all insurance staff members
Primary point of contact for the hospitalwith all staff and employed cons ultants on revenue cycle issues
Orients new staff
Establishes procedures and protocols to ensure patient complaints are resolved.
Participates in the performance improvement process.
Other managerial duties and special projects as assigned.
UT Southwestern Medical Center Dallas Texas:
BillingCoordinator February 2013-June 2014
Post moderate to complex charges for physician services:reviewencounters
Ensure correct data entry of codes; ensure charges are entered/processed in accordancewith the
required targets.
Perform Bath reconciliation of all charges entered
Work and correct moderate to complex edits related to charges entry as assigned
Identifies and reports error trends in edit reports
Review accuracy of billingdocumentation in accordancewith the departmental policies.
May post chargecorrection and perform reconciliations.
Mentors less experience staff and my assistbillingmanager with trainingof new employees.
Perform other related duties.
Medical Claims Analyst April 2010-Feburary2013
Review and process insuranceclaims through the billingsystem (EPIC), includingMedicaid and Medicare,
third party payers
Resolve electronic claims rejectionsand EOB’s denial in a timely manner
Review and resolved correspondence from all organizations
Responsiblefor contactingpatient and /or third party payers to resolved outstandingbalances
2. Jeanette McDow
1119 Park VistaDr. #503 Arlington,Texas 76012 Cell:(713) 301-0823 Email: nettiemcdow@gmail.com
Identifies problems and inconsistencies by usingmanagement reports; summarizes findings and make
recommendations to resolvebillingissues.
Achieve and/or exceed daily collection accountproductivity goals
Function as liaison between clinical department and third party payers
Perform other duties as assigned
Super-user: Trainingnew employees on epic and in workques and workflows
Eligibility Services (ESI) Dallas, Texas:
Medicare/Managed Care Collector June 2009- April 2010
Medical Billingfor Medicareand MedicareHMO’s and all managed care
Performed all aspects of outstandingA/R follow-up includingappeals
Responsiblefor setting payment arrangements with patients who have outstandingbalances
Ensure all charges areposted on patient’s accounts
Ensure insurancecompanies arebilled in a timely fashion
Prepare and process any necessary adjustments/codingchanges on accounts through the system based
upon follow-up procedures
Upon receipt of insurancepayment, bill secondary insuranceand/or patient
Contact patients to obtain insuranceinformation needed to process claims such asCOBinformation,
accidentdetails,preexistingquestionnaire,etc
Prepare adjustments such as refunds, contractual differences and write-offs for approval and processing
Corner Stone Healthcare Group Dallas, Texas Sept 2008- Feb 2009
Medicare/Medicaid Collector
Medical Billingand Collectionsfor Medicare,Medicaid,VA, Commercial Insurances,PrivatePay,and
contractaccounts
Obtained Verification of patient demographics and billinginformation
Strong workingknowledge of ICD-9, HCPC, CPT codingand charge master
Data Entry of all correspondenceand applyingcharges and/or corrections in thesystem
Appeal Submission and performed all aspects of outstandingA/R follow-up
Responsiblefor performing resolution-oriented billingand follow-up to achieve cash recovery and A/R
goals.Performed task required to ensure the timely accuratesubmission and followup of insurance
claims.
Updated and reviewed high dollar logon a weekly basis,to insurereimbursement was received in a timely
manner
MedStar EMS Fort Worth, Texas: Sept 2002-Sept 2008
Patient Account Representative
Medical Billingand Collectionsfor Medicare,Medicaid,VA, Commercial Insurances,PrivatePay,and
contractaccounts
Obtained Verification of patient demographics and billinginformation
Strong workingknowledge of ICD-9, HCPC, CPT codingand charge master
Performed all aspects of outstandingA/R follow-up includingappeals
Responsiblefor performing resolution-oriented billingand follow-up to achieve cash recovery and A/R
goals.Performed task required to ensure the timely accuratesubmission and followup of insurance
claims.
Documented billingactivity in thepatient accountingsystems
Updated and reviewed high dollar logon a weekly basis,to insurereimbursement was received in a timely
manner
Efficient knowledge of TMHP, Net-Billingsystem for EMS
Liaison for patient, payer, and/or facility inquiries
