1. Denise K. Jackson CPC, CPCO
4508 Peckinpaugh Drive Chattanooga, TN 37416 | 423-762-3482 | holtondk23@gmail.com
Education
CERTIFIED PROFESSIONAL CODER | 06/2011 | VIRGINIA COLLEGE OF BUSINESS AND HEALTH,
CHATTANOOGA, TN
· CPC Certificate #01166794
· Certified ICD-10 proficient
· Alpha Beta Kappa Honor Society Inductee, May 2011
CERTIFIED PROFESSIONAL COMPLIANCE OFFICER | 06/2016 | AMERICAN ACADEMY OF
PROFESSIONAL CODERS (AAPC)
Skills & Abilities
· OfficeManagement
· MicrosoftOffice,Word,Excel, Outlook,MicroMDPracticeManagement and EMR
· Resolution specialist
· Strong organization and time management skills
· State of Tennessee Notary Public
COMMUNICATION
· Effectively andprofessionally communicate with Patient/customers, Payers, and Facility associates to resolve
billing and insurance concerns;credentialing and contracting compliance.
· Positiveand professional inter-officecommunication promoting cooperation and support forcommon goals.
LEADERSHIP
· Developed and currently maintain a comprehensive credentialing and contracting process forlicensed staff of
sixteen professionals.
· Successfully implemented new billing processes forEMR/EHR conversion.
· Apprised management of compliance issues and concerns.
Experience
PRACTICE ASSISTANT | ALLIANCE OF CARDIAC THORACIC & VASCULAR SURGEONS | APRIL 2012
TO PRESENT
· Responsible forthe timely and accurate credentialing requirements forall licensed personnel withall facilities
and all insurance payers.
· Responsible forall licensed personnel contract enrollment withpayer entities.
· Responsible forthe timely and accurate processing of all accounts receivableprocesses. Insurance verification,
Pre-Authorization notification,Posting charges, Filing claims (electronic and paper), Posting all payments
(electronic and manual), Posting all refunds and adjustments. Patient account reconciliation.Claims appeals,
reconsiderations and supporting documentation requests.
· Coder foraccurate and timely Cardiac/Thoracic surgical and officevisitencounters in ICD-10, CPT,HCPCS.
· Patient advocacy and education regarding insurance coverage, limitations and restrictions.
· Patient medical recordmaintenance: demographics, scheduling, insurance verification,documentation.

2. Page 2
REIMBURSEMENT SPECIALIST | NATIONAL SEATING & MOBILITY | AUGUST 2011-APRIL 2012
· Accurate and timely billing of custom DME products to secondary and tertiary payers fornational DME provider.
· Collection of large dollar reimbursements on claims.
· Effectively communicatingwitha variety of payers on claims resolution.
MEDICAL BILLING AND CODING INTERN | BENCHMARK PHYSICAL THERAPY | APRIL 2011-JUNE
2011
· Scheduling patients, front desk patient services, daily billing and reconciliation, insurance verification,daily
report compilation.
· Medical record maintenance and EHR projects.
REFERENCES:
· Ned Wiggs PracticeAdministrator Alliance of Cardiac Thoracic & Vascular Surgeons
423-314-1973 nwiggs@actvsurgeons.com Chattanooga, TN
· David Mullins, ACNP Nurse Practitioner Tennova HealthCare
423-240-2075 david.mullins@mytennova.com Cleveland, TN
· Louise Moreland Certified Paralegal ERMC
423-510-2521 louise.moreland@ermc2.com Chattanooga, TN

3. Page 3
Mid-South Surgical Associates, PLLC
d/b/a Alliance of Cardiac Thoracic & Vascular Surgeons
Job Description
Practice Assistant
 Credentialing of all licensed professional staff (6 Physicians, 6 Nurse Practitioners, 4 Registered
Nurses)
 CAQH, TPQVO professional profile maintenance, update and re-certification.
 Provider enrollment/privileges with three hospitals and all payer entities including but not
limited to Medicare, BCBST, UHC, AETNA, Cigna, TN-GA-AL-NC Medicaid, Humana,
TriCare, and VA/VAPC3.
 Professional license applications and renewals.
 OIG Exclusion verification.
 Payer contract affiliation of licensed professional staff
 NPPES taxonomy maintenance
 Accounts Receivable
 Record all deposits posted to corporate checking account through First Tennessee portal.
 Locate and print all remittance reports from online sources including but not limited to EDI,
Optum, Emdeon, Payspan, Availity.
 Download Medicare and BCBST remittances for auto-posting through practice management
software.
 Prepare internal documentation reflecting each deposit, breaking out individual provider totals
for each deposit.
 Prepare all office receipts (mail payments, office co-pays) for deposit; and prepare
documentation for manual entry.
 Post all remits to patient accounts, reviewing remittance advice for errors, omissions and denials.
 Address and correct clerical errors on claims, note activity on patient account, and prepare claims
for appeal or resubmission.
 Process all credit card payments from payers and patients through online secure portal.
 Review and audit all requests for refund from payers. Communicate effectively to rebuke and/or
negotiate erroneous requests. Prepare documentation for any necessary appeals/reconsiderations.
 Prepare Requests for Refund and provide timely follow up.
 Field phone call inquiries from patients with respect to their accounts. Set up payment
agreements and negotiate discounts on patient balances.
 Balance each day’s receipts.
 Secure, manage and balance petty cash account.
 Prepare month-end reconciliation and print monthly reports for administrative review.
 Prepare patient statements on a twice-monthly cycle for distribution.
 Actively work open claims and A/R reports for follow up with payers and patients.
 Billing
 Review and run insurance eligibility verification for each patient encounter. Update system
demographics with current and accurate policy identification, patient identification and billing
submission data. Scan evidence of verification into patients’ permanent medical record.
 Prepare encounter charge slips for data entry.
 Data entry in practice management program of all office visit encounters and surgical procedures
performed.

4. Page 4
 Review and prepare all charges for claim submission; electronic and paper.
 Batch all claims for upload to EDI.
 Review all edits and make necessary corrections to claims prior to submitting.
 Add supplemental claim information for clinical trial claims, PWK attachments.
 Submit all claims to EDI clearinghouse.
 Print all paper claims, add supporting documentation, scan and mail out.
 Prepare all Secondary claims that require payer portal entry.
 Submit all secondary claims through respective payer portals.
 Follow up on Rejects and Invalids reports.
 Perform daily “close” reconciliation and balancing of all charges.
 Office Management
 Ensure that all outgoing mail is dropped in collection box daily for USPS pickup.
 Ensure that all incoming mail is opened, sorted and distributed according to individual
specifications for all staff.
 Review all patient correspondence for action. Scan documentation into patients’ permanent
medical record as necessary. These items may include but are not limited to: personal
correspondence, payer requests for documentation, payer pre-certification notices, patient
implant notices and billing inquiries.
 Provide staff support for coverage of absent employees.
 Orient and train billing department associates in job functions, practice policies and compliance
policies.
 Maintain all payer files; contracts, addendums, notice of changes, demographic updates and
corrections, completion of satisfaction surveys or other quality monitoring processes.
 Compliance monitoring – HIPAA, OSHA, DRA etc.
 Provide State of Tennessee NOTARY services.
 Attend and participate in annual conferences as provided by individual payers, credentialing
organizations or specialty organizations. BCBS AllBlue, TMA, STS, AAPC.
 Effectively communicate with management regarding changes, updates or new mandates and
compliance requirements.
 Medical Coding
 Medical coding of specialty clinic office visits and surgical procedure encounters; requires
extensive knowledge of ICD-10 (Certified Proficiency), CPT-CM, and HCPCS coding
conventions. Also requires extensive knowledge of CMS guidelines, as well as individual payer
guidelines and restrictions.
 Ongoing maintenance and Continuing Education for core certification of CPC, and also in
supplemental certification of CPCO.
Any and all other duties as requested by Management.