Jeannette Williams

2715 S 160th Lane

Goodyear, AZ 85338
602/731-0563 Cellular Phone
Jeannettewilliams2010@gmail.com
Objective
I am seeking a role in the healthcare field with a company where I can utilize my 15 plus years of
experience. In seeking a company, it is imperative that there are growth opportunities. I would be
an excellent member of your company for numerous reasons mostly because I go above and
beyond my job duties when needed, I am dependable, and I am a hard worker.

Key Strengths
● Worked in every area of physician, specialties billing, pharmaceutical, durable
equipment, facility and hospital billing
● Utilized ESAWS, EAM, EPaces, OTC software, QCARE, Eaglesoft, Dentrix G5, Facets,
Claims Extend, Claims Interface, Optum, O’Clever, Nimsoft. DMS, QNXT, Oracle,
TRIWIKI, Citrix, HIPPA Gateway, Advanced MD, ROAR, MAARS, Google Chrome,
EMR, AHCCS Online Verification, Medicare and Medicaid Software, QNXT, E Clinical
Works, Big Biller Recruitment, Meditech, Citrix, CMC, EPIC, Medisoft, Infinity, NEBO,
Intuition PM, IDX, Medical Manager, HDAS, Oacis, I Suite, Last Word, Correct Code,
MedV, and Novis
● Worked Denial and Appeals resolving issues and retrieving payments until exhausted
● A/R posting, investigation, and clean up
● Report generating
● Authorization verification and retrieval
● Insurance Verification with all insurances, Medicare, and Medicaid
● Processing charges for submission
● Correcting ICD-9 and DX codes when needed for submission and resubmission
● Coding claims properly using visit notes
● Medicare, Medicaid, and insurance corrections complete for resubmission
● Self-pay retrieval
● Collections from Medicare, Medicaid, Insurance companies, and self-pay
● Contacting patients for information to process visits
● Contacting insurance companies, Medicare, and Medicaid to resolve denial issues
● Submissions to 2nd Insurances for processing
● Electronic and HCFA filling
● Interviewing and Hiring of staff
● Processing 350+ claims a day
● Obtain insurance benefits and Prior Authorizations and Pre Determinations
● Processing Prior Authorizations and Pre Determinations
● Training new employees
● Case Manager for Specialty Pharmaceutical Company
● Processing claims for Horizon NJ professional, hospital and facility
● Assisting team members with questions
● Running daily reports
● Electronic and claim form filling
● Adjusting of claims
● Managing and supervising of a team of 30 plus examiners for Adjustments, Claims, and
Special Projects examiners
● Work directly with corporate reps to ensure program is running smoothly
● Supervising WAH claims adjusters and examiners
● Supervising 10 to 86 examiners
● Client facing
● Examining and entering complex claims for appropriateness of care and completeness of
information in accordance with accepted coverage guidelines, ensuring all mandated
government and state regulations are consistently met.
● Processing claims for multiple plans with automated and manual differences in benefits, as
well as utilizing the system and written documentation to determine the appropriate payment
for a specific benefit.
● Maintaining external and internal customer relations by interacting with staff regarding
claims issues. Providing service as the key contact for clients and working as directed with
the client. Researching and ensuring accurate and complete claim information, contacting
insured or other involved parties for additional or missing information and updating
information to claim file with regard to claims status, questions or claim payments.
● Identifying and referring all claims with potential third party liability, such as subrogation,
COB, MVA, stop loss claims and potential stop loss files.
● Approving, pending, or denying payment according to the accepted coverage guidelines.
● Assisting in training of new groups and new staff as needed; assisting the management team
in problem resolution, planning and overseeing workflows; testing and preparing
documentation and updating current documentation; as well as providing suggestions and
recommendations to improve workflows and departmental efficiencies.
● Planning, directing and managing a team responsible for processing payments and/or claim
denial of group health which includes medical, dental, HRA, HSA, FSA, vision, and
disability benefits.
● Developing and administering a business plan, controlling expenses, and increasing
profitability to meet established business goals; managing budget while meeting operational,
financial and service requirements.
● Measuring and reporting on service operations performance including, but not limited to,
claims accuracy rates (e.g., statistical and monetary), claims cycle performance, high dollar
claims and late fees, performance of appropriate delegated vendors and partners, and inquiries
and complaints.
● Implementing and maintaining policies and procedures on the claim functions that are
appropriate to the management of the business client.
● Participating in response to Requests for Proposals (RFPs) or Requests for Information (RFIs)
and serving as the liaison for claims operations for onsite visits by prospective and existing
clients.
● Managing resources effectively and efficiently to support the strategic initiatives of the
company. Consistently portraying the image of a role model for the department by
demonstrating the highest levels of customer service, technical skills and professionalism to
ensure mutually rewarding and continued relationships.
● Care treatment plans provided to patients
● Dental billing
● Credentialing medical and dental
● Knowledgeable of CDT codes and dental insurances
● Fee presentations

Professional Experience
Apidel Technologies 02/25 to current
PA Rep
Entering and looking over PA’s being sure that correct information is correct, Communicating with
doctors and patients regarding status of PA’s and entering PA’s

Cognizant 02/16 to 02/25

Customer Service Supervisor, Claims mage, Customer Service Advocate, Claims Rep, Adjustments and
Ticket
Rep, Special Projects, SME, Team Lead, and Customer Service Advocate)

Dental-Temp. 10/18 to 01/19

Office manager and front desk
Private dental office (Evenings and Weekends) 05/14 to 11/18
Office Manager, Billing Specialist, and treatment coordinator using Dentrix and Eaglesoft

McKesson 02/15 to 01/16

Case Manager, Insurance Specialist, PA Specialist, Trainer of new IS, and CM
RemX Staffing Specialist (Temp) 07/14 to 02/15
Case Manager, Insurance Specialist, PA Specialist, Trainer of new IS, and CM

Urgent Care Extra 03/14 to 07/14

Office Manager and Billing Specialist
Northeast Healthcare Recruitment (Temp) 10/13 to 03/14
Medical Biller and Credentialing Advocate

National Temp Services (Temp) 08/13 to 10/13

Heraeus
Melt Machine Operator

National Medical Recruiters (my own business) 04/2006 to 07/2013

Manager, HR, Senior Recruiter, and Marketing Executive

Chicago Magnesium 02/2013 to 6/2013

N.D.T Technician (Q.A X-Ray Tech), Mill and Lathe Operator

Legendary Baking 07/2012 to 12/2012

Oven Worker

Aeroteck Commercial Staffing(Temp) 12/2010 to 06/2012

Fuji Film and APP Pharmaceuticals
Quality Control Inspector and Machine Operator

John's Beauty Supplies 06/2008 to 12/10

Cashier and Customer Service Clerk

Marianjoy Rehabilitation Hospital 01/2006 to 7/2007

Office manager, Medical Biller, Insurance Verifier, Customer Service and Payment Posting

Robert Half Staff/Office Team Healthcare (Temp)12/2005 to 1/2006

Office Manager, Medical Biller, Insurance Verifier, and Insurance Adjuster

Dr. Fredrick Cahan10/05 to 12/06

Office Manager, Medical Biller and Registrar

CSI Staff, Inc.(Temp)03/04 to 03/05

Credentialing Advocate, Office Manager, Medical Biller, Collector, and Coder

Verizon Wireless07/02 to 10/03

Financial Service Rep

SBC/ Ameritech04/01 to 10/03

Solution Specialist

Dr. Antonio Senat08/99 to 04/00

Office Manager, Medical Biller

West Suburban Medical Center07/98 to 07/99

Credentialing Manager, Eligibility Clerk, Customer Service Rep, Office Clerk, Remittance Clerk,
and Claims Analyst

Insurance Overload08/97 to 07/98

Office Manager, Eligibility Clerk, Customer Service Rep, Office Clerk, Remittance Clerk, and
Claims Analyst

Educational Background
Jobs for Youth/Chicago Inc.
GED and Job Training

Pastor
Freedom Ministries Arizona Church Phoenix, AZ