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Linda Y. Jones

Expertise In: Gastroenterology,
Name : Linda Y. Jones
Experience : 16
Specialty : Gastroenterology,
Location : Philadelphia,PA
Description :

Linda Y. Jones is highly experienced, pro-active, multi-dimensional medical billing specialist with excellent communication, interpersonal and organizational skills. The ability to manage projects independently from inception to completion in a timely, professional manner. More than 30 years of experience in handling Medicare, Medicaid, EDI electronic billing front and back end. Working knowledge of HIPPA regulations.


  • Working knowledge of HIPPA regulations
  • Computer skills: HBOC, HBOCstar, IDX, ADS-400, RX-Home, Premise, Medical Manager, HBOCpathways, Meditech, Medisoft, Excel and Word


  • Preparing and submitting clean FQHC (federally qualified health center) claims electronically or paper to various insurances
  • ICD-9 and CPT-4 coding prior to posting hospital charges
  • Post cash, insurance payments/remittances
  • Reconciles claims denials - Process claims in Promise system
  • Checks Navinet or insurance websites for eligibility, referrals and payments
  • Review and mail patient statements
  • Rebill or transfers balances to do secondary billing
  • Follow-up and collection calls to all insurance companies
  • Answer patient phone calls daily
  • ICD-9 and CPT-4 coding prior to charge entry
  • Processes paper claims for 1st / 3rd party, MVA and Workmen's Comp carriers
  • Reduces receivables
  • Reconciles claims to payment in full
  • Post cash in the Medisoft system
  • Insurance verification, enter all demographics prior billing
  • ICD-9 and Cpt-4 coding prior to charge entry for Gastroenterology billing
  • Process electronic and paper billing for all insurance carriers in Perfect Care
  • Extensive telephone contact with insurance carriers and patients
  • Checks Navinet system for referrals, claims status and payments
  • Reconcile claims to payment in full
  • Post cash and reduces receivables
  • Processed Workmen Comp and physical therapy charges into Medisoft
  • Researches all coding problems effecting reimbursement
  • Extensive telephone contact with all insurance carriers and attorneys
  • Post and reconcile payments to patient accounts
  • Organizes the processing of charges into the Next Gen billing system
  • Monitors all charge entry audit journals for accuracy
  • Researches all coding problems effecting reimbursement
  • ICD-9 and CPT-4 coding experience. Research and respond by telephone-in writing to patients inquires regarding billing issues and problems
  • Improved processes for all inaccurate information in the computer registration system
  • Process 500 claims a week
  • Extensive A/R recovery on outstanding accounts 180 days and older for home health  agencies and hospitals
  • Prepares and maintains daily productivity logs
  • Tracks accounts and updates tracking logs
  • Reports directly to CEO/CFO on a weekly basis regarding results of the A/R project
  • Extensive telephone contact with all insurance companies
  • Advance knowledge of Workmen comp, electronic billing for Medicare, Medicaid, Blue Cross, Managed Care and Commercial carriers, ICD-9, CPT-4 codes, calculated auto claims, ambulance billing , long term care and attorneys.
  • Comprehensive experience in insurance contracts and health care pricing
  • Responsible for obtaining pre-cert and authorizations for hospital billing
  • Telephoned insurance carriers for pre-cert and authorizations for Durable Medical Equipment and Infusion products
  • Verified insurance coverage for all orders
  • DME division closed
  • Performed a wide range of tasks associated with claims processing, follow-up and collections
  • Liaison between hospital and managed care carriers
  • Posting adjustments and rejections; ensuring fulfillment of contract requirements regarding  reimbursement; completing daily productivity logs to ascertain status of billing deficiency;  interacting with patients,staff and performing various assignments required
  • Participate in development of procedures and update of forms and manuals


  • Certified Coding Specialist, physician based, through AHIMA       
  • Certificate of Completion Medical Billing /Insurance Claims
  • Certificate of Completion Medical Records Coding

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