JIRAI GOLATT, CPC.
Greer
Summary
Professional with background in medical billing and coding, adept at navigating complex reimbursement processes and optimizing revenue cycles. Strong analytical skills, attention to compliance, and ability to manage claim disputes effectively. Team player focused on collaboration and achieving organizational goals, adaptable to changing needs. Proficient in using healthcare software and maintaining accurate patient records.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Medical Reimbursement Specialist Lead - Revenue Cycle
The Onyx Group
02.2024 - Current
- Analyzed denial trends to identify root causes and recommend corrective actions.
- Reviewed and assigned accurate ICD-10-CM, CPT, and HCPCS codes to ensure compliance and reduce denial risk.
- Trained junior staff on best practices for handling denials and appeals procedures.
- Collaborated with healthcare providers to resolve claim discrepancies and expedite approvals.
- Implemented process improvements that enhanced accuracy in claims submission and follow-up.
- Developed comprehensive reports detailing denial reasons, resulting in targeted training initiatives.
- Managed appeals process for denied claims, ensuring timely follow-up and resolution of outstanding issues.
- Coordinated with internal teams to streamline workflows for timely resolution of denied claims.
- Improved claim denial resolution by thoroughly researching and identifying root causes of denials.
- Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
- Reviewed documentation to ensure compliance with payer requirements before submission.
- Identified root cause of denials to provide plans for denial resolution.
- Documented medical claim actions by completing forms, reports, logs and records.
- Participated in cross-functional projects focused on improving end-to-end revenue cycle performance, leveraging expertise in denial management as a key contributor.
- Collaborated with billing department staff to ensure accurate coding and charge entry, minimizing future claim denials.
- Served as a subject matter expert on denial-related issues within the organization, providing guidance and support to colleagues when needed.
Medical Reimbursement Specialist - Revenue Cycle
The Onyx Group
02.2024 - 05.2025
- Reviewed and processed medical claims for accuracy and compliance with regulatory guidelines.
- Reviewed and assigned accurate ICD-10-CM, CPT, and HCPCS codes to ensure compliance and reduce denial risk.
- Collaborated with healthcare providers to resolve reimbursement discrepancies and streamline claim submissions.
- Managed appeals process for denied claims, ensuring timely follow-up and resolution of outstanding issues.
- Evaluated aged accounts receivable reports to identify overdue payments and initiate appropriate follow-up actions for collection efforts.
- Maintained strict confidentiality regarding sensitive patient information, adhering to HIPAA regulations at all times.
- Reviewed and appealed denied claims, ensuring compliance with regulatory standards.
- Developed and maintained documentation of denial resolutions for audit purposes.
- Improved claim denial resolution by thoroughly researching and identifying root causes of denials.
- Documented medical claim actions by completing forms, reports, logs and records.
- Collaborated with billing department staff to ensure accurate coding and charge entry, minimizing future claim denials.
- Analyzed denial trends to proactively address recurring issues and improve clean claim submission rates.
Patient Account Specialist - Revenue Cycle
The Onyx Group
01.2023 - 02.2024
- Managed patient account inquiries, ensuring timely resolution and enhancing customer satisfaction.
- Collaborated with multidisciplinary teams to resolve complex billing issues effectively.
- Maintained high levels of data accuracy with meticulous attention to detail in processing insurance claims and updating patient records.
- Posted payments and processed refunds.
- Electronically submitted bills according to compliance guidelines.
- Reconciled statements with patient records.
- Contacted patients after insurance was calculated to obtain payments.
- Responded to patient, family, and external payer inquiries.
- Utilized computer programs to create invoices, letters, and other documents.
- Reduced outstanding balances by diligently following up on overdue payments and negotiating payment plans.
Cardiac Telemetry Technician
Prisma Health
05.2022 - 01.2023
- Monitored cardiac patients' vital signs using telemetry equipment to ensure continuous patient safety.
- Assisted healthcare teams in interpreting telemetry data, contributing to timely clinical decisions.
- Maintained accurate documentation of patient monitoring and interventions to support care continuity.
- Operated advanced cardiac monitoring systems, enhancing real-time observation capabilities for critical patients.
- Trained junior technicians on telemetry protocols and equipment usage, fostering team competency.
- Collaborated with nursing staff to develop individualized patient care plans based on telemetry insights.
- Ensured compliance with hospital policies and procedures while managing telemetry operations effectively.
- Maximized efficiency by organizing workstations and ensuring easy access to necessary supplies and tools during shifts.
- Ensured proper equipment functioning through regular maintenance checks and timely repairs when needed.
- Identified arrhythmias, abnormalities or significant changes from baseline cardiac condition.
- Helped maintain a clean, safe working environment by adhering strictly to infection control policies and procedures.
Front Desk Agent
Hyatt Place Haywood
08.2021 - 05.2022
- Managed check-in and check-out processes, ensuring smooth guest transitions.
- Provided exceptional customer service, addressing guest inquiries and resolving issues effectively.
- Coordinated with housekeeping to maintain room standards and readiness for arrivals.
- Processed payments accurately using property management software, enhancing transaction efficiency.
- Assisted in training new front desk staff on operational procedures and customer service protocols.
- Developed strong relationships with repeat guests, fostering loyalty and satisfaction.
- Implemented feedback mechanisms to gather guest insights for service improvement initiatives.
- Collected room deposits, fees, and payments.
- Maintained accurate records of guest information, payments, and reservations using hotel management software systems.
- Provided exceptional service during high-volume periods or challenging situations, ensuring a seamless experience for all guests.
Cashier
Sprouts Farmers Market
05.2020 - 02.2021
- Processed customer transactions efficiently using point-of-sale systems.
- Maintained accurate cash drawer and balanced registers at shift end.
- Provided excellent customer service, resolving inquiries and complaints promptly.
- Assisted in training new cashiers on operational procedures and best practices.
- Implemented effective product placement to enhance shopping experience and increase sales.
- Monitored inventory levels and restocked merchandise as needed during shifts.
- Collaborated with team members to ensure smooth store operations during peak hours.
- Greeted customers entering store and responded promptly to customer needs.
- Welcomed customers and helped determine their needs.
- Worked flexible schedule and extra shifts to meet business needs.
Education
AAPC Medical Coding - Online Course
Greenville Technical College
Greenville, SC12.2023
Healthcare Administration Pathway
Greenville Technical College
Greenville, SC05.2023
Skills
- Healthcare billing management
- ICD-10-CM, CPT, and HCPCS Level II coding
- E/M coding expertise
- Proficient in medical terminology and anatomy
- Adherence to OIG guidelines in coding
- Denial resolution assistance
- Understanding of payer rules and NCCI/LCD/NCD guidelines
- Experienced in utilizing EMR/EHR software (Epic and eClinicalWorks)
- Experienced with coding applications
- Detail-oriented analysis
Certification
- Certified Professional Coder, AAPC - 02144140
Timeline
Medical Reimbursement Specialist Lead - Revenue Cycle
The Onyx Group
02.2024 - Current
Medical Reimbursement Specialist - Revenue Cycle
The Onyx Group
02.2024 - 05.2025
Patient Account Specialist - Revenue Cycle
The Onyx Group
01.2023 - 02.2024
Cardiac Telemetry Technician
Prisma Health
05.2022 - 01.2023
Front Desk Agent
Hyatt Place Haywood
08.2021 - 05.2022
Cashier
Sprouts Farmers Market
05.2020 - 02.2021
Healthcare Administration Pathway
Greenville Technical College
AAPC Medical Coding - Online Course
Greenville Technical College
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