Katric' Jones
Senior Revenue Cycle & Reimbursement Analyst
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About
Revenue Cycle and Reimbursement professional with 20+ years of experience resolving complex commercial and government payer issues, identifying underpayments, and optimizing accounts receivable across infusion, DME, cardiac, and internal medicine settings. Proven track record leading remote teams, driving denial recovery, and collaborating with contracting and provider relations to improve reimbursement accuracy and compliance.
Experience
Biller & Collector - Loving Hearts PCA, SIL and Behavioral Health - Slidell, Lafayette & New Orleans, LA
(2026-05)
- Submit all claims through provider portals and Sharenote.
- Ensure authorization is on file and submit for upcoming expiring authorizations.
- Verify insurance coverage for patients and services.
- Review and correct Billing Hold spreadsheets.
- Assist with Payroll and Mapping.
Reimbursement Analyst - ResMed - Remote
(2024-02 - 2026-05)
- Analyzed commercial and government payer reimbursement to ensure contract compliance and payment accuracy across BCBS, UHC, and Medicaid.
- Identified contract variances and reimbursement discrepancies, recovering underpayments through targeted appeals and payer escalations.
- Resolved high-volume claim processing discrepancies impacting reimbursement accuracy, reducing outstanding AR aging.
- Collaborated with contracting team to flag payer trends and systemic payment issues requiring contract-level resolution.
Lead — UHC & SNF Reimbursement - Vital Care - Remote
(2023-02 - 2024-02)
- Led a remote team of 20+ reimbursement specialists handling UHC and SNF payers, serving as primary escalation point for complex denials and contract payment disputes.
- Identified recurring UHC payer trends resulting in targeted appeals strategies that recovered previously denied payments.
- Conducted 1:1 coaching and team training on appeals strategy, documentation requirements, and denial prevention.
- Implemented process improvements that shortened denial turnaround time and increased recovery rates.
Reimbursement Specialist — Infusion & DME - Vital Care - Remote
(2021-06 - 2023-02)
- Managed 40–50 daily denials and appeals across commercial and government payers for infusion and home-based services.
- Submitted detailed appeals and corrected claims to resolve underpayments and non-payment issues, reducing aging AR balances.
- Flagged contract compliance concerns and credentialing gaps impacting reimbursement to provider relations and contracting teams.
Reimbursement Specialist - Option Care Health - Remote
(2021-05 - 2021-06)
- Supported system and workflow transition following acquisition of BioScrip; maintained continuity of Sunshine Medicaid and Louisiana managed care plan operations.
- Resolved denials for Medicaid and commercial payers including Healthy Blue and Aetna Better Health.
Reimbursement Specialist - BioScrip Infusion Services - Metairie, LA → Remote (2019)
(2014-06 - 2021-05)
- Managed 42–50 daily BCBS and UHC infusion and DME denials, maintaining consistent follow-up and appeals resolution.
- Supported reduction of aging AR through disciplined denial management and timely payment posting.
- Improved denial turnaround timelines, contributing to measurable gains in reimbursement recovery speed.
Reimbursement Specialist - Tulane University Hospital - New Orleans, LA
(2013-06 - 2014-05)
- Appealed commercial insurance denials for internal medicine clinics, with a focus on managed care contract discrepancies.
- Resolved Healthy Blue reimbursement discrepancies through detailed contract analysis and payer escalation.
Medical Collections Specialist — Cardiac Care Clinic - East Jefferson Hospital - Metairie, LA
(2010 - 2013)
- Primary collector for the Cardiac Care Clinic, managing multi-payer denials and follow-up across commercial and government payers.
- Met regularly with practice management and provider representatives to address contract compliance and authorization issues.
- Supported end-of-month payment posting and revenue reporting.
Education
Medical Billing & Collections Program - Delta Community College (2008 - 2009) Baton Rouge, LA
Pre-Law Studies - Louisiana State University Baton Rouge, LA
