Kimberly Cain
Morgantown
Summary
Experienced with strategic planning and project management. Utilizes leadership skills to drive team performance and operational excellence. Track record of delivering high-impact results through innovative problem-solving and effective communication.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Asst Director/Teacher
Preston County Youth Center
03.2024 - Current
- Scheduled employees for shifts, taking into account customer traffic and employee strengths.
- Reported issues to higher management with great detail.
- Managed purchasing, sales, marketing and customer account operations efficiently.
- Developed strong relationships with students, parents, and colleagues by maintaining open lines of communication and fostering a supportive learning environment.
- Managed classroom behavior effectively by establishing clear expectations, modeling appropriate conduct, and consistently enforcing established rules and consequences.
- Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
- Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale.
- Fostered positive learning environment that encouraged student curiosity and critical thinking.
- Self-motivated, with a strong sense of personal responsibility.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Worked well in a team setting, providing support and guidance.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
Medical Insurance Biller
Playworks Child Development Center
11.2015 - 03.2024
- Boosted customer satisfaction through professional handling of patient inquiries regarding billing matters and insurance coverage.
- Contributed to company growth by accurately analyzing trends in denial rates, payer mix, and other key performance indicators relevant to revenue cycle management.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Liaised between patients, insurance companies, and billing office.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Prepared detailed monthly reports highlighting key metrics such as collections ratio, days in accounts receivable, and percentage of aged accounts for management review.
- Reduced claim denials by effectively communicating with healthcare providers to obtain necessary documentation and information.
Medical Authorization Specialist
HealthWorks Rehab & Fitness
08.2014 - 11.2015
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Resolved discrepancies with client applications to verify eligibility.
Education
Associate of Applied Science - Paralegal Studies
West Virginia Business College
Clarksburg, WV05-1993
High School Diploma -
Lincoln High School
Shinnston, WV05-1992
Skills
- Relationship building
- Strategic planning
- Verbal and written communication
- Decision-making
- People management
Certification
- CPR/AED Certification
Timeline
Asst Director/Teacher
Preston County Youth Center
03.2024 - Current
Medical Insurance Biller
Playworks Child Development Center
11.2015 - 03.2024
Medical Authorization Specialist
HealthWorks Rehab & Fitness
08.2014 - 11.2015
Associate of Applied Science - Paralegal Studies
West Virginia Business College
High School Diploma -
Lincoln High School
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