Alfonsa Kyles
Atlanta,GA
Summary
Helpful Patient Service Representative and Billing Specialist with over five years of experience. Adept at collecting patient information, maintaining efficient office skill, and coordinating with medical professionals. Extensive knowledge of Patient Financial Clearance and commitment to patient happiness.
Overview
12
12
years of professional experience
Work History
Revenue Cycle Specialist
KNOWTION
12.2021 - 09.2025
- Analyzed revenue cycle process
- Implemented software solutions to streamline patient acreceivable management and reporting.
- Worked effectively in fast-paced environments.
- Upheld strict confidentiality standards to protect sensitive patient information in accordance with HIPAA regulations.
- Processed medical claims using billing software to ensure timely reimbursement.
- Collaborated with medical coders to ensure proper use of CPT, ICD-10, and HCPCS codes for accurate claim submission and compliance with industry standards.
- Facilitated communication between stakeholders to resolve lien-related inquiries effectively.
Revenue Cycle Specialist
First Financial Asset Management Inc.
09.2020 - 11.2021
- Complied with all HIPAA Privacy and Security Regulations to protect patient's medical records and information
- Handled, initiated, and faxed UB-04, CMS 1500 and medical records to patient's insurance company. Experience in billing auto insurance, commercial/government insurance, and worker's comp.
- Responsible for obtaining patient's worker's comp, auto, or commercial insurance. Knowledgeable in PIP states and non PIP states. Responsible for billing patient commercial insurance before the timely filing date.
- Received and reviewed EOBs to check if insurance needs more information to pay for medical bill or if the benefits have been exhausted. Handled settlements from insurance company or attorney office and adjusted balance via software Meditech
- Prevented financial delinquencies by working closely with managers to ensure billing issues were resolved before becoming unmanageable.
- Contacted insurance companies to follow up on bill status for payment.
- Reached out to insurance companies to verify coverage.
Patient Access Representative
GetixHealth
10.2018 - 07.2020
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks
- Tracked referral submission during facilitation of prior authorization issuance.
- Worked patients accounts through Epic by inserting the correct CPT codes and diagnostic codes
- Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
- Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient privacy.
- Utilized Epic to manage and confirm patient data, such as insurance, demographic and medical history information.
- Trained new agent as team lead by relaying information on company procedures, HIPAA compliancy, managing Epic and phone etiquette.
Customer Service Representative
Trubridge
09.2015 - 10.2018
- Resolved customers service billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills.
- Provided excellent customer service to patient by provided thorough explanation of medical bill, provided information in regards to financial assistance, and offered discounts that would help reduce the cost of patient's bill
- Processed payment via telephone with focus on accuracy and efficiency.
- Obtain patient medical insurance and forward information to the accurate department for billing
- Accepted payments for outpatient and inpatient services and also provided billing explanation and charges to patients.
- Took copayments and compiled daily financial records.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Handled outbound and inbound calls daily with goal of collecting owed debt.
Call Center Representative
Alorica
04.2013 - 08.2015
- Enhanced productivity by staying on top of call scripts and maintaining control over direction of conversations.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Conferred with customers by telephone to provide information about products or services, took or entered orders, canceled accounts, or obtained details of complaints.
- Checked to ensure that appropriate changes were made to resolve customers' problems.
- Kept records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
- Assisted trainees and employees of the company on positive positioning and billing explanation.
Education
Associate of Arts - General Studies
Atlanta Metropolitan State College
Atlanta, GA05-2022
Skills
- Insurance Billing
- Scheduling
- HIPAA Regulations
- Medical Coding
- Financial Consulting
- Data entry
- Supervisory training
- Insurance Knowledge
- CPT Coding
- Medical Records Management
- Insurance verifying
- Managing records
- Epic competency
- Meditech software proficiency
- Claims review
- Claims processing proficiency
- Medical billing expertise
- Revenue cycle management
- Multitasking
- Verbal communication
- Active listening
Timeline
Revenue Cycle Specialist
KNOWTION
12.2021 - 09.2025
Revenue Cycle Specialist
First Financial Asset Management Inc.
09.2020 - 11.2021
Patient Access Representative
GetixHealth
10.2018 - 07.2020
Customer Service Representative
Trubridge
09.2015 - 10.2018
Call Center Representative
Alorica
04.2013 - 08.2015
Associate of Arts - General Studies
Atlanta Metropolitan State College
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