Pasadena High School
High School Diploma
Hi, I’m
Caprice Lee
Summary
Well-versed collector offering
proficiency and experience in Finance, Medicare, Medi-Cal, COB, Commerical, Customer Service, Denials, Healthcare, Call Centers and Support Services
Work History
Kaiser Permanente
Collector II
2012 - 2023 (11 education.years_Label)
Job overview
- Determine appropriate collection action for Kaiser Members and
Non-members relating to inpatient, outpatient, commercial,
Medi-Cal, COB, Medicare, emergency room and pharmacy
charges for all in- and out-of-network services, etc. - Make recommendations and decisions to refer accounts for billing,
rebilling and or outside collection agencies at any stage of the
internal collection process - Review accounts to ensure compliance with local, state, and federal
laws relating to adjustments, refunds, copayments, deductibles,
refunds and uncollectible balances along with approving patient/
third party settlement payment release - Interpret patient's benefits and exclusions of primary and secondary
insurance coverage - Process payment appeals, revenue reversal and write-offs and denials
- Reconciled high dollar accounts
- Receive inbound/outbound calls
Kaiser Permanente
Medical Reviewer
2006 - 2012 (6 education.years_Label)
Job overview
- Assessed risk value in the California, Ohio, and Colorado regions for
prospective and returning members who sought medical insurance
with Kaiser Permanente - Adhered to productivity, turnaround times, and customer service
inquiries - Process enrollments for new Kaiser Permanente members
- Call / Receive and obtain applicant's medical information that would
further, assist in determining the correct Medical Review decision
Kaiser Permanente
Support Associate
1998 - 2006 (8 education.years_Label)
Job overview
- Process write-off/ adjustments to Medicare / Medi-Cal accounts based on contractual and/or billing statute limitations
- Created patient accounts for Medicare deductible charges
- Exhibited high energy and customer service to every customer by investigating and resolving a broad variety of inquires and complaints, while leveraging extensive knowledge of products and services and creating welcoming, positive experiences
Kaiser Permanente
Temporary Worker
1996 - 1998 (2 education.years_Label)
Education
Pasadena High SchoolPasadena, CA
High School Diploma
University Overview
- Shop Steward - Intermediary between the employees and management to ensure the best working conditions and that all parties adhere to their collective agreements
- Medical Terminology
Chaffey CollegeRancho Cucamonga, CA
from American Sign Language (ASL)
Skills
- 27 years of collector experience
- Understand the business and how to individually contribute to success
- Ability to to set performance goals and determine how to achieve them
- Active listening and communication skills (both oral & written)
- Microsoft Systems
- Extremely organized
Timeline
Chaffey College
from American Sign Language (ASL)
Collector II
Kaiser Permanente
2012 - 2023 (11 education.years_Label)
Medical Reviewer
Kaiser Permanente
2006 - 2012 (6 education.years_Label)
Support Associate
Kaiser Permanente
1998 - 2006 (8 education.years_Label)
Temporary Worker
Kaiser Permanente
1996 - 1998 (2 education.years_Label)
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