Debra Kamuda
Akron,OH
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
39
39
years of professional experience
Work History
Rural Carrier Associate
United States Postal Service, USPS
Akron, OH
02.2023 - Current
- Maintained records on customers with mail forwarding and change of address requests.
- Delivered mail and packages to customers on prescribed route while processing check submissions, money orders, and stamp purchases in field.
- Signed and received mail with signature requirements upon delivery and loading.
- Sorted mail according to order of address appearance for easy access in field.
Patient Account Representative II
Cleveland Clinic Home Care
Brecksville, OH
11.2015 - 02.2023
- Prepared reports detailing billing actions, flags and other key information.
- Utilized computer programs to create invoices, letters and other documents.
- Reconciled statements with patient records.
- Electronically submitted bills according to compliance guidelines.
- Posted payments and processed refunds.
- Contacted patients after insurance was calculated to obtain payments.
- Monitored flags and resolved urgent items with accuracy and efficiency.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Researched billing errors and discrepancies to initiate corrective action.
- Worked with customer to create debt repayment plan based on current financial condition.
- Established relationships with customers to encourage payment of delinquent accounts.
Hospice Patient Account Representative
Cleveland Clinic Akron General Medical Center
Akron, OH
04.2017 - 12.2019
- Utilized computer programs to create invoices, letters and other documents.
- Prepared reports detailing billing actions, flags and other key information.
- Responded to patient, family and external payer inquiries.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Reconciled statements with patient records.
- Electronically submitted bills according to compliance guidelines.
- Posted payments and processed refunds.
- Generated and distributed monthly customer statements.
Home Health Patient Account Representative
Cleveland Clinic Akron General Medical Center
Akron, OH
04.2016 - 04.2017
- Utilized computer programs to create invoices, letters and other documents.
- Contacted patients after insurance was calculated to obtain payments.
- Responded to patient, family and external payer inquiries.
- Electronically submitted bills according to compliance guidelines.
- Reconciled statements with patient records.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Monitored customer accounts for payment delinquency and initiated collection efforts.
Home Health Patient Account Representative
Visiting Nurse Service
Akron, OH
11.2015 - 03.2016
- Prepared reports detailing billing actions, flags and other key information.
- Utilized computer programs to create invoices, letters and other documents.
- Contacted patients after insurance was calculated to obtain payments.
- Responded to patient, family and external payer inquiries.
Home Health Patient Account Representative
Aerotek/Visiting Nurse Service
Akron, OH
08.2015 - 11.2015
- Data entry of patient and equipment details from old software to new software system for conversion.
- Prepared reports detailing billing actions, flags and other key information.
- Utilized computer programs to create invoices, letters and other documents.
- Contacted patients after insurance was calculated to obtain payments.
- Responded to patient, family and external payer inquiries.
Third Party Reimbursement Representative
Discount Drug Mart/Hastings Professional Medical
Medina, OH
10.2014 - 05.2015
- Completion of weekly system reports
- Requested, received, and entered data in BrightTree
- Order confirmations
- Data entry of order specifics
- Verified reimbursements were correct
Temporary Pharmacy Billing Clerk
Envision Rx Options
Twinsburg, OH
04.2014 - 10.2014
- Verification of pharmacy eligibility.
- Executed billing tasks and recorded information in company databases.
- Temporary prescription drug invoice reviewed for accuracy and completion.
- Temporary prescription drug invoice data entry.
- Report created for each invoice, printed, and attached to pharmacy backup.
Medicare and Commercial Insurance Patient Acct Rep
Linde/Lincare/Health Care Solutions
Akron, OH
12.2011 - 04.2014
- Monthly Excel report including quantity and claims totals.
- Monthly written report with details of claim findings, resolution, and status to date.
- Managed large volume of medical claims on daily basis.
- Responded to correspondence from insurance companies.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Reviewed provider coding information to report services and verify correctness.
Practice Representative/Insurance Billing FollowUp
Physicians Practice Mgmt/Matrix Mgmt Solutions
N. Canton, OH
06.2007 - 09.2010
- Recommended service improvements to minimize recurring patient issues and complaints.
- Resolved customer complaints using established follow-up procedures.
- Facilitated communication between patients and various departments and staff.
- Followed document protocols to safeguard confidentiality of patient records.
- Provided excellent customer service to patients and medical staff.
- Verified patient insurance eligibility and entered patient information into system.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
Temporary Medical Claims Processor/Analyst
AccounTemps-PrimeTime Helath Plan/Aultra Admin Grp
Canton, OH
03.2007 - 06.2007
- Data entry of medical claims.
- Claims adjudication.
- Responded to correspondence from insurance companies.
- Reviewed provider coding information to report services and verify correctness.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Customer Service.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Verified patient insurance coverage and benefits for medical claims.
- Identified and resolved discrepancies between patient information and claims data.
Temporary Claims Processor
Health Designs Plus
Hudson, OH
05.2003 - 06.2003
- Followed up with customers on unresolved issues.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Evaluated accuracy and quality of data entered into agency management system.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
Provider Relations Data Specialist
SummaCare
Akron, OH
08.2002 - 04.2003
- Provider eligibility research
- Verify accuracy of provider information
- Data entry of provider data in Amisys provider data sub system
Computer Operator
SummaCare
Akron, OH
10.2001 - 08.2002
- Generated weekly claim runs after ensuring accuracy.
- Generated reports covering details about data, system operation, and error monitoring.
- Changed and replaced backup tapes regularly and performed detailed server backups.
- Report database manipulation to achieve requested user reports.
Subrogation Specialist
Akron City Health System
Akron, OH
04.2000 - 10.2001
- Utilized appropriate cost containment techniques to reduce overall claim costs.
- Followed up with customers on unresolved issues.
- Conducted full claim investigations and reported updates and legal actions.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Examined claims forms and other records to determine insurance coverage.
- Maintained contact with claimants and attorneys to determine treatment status.
Claims Adjudicator
Akron City Health Systems
Akron, OH
02.1993 - 04.2003
- Executed claims processing.
- Investigated high volume of insurance claims to determine validity and coverage eligibility.
- Prepared and presented claims to other insurance companies and collaborated to gain necessary information to resolve claims.
- Collaborated with team members and management to meet goals.
- Optimized organizational efficiency by mentoring personnel on customer service protocols.
- Used claims systems to program, set up functions and enter data for claims.
Dental Claims Examiner
Benefit Services
Akron, OH
05.1991 - 03.1992
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Verified client information by analyzing existing evidence on file.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
Dental Claims Processor and Supervisor
Browne And Associates, Insured Plans
Akron, OH
06.1989 - 03.1992
- Processed new claims.
- Verified client information by analyzing existing evidence on file.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Set up new monthly Orthodontia files.
- Processed monthly Orthodontia claims.
Claims Computer Data Specialist
Browne And Associates, Insured Plans
Akron, OH
06.1984 - 02.1992
- Managed documents by organizing forms, making photocopies, filing records, preparing correspondence, and creating reports.
- Reviewed and updated client files and database information to maintain accurate records.
- Validated incoming data against quality standards to eliminate irrelevant or unusable information.
- Optimized quality of data by developing and continuously improving data collection and automated upload strategies.
- Created claims invoices for covered groups.
- Released claim run after receipt of payment transfers.
Education
No Degree - Health Care Administration
University of Phoenix
Independence, OH 05.2001 -
No Degree - Pre-Nursing
Stark State College
Canton, OH 05.2001 -
No Degree - Pre-Nursing
University of Akron
Akron, OH 05.2001 -
Skills
Multitasking Abilities
Teamwork and Collaboration
MS Office
Attention to Detail
Quick learner
Kaisen Process Improvement participation
Timeline
Rural Carrier Associate
United States Postal Service, USPS
02.2023 - Current
Hospice Patient Account Representative
Cleveland Clinic Akron General Medical Center
04.2017 - 12.2019
Home Health Patient Account Representative
Cleveland Clinic Akron General Medical Center
04.2016 - 04.2017
Patient Account Representative II
Cleveland Clinic Home Care
11.2015 - 02.2023
Home Health Patient Account Representative
Visiting Nurse Service
11.2015 - 03.2016
Home Health Patient Account Representative
Aerotek/Visiting Nurse Service
08.2015 - 11.2015
Third Party Reimbursement Representative
Discount Drug Mart/Hastings Professional Medical
10.2014 - 05.2015
Temporary Pharmacy Billing Clerk
Envision Rx Options
04.2014 - 10.2014
Medicare and Commercial Insurance Patient Acct Rep
Linde/Lincare/Health Care Solutions
12.2011 - 04.2014
Practice Representative/Insurance Billing FollowUp
Physicians Practice Mgmt/Matrix Mgmt Solutions
06.2007 - 09.2010
Temporary Medical Claims Processor/Analyst
AccounTemps-PrimeTime Helath Plan/Aultra Admin Grp
03.2007 - 06.2007
Temporary Claims Processor
Health Designs Plus
05.2003 - 06.2003
Provider Relations Data Specialist
SummaCare
08.2002 - 04.2003
Computer Operator
SummaCare
10.2001 - 08.2002
No Degree - Health Care Administration
University of Phoenix
05.2001 -
No Degree - Pre-Nursing
Stark State College
05.2001 -
No Degree - Pre-Nursing
University of Akron
05.2001 -
Subrogation Specialist
Akron City Health System
04.2000 - 10.2001
Claims Adjudicator
Akron City Health Systems
02.1993 - 04.2003
Dental Claims Examiner
Benefit Services
05.1991 - 03.1992
Dental Claims Processor and Supervisor
Browne And Associates, Insured Plans
06.1989 - 03.1992
Claims Computer Data Specialist
Browne And Associates, Insured Plans
06.1984 - 02.1992