DEMETRIA KIMBROUGH
Healthcare Management
Humble,TX
Summary
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information. Reliable Medical Biller with coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Overview
12
12
years of professional experience
11
11
years of post-secondary education
Work History
Medical Biller
ACCLARA HEALTHCARE SOLUTIONS LLC
Humble, TX
02.2022 - 06.2022
- Able to obtain necessary information for account resolution
- Excellent verbal and written communication skills
- Reliable attendance record
- Knowledge of EOBs, CPT & ICD-9 codes, HCFAs, UB04s, HCPCS, DRGs, and Authorizations/referrals
- Good problem-solving skills
- Detail-oriented and well organized
- Ability to perform under pressure in a calm manner
- Track record of over-achieving quota
- Ability to exercise basic judgment in identifying and implementing solutions to customer concerns and inquiries with supervision and guidance from managers
- Familiarity with CRM systems and practice
- Ability to multi-task, set priorities, and manage time effectively
- Manage large amounts of inbound and outbound calls promptly
- Receive electronic payments from patients
- Keep records of all conversations in our call center database in a comprehensible way
- Meet personal/team qualitative and quantitative metrics
- Identify customers’ needs, clarify information, research every issue, and provide solutions and/or alternatives
- Identification and billing of secondary insurances
- Responsible for a team that performs professional external audits to verify the accuracy of claims reimbursement, clinical significance, medical necessity, coding, and billing in accordance with the Plans’ agreements and the National Healthcare Billing Audit guidelines
- Prepared billing statements for patients and verified correct diagnostic coding.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Gathered information from multiple sources to simplify billing and organize accounts.
- Managed billing calendar and scheduled claims for payments.
Scheduler/Medical Records
COVID-19 Vaccinator, Houston Memorial, JBR
Houston, TX
03.2020 - 02.2022
- Performs professional public health nursing services focusing on prevention of COVID-19 and other duties as assigned
- Collaborates with vulnerable populations and community partners to ensure optimal health, especially as it relates to COVID-19 outbreaks in long-term care facilities, food, plants, and other areas
- Utilizes data on community health needs related to COVID-19 to provide health education, promote optimal health, and mitigate disease spread
- Investigates COVID-19 in diverse settings and makes recommendations for control
- Presents health education and transmission risks related to COVID-19
- Instructs in prevention and care of COVID-19, interviews clients to obtain health histories and/or health co-morbidities, and obtains laboratory data
- Seeks out and attends COVID-19 training sessions and/or continuing education classes as needed
- Educates and informs the community about health-related topics as needed
- Ensures that all grant deliverables are completed successfully and on time
- Government Scheduling - 1800 Government Dr
Scheduling Coordinator/Administrative Assistant
Care Connection at Home
Bellaire, TX
12.2017 - 05.2020
- Maintaining and updating schedules, calendars, and agendas
- Verifying the availability of in house and external participants for planned meetings
- Confirming appointments and arranging meeting venues
- Reschedule or cancel meetings in a timely manner
- Send out reminders for scheduled meetings
- Answer scheduling queries via email and phone
- Document scheduling processes and keep thorough records
- Extensive experience with office software, including MS Word, Excel, and Outlook Express
- Gathered employee data to develop monthly work schedules, enabling proper staffing for departments for each shift.
Team Lead Trainer
VetFedCareNET
Pensacola, FLORIDA
11.2017 - 02.2019
- Schedule veterans based on the regional availability of facilities, availability of veterans, and VA expectations while utilizing mapping software and other tools
- Prioritize scheduling based on VA and VES expectations
- Act as a point of contact for facilities in order to certify that veterans are seen according to VES guidelines and in a timely manner
- Access vendor websites and materials to coordinate shipping
- Assist diagnostic management with reschedules while adhering to internal and VA guidelines
- Ensure that all HIPAA standards are met throughout the scheduling and CAPS process
- Calculate mileage for VBA cases to safeguard the compensation of veterans for travel to Diagnostic appointments
- Assist diagnostic uploaders with redundancy checks by cross-referencing facility correspondence with
- VES databases to ensure all diagnostic results have been received
- Assists add-on scheduler with last-minute scheduling requests from the QA dept
- Checks voicemail and email throughout the day to respond to facility and veteran inquires
- Communicating, through managerial staff, ways in which various departments could improve performance to ensure the completion of VES cases in the best possible manner
- Maintain facility information and obtain up-to-date contact information for facilities in order to execute a cohesive scheduling process
- Continued monitoring of improvements in ICD10 coding, to certify that veterans are being seen for correct diagnosis
- Created and deployed successful strategies to boost restaurant performance, streamline food prep processes and reduce waste.
- Delivered in-depth training to workers in food preparation and customer-facing roles to promote strong team performance.
Certified Medical Assistant
West Florida Cardiology Hospital
Pensacola, FL
05.2012 - 12.2017
- Systems used are ECW, Allscripts, E-clinical
- Greeted patients and scheduled appointments.Prepared patients for diagnostic tests, such as stress echocardiograms and nuclear stress testing, by recording vital signs and administering medication
- Collected blood samples from the in-patient cardiology unit for analysis of cardiac enzymes and electrolytes
- Maintained patient records, including scheduling appointments, entering test results, and distributing prescriptions
- Scheduled follow-up appointments with primary care physicians or cardiologists when appropriate
- Answered phones and scheduled appointments for new patients at the front desk
- Performed routine clinical tasks such as taking vital signs and collecting patient medical history information
- Assisted physicians with patient examinations and procedures.
- Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
- Communicated clearly and effectively with patients to verify information, determine purpose of visit and record medical history.
- Directed patients to exam rooms, fielded questions and prepared for physician examinations.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens.
- Educated patients by providing medication and diet information and clarifying physicians' orders, answering questions thoroughly.
- Performed or scheduled preventive maintenance on equipment to promote longevity of use, troubleshooting technical issues and coordinating repairs.
- Directed patients to examining rooms and coordinated transportation assistance as necessary.
- Arranged surgeries with surgical center, confirming times with patients and preparing admission and consent forms.
Education
Bachelor of Science - Science
The College of Health Care Professions
Houston, TX 06.2022 - Current
Associate of Applied Science - Healthcare Administration
College of Health Care Professions-Southwest Houston
Houston, TX 05.2020 - 03.2022
High School Diploma -
Pensacola High School
Pensacola, FL 05.2000 - 05.2004
Medical Assistant Certification - Nursing
Pensacola School of Massage Therapy
Pensacola, FL 05.2015 - 07.2017
High school diploma or GED - Early Childhood Education
Pensacola State College
05.2006 - 08.2008
Skills
Tax reporting
Sheet balancing
A/P and A/R expertise
Quickbooks mastery
Invoicing prowess
Vendor invoice processing
General accounting
Cost accounting
Database Management
Regulatory filings
Customer service support
Quality Assurance Management
Accounting systems and controls
Management accounting
Financial Management
Financial report creation
Automated processing
Budgeting
Billing statement review
Accounting remittances
Collections duties
Financial statement analysis
Medical terminology expert
Medical record security
Signature verification
Budgeting proficiency
Medical claims submission
Payment posting
Data analysis
Patient account analysis
Records Maintenance
Accounts receivable management
Medicare and Medicaid process
Account development
Lead prospecting
Network development
Strategic planning
Staff Training
Customer Relations
Decision-Making
Clerical Support
PPE Compliance
Multitasking Abilities
Organization and Time Management
Teamwork and Collaboration
Revenue Generation
Additional Information
- Willing to relocate to:, Authorized to work in the US for any employer
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
The real test is not whether you avoid this failure, because you won’t. It’s whether you let it harden or shame you into inaction, or whether you learn from it; whether you choose to persevere.
Barack Obama
Timeline
Bachelor of Science - Science
The College of Health Care Professions
06.2022 - Current
Medical Biller
ACCLARA HEALTHCARE SOLUTIONS LLC
02.2022 - 06.2022
Associate of Applied Science - Healthcare Administration
College of Health Care Professions-Southwest Houston
05.2020 - 03.2022
Scheduler/Medical Records
COVID-19 Vaccinator, Houston Memorial, JBR
03.2020 - 02.2022
Scheduling Coordinator/Administrative Assistant
Care Connection at Home
12.2017 - 05.2020
Team Lead Trainer
VetFedCareNET
11.2017 - 02.2019
Medical Assistant Certification - Nursing
Pensacola School of Massage Therapy
05.2015 - 07.2017
Certified Medical Assistant
West Florida Cardiology Hospital
05.2012 - 12.2017
High school diploma or GED - Early Childhood Education
Pensacola State College
05.2006 - 08.2008
High School Diploma -
Pensacola High School
05.2000 - 05.2004