Heather Kimbler
West Jefferson
Summary
I am a highly motivated, detailed- oriented, and experienced individual seeking a position to utilize and enhance my industry knowledge, experience, and education in a growth-oriented company.
Seasoned Medical Coding and Billing Specialist possessing deep familiarity with medical terminology, coding procedures, and billing protocols. Strengths include accuracy in data entry, interpretation of complex medical records, and adherence to regulatory guidelines. Past roles demonstrate success in streamlining billing processes and enhancing revenue cycles by ensuring accurate code assignment. Known for stringent quality checks and prompt resolution of discrepancies, contributing to overall efficiency and productivity in healthcare administration tasks.
Overview
19
19
years of professional experience
Work History
Home Health Aid
Divine Home Health
Columbus
01.2013 - Current
- Maintain home care records.
- Maintain weekly reports to case manager and review any important changes in the patient’s conditions.
- Assist patients in performing daily activities.
- Help maintain patient meals and feeding.
- Organize a client’s schedule and plan appointments.
- Provide companionship.
Billing and Follow -up representative 2
Trinity Health
Livonia
01.2022 - 10.2024
- Performed day-to-day billing and follow-up activities within the revenue operations
- Documented claims billed, paid, settled, and follow-up in appropriate system
- Identifies and escalates issues affecting accurate billing and follow-up activities.
- Communicates with appropriate hospital departments to clarify billing discrepancies and obtains demographic, clinical, financial, and insurance information.
- Performed all routine follow-up functions which includes the investigation of overpayments, underpayments, credit balances and payment delays.
- Researched claim rejections, make corrections, take corrective actions, and/or refer claims to appropriate colleagues to ensure timely and accurate claim resolution.
Receptionist/Billing Specialist
Lifetime Vision Center
West Jefferson
01.2018 - 07.2020
- Answer phones, Schedule patients, Call and verify appointments.
- Post payments and process to secondary insurance if applicable
- Work denials make corrections as needed.
- Maintain and process monthly billing statements for patients.
- Verifies insurance coverage, obtain any prior authorizations
A/R Specialist Revenue Cycle
Ohio Health
Columbus
01.2017 - 01.2019
- Maintains accounts receivable balance and follows up on collection of accounts:
- Reconciles cash receipts/cash posting.
- Updates appropriate records as payments are received.
- Maintains accounts receivable, does follow-up with payors on regular and on-going basis.
- Balance bills secondary insurance and patients/families.
- Works with medical records to ensure complete/accurate charts for billing compliance.
- Reports denials and billing problems to Account Receivable Supervisor.
- Prepares recertification reports.
- Verifies insurance information to ensure accurate and timely billing of all patient revenue, negotiation of per diem payment with commercial payors and timely billing of all patient revenue:
- Assists patients/families and staff in completion of all paperwork to obtain eligibility.
- Verifies primary and secondary payors for each patient from admission paperwork.
- Verifies coverage for all commercial insurance prior to admission, negotiating payment with assistance from Accounts Receivable Supervisor as appropriate.
- Documents all pertinent information in the patient billing file and maintains file.
- Works with patients/families to advise of potential financial responsibility.
- Notifies payors of patient elections and discharges as appropriate.
- Coordination of third party and patient billing:
- Prepares billing forms and required documentation and completes billing of all services to the appropriate payors.
EMS Remote Coding Specialist
Intermedix
Columbus
01.2007 - 01.2017
- Assigned correct Levels of Service, Codes, Contra’s, Modifiers and Signatures.
- Worked with Client Services team members to help maintain client info sheets.
- Relay and help adjust any issues with client or system errors.
- Averaged 30-40 accounts an hour.
EMS Coding Team Lead
Intermedix
Columbus
01.2007 - 01.2017
- Worked with upper management, and auditors.
- Help maintain workflow, assess any issues with other team leads and staff.
- Monitor overall production, assist with progress reviews.
- Communicating progress and deficiencies with current staff.
- Maintain accessibility to employees for questions and additional training.
- Assist in staff hours and schedules.
EMS Coding Trainer
Intermedix
Columbus
01.2007 - 01.2017
- Trains new or existing coders and evaluates their performance.
- Reviews charts for proper Levels of Service, Codes, Contra’s, Modifiers and signatures.
- Develop and implement Coding documentation and training programs.
- Review Coding staff quality of work and provide feedback.
- Ensure compliance with all coding and billing regulations.
Education
Health Information Management- Associates -
Anthem
Medical Insurance Billing and Coding- Certification -
Everest
Certified Professional Coder Preparation Course -
AAPC
Skills
- ICD-10 CM
- CPT
- HCPCS
- HIPAA Compliance
- Medical Insurance
- Medical Terminology
- EPIC/Care Connect
- MITZ
- Airmed
- HDMS
- Zirmed
- Claim Entry
- Payment Posting
- Coding Systems
- Emergency
- Medical Billing
- Imagine Trend
- Safety Pad
- MS Word
- Excel
- Power Point
- Outlook
Timeline
Billing and Follow -up representative 2
Trinity Health
01.2022 - 10.2024
Receptionist/Billing Specialist
Lifetime Vision Center
01.2018 - 07.2020
A/R Specialist Revenue Cycle
Ohio Health
01.2017 - 01.2019
Home Health Aid
Divine Home Health
01.2013 - Current
EMS Remote Coding Specialist
Intermedix
01.2007 - 01.2017
EMS Coding Team Lead
Intermedix
01.2007 - 01.2017
EMS Coding Trainer
Intermedix
01.2007 - 01.2017
Health Information Management- Associates -
Anthem
Medical Insurance Billing and Coding- Certification -
Everest
Certified Professional Coder Preparation Course -
AAPC