James Kimbrough
Garland,TX
Overview
11
11
years of professional experience
Work History
Patient Access Representative
SmithRx
Plano
05.2023 - Current
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Using TalkDesk Systems to take calls, answer voicemails and access phone systems.
- Improved customer satisfaction by implementing effective call center strategies and streamlining operations.
- Streamlined communication processes for improved team collaboration and increased team efficiency.
- Enhanced customer satisfaction by efficiently addressing and resolving inquiries.
- Maintained detailed records of customer interactions for accurate tracking and reporting purposes.
- Reduced call resolution time with efficient multitasking and prioritization of tasks.
- Balanced competing priorities while fielding simultaneous calls from customers seeking information about products, services or account details.
- Managed escalated calls professionally, working towards swift resolutions that satisfied both customer and company needs.
- Assisted in the creation of call scripts, optimizing efficiency and effectiveness of communications with clients.
Lead Patient Care Technician
Wasatch Medical Clinic
06.2022 - Current
- Pre-register/Register patients for scheduled/unscheduled services, inpatient/outpatient procedures within all applicable hospital- based areas
- Interview patient(s) and/or their representative information or verify information already on file
- All registrations performed utilizing available up to date technology (workstation, tablets, etc.)
- Managing 8 employees hourly times
- Vacation approvals, Scheduling, Benefits etc
- Obtain copies of necessary identification and medical docs and paperwork
- Document appropriate information in the registration system based upon departmental documentation standards
- Handling Patient grievances and assisting to help to better assist through active listening
- Accurate and timely deployment of legal and compliance consent forms and documents
- Initiates the Advance Directive process when applicable
- Follow and comply with HIPAA guidelines
- Ensures all patients are continually informed of their visit status when services are delayed
- Initiate, obtain and/or update insurance verification as appropriate for patient services
- Coordinate accurate patient data to determine financial obligation
- Collection of insurance copayments, deductible amounts, self-pay deposits and patient balances from the patient/guarantor
- Request full or partial payment for services rendered according to collection policies
- Follows all guidelines set forth in the Cash Handling policy
- Produce paperwork on each patient for distribution to appropriate departments.
Service Advocate/Training Coordinator
Studio Movie Grill
06.2013 - Current
- Scheduling of department employees
- Mediation of guest grievances
- Training fellow employees under a new hire process
- Conducting news employee training and orientation
- Instructing, teaching and preparing training classes
- Being compliant and competent with cash out and cash handling and processing procedures
- Responsible for budget of assigned department
- Others duties assigned but not limited to as stated
- Daily monitor of guest activity through service programs
- Monitoring and managing up to 25-30 Employees at at time
- Taking care of guest grievances and consolidating in a timely manner
Sr. MRA Service Support Associate
Multiplan
11.2018 - 02.2020
- Currently responsible for assisting with performance review and validation of potential duplicate issues
- Provide resolution and closure to the applicable recipients
- Create and execute business correspondence to clients using multiple media formats
- May include call center capabilities
- Ensure notes, codes and appropriate closure processes for inquiries/appeals are followed and documented in applicable systems
- Working on programs and information through EPIC Software
- Adhere to client TAT requirements as relates to response time and required actions
- Responsible for the departmental shared email box
- Manage departmental reports and projects as required
- Provide backup duties for MRA Services Support Associate
- Collaborate, coordinate, and communicate across disciplines and departments
- Ensure compliance with HIPAA regulations and requirements
- Demonstrate Company's Core Competencies and values held within
- The position responsibilities outlined above are in no way to be construed as all encompassing
- Other duties, responsibilities, and qualifications may be required and/or assigned as necessary
- Also, my duties include keeping the needs of external and internal customers as a priority when making decisions and taking action
- Work is generally complex and requires independent judgment within established guidelines
- More complex issues are referred to higher levels
- Accurate and timely processing of claims documents and requests directly impacts company revenue and client savings
- Greet all visitors (customers, salespeople, vendors, and employees) to the Company in a professional, friendly, and hospitable manner and maintain a secure entrance to the facility
- This includes verification of visitor identity, tracking visit in reception book, issuing visitor badges/authorization, ensuring visitors are escorted appropriately, and confirming employment status of employees without badges prior to granting access to the facility
- Answer calls to the switchboard system and ensure that the calls are properly redirected or transferred to the appropriate employee or department
- This may include taking messages and/or accepting packages on behalf of the company or employees
- Operate public address system to announce emergency closings, parking lot issues of concern, and pages for employees as necessary
- Provide callers with information such as company addresses, directions to company locations, company website information, and other related information
- May open and close the reception and adjacent areas (based on location) and maintain the area throughout the day to ensure a positive first impression of the company image
- May perform some of the following duties (based on location): distribute mail; prepare packages for shipment; prepare client letters for mailing; email clients for retum letter information; distribute 'save appeal closing documentation relative to claims processing; scan and save documents into storage database; enter and verify data; and coordinate conference room reservations, travel arrangements, catering, and special events as needed Collaborate, coordinate, and communicate across disciplines and departments.
Customer Service Representative/Employee Relations HR Rep
Moxie Pest Control
03.2017 - 01.2018
- Responsible for managing FMLA and other leaves of absence from start to finish
- Work-related injuries}incidents and workers' compensation management
- Assists with recruitment, sourcing, and screening applicants, drafting offer letters, and managing pre-employment testing procedures
- Processes new hires, status changes and terminations
- Proactively develops, recommends, and assists with the implementation of new HR Initiatives, procedures, and documentation;
- Responsible for benefits administration, maintenance of personnel files, employment inquiries, and new employee orientation and onboarding
- Provide guidance and respond to employee questions regarding benefits, compensation, and salary administration
- Recruiting and staffing coordination
- Employment and compliance to regulatory concerns and reporting;
- Policy development and documentation
- Developing and implementing procedures; including communication plans, performance reviews, new hire orientation, training programs, compensation and benefits planning, and talent assessments
- Conduct termination exit interviews, and subsequently compile and distribute acquired information
- Maintain up-to-date knowledge of employment law;
- Evaluate and update company policies and procedures as needed
- Managing employees and I9 as well as other paperwork through Workday.
Education
Skills
- Basic computer data entry and typing skills — typing minimum 35 wpm
- Excellent written and oral communication skills
- Excellent internal and external customer service skills
- Ability to work with confidential information on a daily basis
- Effective and Efficient Problem Solving
- Attention to Detail
- Customer Service
- Employee Engagement
- Advising Department Managers
- Cross Functional Collaboration
Timeline
Patient Access Representative - SmithRx
05.2023 - Current
Lead Patient Care Technician - Wasatch Medical Clinic
06.2022 - Current
Sr. MRA Service Support Associate - Multiplan
11.2018 - 02.2020
Customer Service Representative/Employee Relations HR Rep - Moxie Pest Control
03.2017 - 01.2018
Service Advocate/Training Coordinator - Studio Movie Grill
06.2013 - Current
Eastfield College - ,