Summary
Work History
Education
Skills
Timeline
Generic

Kadesia Golden

Savannah,GA

Summary

Seasoned Revenue Cycle Specialist with over 10 years of experience seeking to leverage expertise in full revenue cycle management, including billing, coding, collections, and appeals. Skilled in physician credentialing and proficient in working with multiple payors, including Medicare and Medicaid. Proven track record in enhancing revenue processes and patient assistance coordination. 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.

Work History

Billing Team Lead

GI Care for Kids
2021 - 2023
  • Managed accurate entry of both professional and hospital billing claims to ensure timely reimbursement and maintain financial integrity
  • Addressed and resolved appeals and clearinghouse rejections, contributing to consistent cash flow and reduced denials by 25%.
  • Prepared and issued patient statements and processed insurance and patient refunds, alongside generating comprehensive monthly revenue reports for financial analysis.
  • Streamlined billing processes by implementing efficient procedures, resulting in reduced errors and increased productivity.
  • Developed comprehensive training materials for new hires, expediting onboarding process and ensuring consistent performance standards.
  • Increased revenue collection 30% by implementing efficient and effective strategies.
  • Conducted regular performance reviews for team members, providing constructive feedback and identifying areas for improvement.
  • Ensured compliance with federal, state, and industry regulations by staying informed of updates in policies or guidelines related to medical coding practices or other relevant financial matters.

Regional Coordinator

Pharmpacc
2019 - 2021
  • Reviewed uninsured patient profiles to identify eligibility for patient assistance programs, ensuring compliance with healthcare privacy regulations
  • Facilitated communication with patients to complete and obtain necessary consent forms for pharmaceutical applications
  • Managed coordination and shipment of medications, including submission of invoices for payment processing.
  • Educated patients on available resources and community programs, increasing their access to needed services.
  • Enhanced shipment coordination by implementing efficient tracking procedures and streamlining communication with carriers.
  • Contributed to 30% enrollment increase by meticulously reviewing ande evaluating patent applications.
  • Evaluated clients'' eligibility for various types of aid based on established criteria while considering individual circumstances such as income levels or family size for equitable distribution of resources.

Revenue Cycle Specialist

J C Lewis Primary Healthcare (FQHC)
2012 - 2019
  • Managed end-to-end billing and coding processes, ensuring accuracy and compliance across various medical specialties such as primary care, dental, and behavioral health
  • Coordinated with commercial and government insurers, successfully navigating Medicare and Medicaid claims, and facilitated resolution of collections, appeals, and denials
  • Performed physician credentialing and verified patient insurance coverage, securing necessary authorizations for medical procedures.
  • Increased revenue by 50% identifying and resolving billing errors in timely manner.
  • Ensured accurate billing with thorough audits of patient accounts and insurance claims.
  • Analyzed financial reports to identify trends and areas for improvement in revenue cycle operations.
  • Streamlined revenue cycle process for improved efficiency and faster payment collection.
  • Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.

Education

Master of Science - Human Resources Management

Strayer University
Savannah, GA
10.2021

Bachelor of Science - Healthcare Management

Saint Leo University
Savannah, GA
06.2017

Skills

  • Detail-Oriented
  • Adaptability
  • Problem Solving
  • HIPAA and Privacy Policies
  • Leadership
  • Medicaid
  • Medicare Guidelines
  • Accounts Receivables
  • Hospital Claims
  • Communication skills
  • Understanding of healthcare reimbursement processes
  • Critical Thinking
  • Performance Monitoring
  • Collections Management
  • Analyzing Claims

Timeline

Billing Team Lead

GI Care for Kids
2021 - 2023

Regional Coordinator

Pharmpacc
2019 - 2021

Revenue Cycle Specialist

J C Lewis Primary Healthcare (FQHC)
2012 - 2019

Master of Science - Human Resources Management

Strayer University

Bachelor of Science - Healthcare Management

Saint Leo University

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Kadesia Golden