Kareen Richards-Thames
West Park,FL
Summary
Experienced Healthcare Collections Representative with a strong background in medical billing, insurance follow-up, and patient account resolution. Skilled in managing delinquent accounts, negotiating payment arrangements, and ensuring compliance with HIPAA and healthcare regulations. Proficient in EHR/RCM systems, denial management, and working with insurance providers to resolve claim issues efficiently. Known for maintaining professionalism, improving recovery rates, and delivering accurate, patient-focused financial communication.
Overview
1
1
Certification
25
25
years of professional experience
Work History
Collections Representative
Memorial Hospital Healthcare Systems
04.2026 - Current
- Maintain strict confidentiality and comply with HIPAA and company privacy policies
- Facilitated release of information (ROI) process to ensure compliance and transparency.
- Knowledge of insurance billing, patient balances, and account reconciliation processes preferred
- Have experience with Medicaid and Medicare programs.
- Facilitated grievance and appeal resolution processes, ensuring compliance with organizational policies.
- Achieved proficiency in medical terminology through dedicated coursework and collaborative learning.
- Reviews pre-specified claims and those that exceed specialist adjudication authority or processing expertise.
- Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost-containment measures to support accurate claim adjudication.
- Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures.
- Identifies and reports potential overpayments, underpayments, and other claim irregularities.
- Performs claim rework calculations as needed.
- Collects payments from state and federal agencies, commercial insurance companies, third party organizations andother responsible parties and posts payments to proper accounts.
- Conducts outbound calls to obtain required informatic claims or reconsideration requests.
Customer Support Analyst
Verizon Wireless
02.2020 - 04.2025
- Supported customer inquiries across phone, email, and chat troubleshooting product and service concerns, documenting case notes, and confirming next steps through resolution.
- Verified account details, corrected request discrepancies, and updated records accurately to prevent repeat contacts while meeting service level and quality standards.
- Coordinated escalations compiling documentation, routing exceptions to product and technical partners, and delivering clear customer updates through case closure.
- Maintained clean documentation validating order data, reviewing exception trends, and completing final quality checks to ensure accurate outcomes and compliance.
- Received Employee of the Month in recognition of hard work, dedication, and consistent performance excellence.
Product Support Specialist
TracFone Wireless
08.2012 - 02.2020
- Processed product support requests verifying eligibility, updating service records, and documenting outcomes while maintaining consistent communication through email updates.
- Managed assigned work queues prioritizing requests, tracking status, and escalating exceptions that impacted order completion, customer experience, or service levels.
- Coordinated cross functional tasks confirming requirements, routing tickets appropriately, and maintaining complete documentation to support timely resolution and audit readiness.
- Improved queue turnaround 15% standardizing documentation steps, organizing priorities, and reducing avoidable rework across recurring request types.
Administrative Support Coordinator
TracFone Wireless
11.2009 - 09.2012
- Supported administrative operations coordinating internal communications, documenting status updates, and maintaining accurate tracking logs for reporting and follow up.
- Reviewed workflow discrepancies, routed escalations to the correct teams, and ensured exception handling followed documented procedures and service standards.
- Maintained organized records updating trackers, validating request details, and ensuring case documentation remained complete, accurate, and ready for review.
- Assisted cross functional teams tracking action items, confirming completion requirements, and supporting consistent follow-through across multiple work queues.
Administrative Assistant
St. Thomas University
08.2001 - 06.2004
- Provided administrative and office support by managing calendars, coordinating meetings, and preparing professional correspondence.
- Maintained organized filing systems, performed accurate data entry, and handled records with strict confidentiality.
- Supported faculty and staff with documentation, scheduling, and daily office operations to ensure smooth departmental workflow.
Education
Bachelor's Degree - Business Management
St Thomas University
Miami, Florida01.2004
High School Diploma - undefined
Hallandale High School
Hallandale, Florida01.2000
Skills
Written and Verbal Communication
Email and Chat Support
Product Support
Order Processing
SQL Certified
Administrative
Assistant/Data Entry
Supervisor Role
Microsoft Office Expert/ Types 65 WPM
Customer service excellence
Certification
Medical Billing and Coding for Beginners, March 2026.
Introduction to medical terminology and anatomy for accurate billing and
coding.Understanding the basics of healthcare regulations and compliance
standards.Training on ICD-10, CPT, and HCPCS coding systems.
Timeline
Collections Representative
Memorial Hospital Healthcare Systems
04.2026 - Current
Customer Support Analyst
Verizon Wireless
02.2020 - 04.2025
Product Support Specialist
TracFone Wireless
08.2012 - 02.2020
Administrative Support Coordinator
TracFone Wireless
11.2009 - 09.2012
Administrative Assistant
St. Thomas University
08.2001 - 06.2004
High School Diploma - undefined
Hallandale High School
Bachelor's Degree - Business Management
St Thomas University