Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Karletta Thompson

Raeford,NC

Summary

Seasoned healthcare professional with a proven track record of delivering high-quality insurance solutions. Skilled in navigating insurance company complexities, including authorizations and claims denials. Possesses extensive knowledge of the insurance industry and excels at assessing customer risk to provide tailored solutions. Trusted advisor who builds strong client relationships, offering guidance and financial advice with exceptional service. Detail-oriented team player with excellent organizational skills, capable of managing multiple projects simultaneously while maintaining a high level of accuracy.

Overview

13
13
years of professional experience
1
1
Certification

Work History

Licensed Insurance Agent

American Exchange
10.2021 - Current
  • Calculated quotes and educated potential clients on insurance options.
  • Recommended type and amount of coverage based on analysis of customers' circumstances using persuasive sales techniques.
  • Leveraged knowledge of company insurance products and services to advise customers on appropriate choices.
  • Established trust with clients through transparent communication regarding policy costs, coverages, exclusions, limitations, endorsements or riders available upon request.
  • Improved client satisfaction by providing tailored insurance solutions and exceptional customer service.
  • Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
  • Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
  • Educated prospective clients on the benefits of various health insurance options, effectively matching them with suitable plans that met their unique needs.

Authorization Coordinator

R1 RCM - Remote
05.2019 - 10.2021
  • Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
  • Maintained consistent follow-up on status of prior authorization requests.
  • Supported revenue cycle management efforts by ensuring accurate capture of authorized services during billing processes.
  • Facilitated timely renewals of ongoing authorizations by closely monitoring expiration dates and initiating renewal processes proactively.
  • Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
  • Reviewed authorizations from payer to determine approved or denied items.
  • Enhanced communication between healthcare providers and insurance companies, reducing delays in patient treatment approvals.
  • Submitted for prior authorization with required documentation to appropriate funding source.
  • Calculated estimated copay based on current insurance benefits.
  • Conducted thorough reviews of medical records to identify and address potential issues affecting authorization approvals.

Medical Billing Specialist

Carolina Heart and Leg Center
04.2018 - 03.2019
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
  • Collected payments and applied to patient accounts.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Posted and adjusted payments from insurance companies.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Located errors and promptly refiled rejected claims.
  • Identified and resolved patient billing and payment issues.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Precisely evaluated and verified benefits and eligibility.

Front Desk Receptionist

Carolina Heart and Leg Center
04.2017 - 04.2018
  • Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
  • Maintained organized and clean front office area to create professional and welcoming environment for visitors and employees.
  • Scheduled, coordinated and confirmed appointments and meetings.
  • Collected co-payments.
  • Scheduled appointments accurately using reservation software, reducing conflicts.
  • Handled sensitive customer information with confidentiality, adhering to company privacy guidelines.
  • Expedited check-in and check-out procedures for guests, ensuring seamless experiences during their visits.

Front Desk Receptionist

Carolina Neurology Associates
05.2016 - 04.2017
  • Maintained patient accounts by obtaining, recording, and updating personal and financial information.
  • Managed office and medical supply inventories; received deliveries and organized supplies in stockrooms and exam rooms.
  • Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
  • Maintained organized and clean front office area to create professional and welcoming environment for visitors and employees.
  • Scheduled, coordinated and confirmed appointments and meetings.
  • Managed high-volume phone calls, directing inquiries to appropriate personnel for prompt resolution.
  • Assisted with administrative tasks such as filing, data entry, and document preparation, supporting overall office productivity.
  • Streamlined check-in processes, reducing wait times for guests.

Patient Access Representative

Cape Fear Valley Health System - Raeford, NC
01.2015 - 01.2016
  • Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
  • Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
  • Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
  • Streamlined patient registration processes by implementing efficient data collection methods and reducing wait times.

Call Center Supervisor

Power Home Technologies
12.2011 - 01.2013
  • Monitored call quality and provided individual constructive feedback to enhance performance and address areas in need of improvement.
  • Trained team members on performance metrics and consumer behavior identification.
  • Enhanced team performance with consistent coaching, feedback, and development opportunities.
  • Reduced average handle time through the implementation of effective call handling techniques and scripts.
  • Improved customer satisfaction by effectively resolving escalated issues and providing timely support.
  • Improved caller satisfaction with thorough quality assurance protocols, ensuring every team member delivered consistent service.

Education

A.A. in Healthcare Management Technology in Medical Coding Specialist -

Fayetteville Technical Community College
Fayetteville, NC
05.2015

Skills

  • Microsoft Office
  • Athenahealth
  • EClinicalWorks
  • Customer Service
  • Call Center Management
  • Medical Terminology (5 years)
  • Medical Billing (1 year)
  • Medical coding
  • Medical office experience
  • HIPAA
  • Medical Scheduling
  • Healthcare Management
  • EMR Systems
  • Insurance Verification
  • Clerical Experience
  • Practice Management
  • CPT Coding
  • Office Management
  • Management
  • ICD coding
  • Utilization management
  • Microsoft Word
  • Microsoft Powerpoint
  • Microsoft Outlook
  • Phone Etiquette
  • Typing
  • Insurance product expertise
  • Insurance sales expertise
  • Client Relationship Management
  • Client Account Management
  • Prior Authorization Process
  • ICD-10 Coding Familiarity
  • Medical Terminology
  • Medical Appeals Handling
  • Data Entry
  • HIPAA Compliance Knowledge
  • Patient Referrals
  • Medicare and Medicaid knowledge
  • Effective communication skills
  • Coordination of Benefits
  • Medical Office Procedures
  • Payment posting
  • Claim submission
  • Patient Billing
  • Denial Management

Certification

  • CRC, 11/01/21, 05/01/23, AAPC CRC
  • Licensed Insurance Agent, 06/01/22, 09/01/25, Accident & Health or Sickness

Timeline

Licensed Insurance Agent

American Exchange
10.2021 - Current

Authorization Coordinator

R1 RCM - Remote
05.2019 - 10.2021

Medical Billing Specialist

Carolina Heart and Leg Center
04.2018 - 03.2019

Front Desk Receptionist

Carolina Heart and Leg Center
04.2017 - 04.2018

Front Desk Receptionist

Carolina Neurology Associates
05.2016 - 04.2017

Patient Access Representative

Cape Fear Valley Health System - Raeford, NC
01.2015 - 01.2016

Call Center Supervisor

Power Home Technologies
12.2011 - 01.2013

A.A. in Healthcare Management Technology in Medical Coding Specialist -

Fayetteville Technical Community College

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Karletta Thompson