Katherine Knight
Gordonville,TX
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.
Overview
12
12
years of professional experience
Work History
Director
My Montessori School
08.2022 - Current
- Provided ongoing direction and leadership for program operations.
- Maintained and updated project related documents.
- Scheduled and supervised staff meetings to discuss new ideas and update participants on program details and milestones.
- Collaborated with various teams to uncover issues, identify applicable solutions, and offer guidance.
- Delivered outstanding program results by setting clear objectives and proactively addressing potential challenges.
- Implemented best practices in project management to optimize workflow efficiencies across the organization.
- Developed and implemented marketing strategies to promote program awareness and participation.
- Developed and implemented program goals and objectives, establishing specific and measurable outcomes aligned with organization's overall mission.
- Negotiated program contracts and agreements to obtain cost-effective pricing.
Claims Adjuster
Cotiviti
06.2020 - 08.2022
- Answered customer questions regarding deductibles.
- Examined claims forms and other records to determine insurance coverage.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Achieved cost savings through successful subrogation efforts, recovering funds from responsible parties in various claims scenarios.
- Contributed to a positive work environment through active participation in team meetings and collaborating on cross-functional projects.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Substantiated legitimate claims and denied unjustified claims.
- Facilitated smooth transitions for policyholders during the claim process by liaising between various departments, ensuring all parties were informed and engaged.
- Coordinated with medical professionals to evaluate injury claims fairly while ensuring policyholder needs were met throughout the healing process.
- Mentored junior adjusters on best practices and industry regulations, contributing to their professional growth and development.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
- Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Analyzed information gathered by investigation and report findings and recommendations.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Followed up with insured individuals regarding premium and deductibles payments.
Medical Representative
UnitedHealthcare Clinical Services
02.2014 - 08.2017
- Performed billing and coding procedures for ambulance, emergency room, impatient, and outpatient services.
- Evaluated patients' financial status and established appropriate payment plans.
- Increased accuracy in billing by meticulously reviewing and verifying medical codes and patient information.
- Pre-certified medical and radiology procedures, surgeries and echocardiograms.
- Achieved high levels of accuracy in patient data entry by consistently cross-referencing information sources and seeking clarification as needed.
- Optimized revenue cycle management by analyzing trends in denials and identifying areas for improvement in the billing process.
- Maintained HIPAA compliance while managing confidential patient data, enhancing security measures for sensitive information.
- Promptly sent out and posted all medical claims.
- Confidently and adeptly handled claim denials and/or appeals.
- Improved efficiency of the billing process through streamlining workflows and implementing automation tools.
- Prevented fraudulent activities through vigilant review of suspicious claims patterns, alerting relevant authorities as needed.
- Participated in quality assurance initiatives aimed at improving overall accuracy rates within the medical billing department.
- Precisely evaluated and verified benefits and eligibility.
- Contributed to the development of internal policies related to medical billing procedures, promoting consistency across departments.
- Expedited the claims submission process by using electronic health record systems efficiently, reducing time spent on manual tasks.
- Managed a high volume of medical claims by prioritizing tasks based on due dates and urgency, preventing delays in processing.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Stayed current with industry regulations, attending seminars and workshops to continually update knowledge on coding guidelines and best practices.
- Managed collections claims for unpaid bills against estates of debtors.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Diligently filed and followed up on third party claims.
- Supported team members in resolving complex cases, applying problem-solving skills to reach favorable outcomes for all parties involved.
- Reduced claim denials by diligently following up with insurance companies and promptly addressing any discrepancies.
- Ensured timely payments from patients and insurance providers by monitoring outstanding balances and initiating collection efforts when necessary.
- Conducted periodic audits of billing records to identify errors or inconsistencies, ensuring proper documentation for future reference.
- Posted and adjusted payments from insurance companies.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Assisted new hires in understanding departmental processes through comprehensive training sessions and ongoing mentorship opportunities.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Enhanced customer satisfaction by providing clear explanations of charges on bills, addressing concerns with patience and empathy.
- Established a positive work environment through open communication channels and active participation in team meetings, fostering a culture of collaboration and growth.
- Collaborated with healthcare providers to resolve billing issues, fostering strong professional relationships for better communication.
- Served as a liaison between patients, insurance companies, and healthcare providers to facilitate accurate claims processing and payment resolution.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Collected payments and applied to patient accounts.
- Delivered timely and accurate charge submissions.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Filed and updated patient information and medical records.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Liaised between patients, insurance companies, and billing office.
- Adhered to established standards to safeguard patients' health information.
- Posted payments and collections on regular basis.
Customer Service Specialist
Weber Aircraft/ Zodiac Seats
06.2012 - 01.2014
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
- Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
- Resolved concerns with products or services to help with retention and drive sales.
- Provided primary customer support to internal and external customers in the European Market.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Collaborated with team members to create effective strategies for improving overall customer experience.
- Developed customer service improvement initiatives to decrease customer wait times.
- Reduced response time for customer inquiries by streamlining communication processes.
- Conducted thorough research to address complex customer issues, ensuring complete resolution within specified timeframes.
- Maintained and managed customer files and databases.
- Assisted new employees with training, sharing best practices for handling difficult situations and achieving positive outcomes.
- Reinforced established quality control standards and followed procedures for optimal customer interactions.
- Handled escalated calls calmly, finding resolutions that satisfied both the company and the customer''s needs.
- Managed high call volume while maintaining a courteous and professional demeanor.
- Ensured timely follow-up on pending cases, reducing the number of unresolved issues significantly over time.
- Applied basic sales strategy to engage customers and present solutions to suit individual needs.
- Enhanced customer satisfaction by resolving issues promptly and professionally.
- Monitored quality assurance metrics regularly, identifying opportunities for personal growth and development within the role.
- Offered internal and external customers first-rate customer service to maximize satisfaction and business success.
- Adapted quickly to changes in company policies or procedures ensuring consistency in delivering accurate information to customers.
- Complied with company policies and procedures by encouraging positive and effective work environment among employees.
- Developed rapport with customers, fostering long-term relationships and repeat business.
- Established trust with clients through clear communication, patience, and understanding their unique challenges fully before offering solutions tailored to their needs.
- Overcame language barriers when necessary by utilizing translation tools or coordinating assistance from multilingual colleagues.
- Maintained up-to-date knowledge of products and services to provide accurate information to customers.
- Actively participated in team meetings and professional development workshops, continuously seeking opportunities to enhance skills and provide exceptional customer service.
- Provided comprehensive support during periods of high call volume by adjusting schedules to accommodate increased needs efficiently.
- Tracked customer interactions using CRM software, helping the team identify trends and areas of improvement in service delivery.
- Increased customer retention rates by providing exceptional problem-solving skills and personalized solutions.
- Educated customers about available resources such as online FAQs or user guides that could help them resolve future concerns independently.
- Answered constant flow of customer calls with minimal wait times.
- Updated account information to maintain customer records.
- Responded to customer requests for products, services, and company information.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Handled customer inquiries and suggestions courteously and professionally.
Education
GED -
Middle Georgia Technical College
Warner Robins, GACertificate - Medical Insurance Billing
Middle Georgia Technical College
Warner Robins, GA04.2004
Certificate - Medical Office Management
Middle Georgia Technical College
Warner Robins, GA04.2004
Associate of Arts - Psychology
University of Maryland - College Park
College Park, MDAssociate of Science - Surgical Technology
Grayson College
Denison, TXSkills
- Staff Management
- Hiring and Retention
- Company Guidelines
- Understanding of Human Resources
- Customer Service Experience
- Policy Implementation
- Administration Knowledge
- Curriculum Development
- Classroom Management
- Personnel Supervision
- Child Development
- Student Counseling
- Group and Individual Instruction
- Academic Advisement
- Student Records Management
- Lesson Planning
- Time Management
- Public Speaking
- Personnel Management
- Attention to Detail
- Staff Hiring and Evaluations
Timeline
Director
My Montessori School
08.2022 - Current
Claims Adjuster
Cotiviti
06.2020 - 08.2022
Medical Representative
UnitedHealthcare Clinical Services
02.2014 - 08.2017
Customer Service Specialist
Weber Aircraft/ Zodiac Seats
06.2012 - 01.2014
GED -
Middle Georgia Technical College
Certificate - Medical Insurance Billing
Middle Georgia Technical College
Certificate - Medical Office Management
Middle Georgia Technical College
Associate of Arts - Psychology
University of Maryland - College Park
Associate of Science - Surgical Technology
Grayson College