Katherine Swisher
Fairbanks,AK
Summary
Accomplished billing operations manager with a proven track record in resolving discrepancies and enhancing process efficiency. Expertise in eligibility verification and client management, consistently delivering high-quality service.
Overview
32
32
years of professional experience
Work History
Hospital Billing Respresentative
Foundation Health Partners
FAIRBANKS, AK
2023.05 - Current
- Processed insurance claims while verifying patient eligibility efficiently.
- Resolved customer account issues and managed billing inquiries promptly.
- Assisted patients with payment plans and clarified billing statements.
- Collaborated with team members to streamline billing operations.
- Resolved customer complaints related to billing issues to improve satisfaction.
- Processed and sent invoices, adjustments, and credit memos to customers.
- Documented all customer interactions and transactions to ensure accuracy.
- Answered customer invoice questions and resolved issues discovered during invoicing and collection process.
- Evaluated accounts for payment compliance and contacted customers.
- Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
- Trained new staff on billing procedures and customer service techniques effectively.
- Assisted with training new staff members on proper billing procedures and protocols.
- Collaborated with other departments to resolve any outstanding billing issues quickly.
- Resolved customer inquiries related to billing issues promptly.
- Performed data entry to update customer accounts with payment details.
- Processed credit card transactions securely to ensure customer payment. payments from customers using secure online systems.
- Generated and distributed month-end statements for customers and resolved related concerns.
- Completed quality assurance reviews of practices and billing histories.
- Contacted vendors to follow up on late invoices.
- Worked with outside parties to obtain payments and solve problems.
Case Manager Coordinator Administration
Fairbanks Health Partner
Fairbanks, Alaska
2021.03 - 2023.04
- Analyzed patient information to determine authorization eligibility and compliance.
- Reviewed prior authorization requests for medical procedures and services.
- Coordinated with internal teams to resolve discrepancies in authorization requests.
- Coordinated communication among health plan representatives, providers, and members.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Coordinated resolutions for issues and appealed denied authorizations.
- Processed appeals for denials in accordance with established procedures.
- Followed up on pending prior authorization requests to ensure timely processing.
- Educated patients about the prior authorization process and requirements.
- Verified patient's insurance eligibility prior to appointment date for payment purposes.
- Made outbound calls to insurance companies, patients, and physicians to perform eligibility checks for patients.
- Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
- Communicated with internal teams regarding changes in policy or procedure related to prior authorization process.
- Developed strategies for resolving complex issues concerning benefit coverage determinations.
- Identified and proposed enhancements to existing processes related to prior authorizations to improve overall effectiveness.
- Collaborated with internal departments to provide account status updates.
- Maintained high level of professionalism when speaking to doctors and insurance companies.
- Conducted periodic audits of documentation submitted with prior authorization requests.
- Submitted prior authorization requests electronically or by phone to payers.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Input claim, prior authorization, and other important medical data into the system.
- Participated in multidisciplinary team meetings to discuss complex cases requiring prior authorization.
- Trained new staff on prior authorization procedures and company policies.
- Developed and implemented strategies that increased efficiency and accuracy in prior authorization workflows.
- Maintained organized spreadsheets and document filing systems for efficient record-keeping.
- Developed and implemented process improvements to enhance efficiency and accuracy of prior authorization workflows.
- Maintained organized spreadsheets and document filing systems for efficient record-keeping.
Automotive Shop Manager
Clage Automotive LLC
North Pole, Alaska
1995.01 - 2018.11
- Managed daily shop operations and ensured smooth workflow.
- Trained and supervised staff to enhance team performance.
- Oversaw inventory control and maintained accurate stock levels.
- Implemented safety protocols to ensure a secure working environment.
- Coordinated customer service efforts to resolve inquiries effectively.
- Scheduled maintenance for tools and equipment to optimize functionality.
- Developed training materials for new employees on shop procedures.
- Collaborated with suppliers to source quality parts and materials.
- Evaluated staff performance and offered constructive feedback.
- Resolved customer complaints promptly and professionally.
- Supervised daily operations by establishing procedures and monitoring team performance.
- Responded to customer inquiries in a timely manner.
- Developed and implemented procedures for the efficient operation of the shop.
- Maintained high standards of customer service throughout the store.
- Connected with customers to provide assistance and collect feedback to optimize operations.
- Oversaw the recruitment, training and development of new staff members.
- Built and maintained sound business relationships with vendors and suppliers.
- Implemented strategies to increase sales and profitability of the shop.
- Enforced company policies regarding employee conduct, attendance, dress code.
- Mentored employees in management of complicated sales, complex issues and difficult customers.
- Developed pricing strategies that maximized profits while remaining competitive.
- Analyzed sales data to identify trends in consumer behavior.
- Scheduled staff shifts according to business needs.
- Improved cost control and staff efficiency to maximize profitability.
- Taught junior employees proactive strategies to meet operational and sales goals.
- Organized special events such as product launches, promotions or discounts.
- Reviewed financial reports and took corrective action when needed.
- Streamlined operational processes, achieving an increase in daily transactions.
- Resolved customer complaints with professionalism, preserving the shop's reputation.
- Managed financial operations, including budgeting, payroll, and cash flow management.
- Led customer service initiatives, resultingin an increase in customer retention.
- Conducted regular staff meetings to communicate goals and solicit feedback.
- Negotiated contracts with suppliers to secure favorable terms and reduce costs.
- Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
- Formed and sustained strategic relationships with clients.
- Completed thorough opening, closing, and shift change functions to maintain operational standards each day.
- Used strong issue resolution and communication skills to cultivate and strengthen lasting client relationships.
- Improved productivity initiatives, managing budgets and accounts, coordinating itinerary and scheduling appointments.
- Resolved customer inquiries to enhance satisfaction and build loyalty. and provided detailed service recommendations.
- Coordinated service appointments and maintained accurate records for clients.
- Communicated with technicians to ensure timely service fulfillment and updates.
- Assisted customers with billing inquiries and payment processing solutions.
- Created detailed invoices for each job completed which included labor charges, parts costs, taxes, fees.
- Reviewed work orders with technicians, ensured accuracy of labor times and parts costs.
- Communicated repair information to customers in a professional manner.
- Presented accurate estimates to inform customers of service charges and expectations.
- Resolved customer complaints regarding service quality or billing issues promptly and professionally.
- Delivered fast, friendly, and knowledgeable service for routine questions and service complaints.
- Advised customers on preventative maintenance schedules for their vehicles based on manufacturer recommendations.
- Processed payments for completed services using cash register or point-of-sale systems.
- Assisted technicians in locating parts from vendors when needed for specific jobs.
- Discussed options with customers, helping each make optimal choices for individual needs.
- Followed up with customers after the completion of service to ensure satisfaction with the results.
- Supported timely and accurate service by producing daily job status reports.
- Verified that all required safety checks had been performed on vehicles before release to customers.
- Developed relationships with local auto parts suppliers in order to secure discounts on parts purchases.
- Scheduled and coordinated work for many customers each day in fast-paced setting.
- Prepared daily reports summarizing hours worked by each technician as well as total sales figures.
- Scheduled appointments for customers based on technician availability.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
- Updated databases with new and modified customer data.
- Managed bookkeeping duties such as invoicing, tracking expenses and preparing reports.
- Performed basic bookkeeping activities such as invoicing customers.
- Performed basic bookkeeping duties including reconciling accounts receivable and payable transactions each month.
- Performed bookkeeping duties including accounts payable and receivable, general ledger entries, bank reconciliations.
- Performed administrative tasks such as data entry, filing, bookkeeping.
- Investigated discrepancies between actual balances versus bookkeeping records.
- Coordinated recruitment processes, including posting job listings and screening candidates.
- Executed payroll processing for all employees, ensuring accuracy and compliance. and benefits administration, ensuring timely disbursements to employees.
- Prepared payroll information based on approved timesheets each week.
- Conducted initial interviews to assess candidates' skills and qualifications.
- Resolved conflicts between employees in a professional manner.
- Assisted in employee recruitment, hiring and interview processes.
- Handled employee discipline and termination to address policy infractions.
- Scheduled meetings with employees to address concerns and grievances.
- Managed compensation, insurance and vacation days within employee benefits programs.
- Structured employee directories to streamline communication and access to information. and updated individual contact information.
- Process payroll for employees using advanced payroll software systems.
- Assisted with year-end tax filing processes including W2s and 1099s.
- Processed garnishments, child supports, and levies in accordance with federal and state laws.
- Managed payroll processing for over XXX employees, ensuring accurate calculation of wages, bonuses, and deductions.
Education
High School Diploma -
North Pole High School
North Pole, AK2001-05
Business
University of Alaska Fairbanks
Fairbanks, AKSkills
- Eligibility verification
- Payment processing
- Authorization management
- Billing software
- Collections
- Data entry
- Client management
- Office administration
- Microsoft Office
- Team collaboration
- Staff training
- Engagement strategies
- Attention to detail
- Decision making
- Problem solving
Timeline
Hospital Billing Respresentative
Foundation Health Partners
2023.05 - Current
Case Manager Coordinator Administration
Fairbanks Health Partner
2021.03 - 2023.04
Automotive Shop Manager
Clage Automotive LLC
1995.01 - 2018.11
High School Diploma -
North Pole High School
Business
University of Alaska Fairbanks