Summary
Overview
Work History
Education
Skills
Timeline
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Kathleen Mccraw

Edmonda,WA

Summary

Highly accomplished healthcare professional in the medical and insurance industry. Adept at seamlessly transitioning between diverse areas of expertise, I bring a wealth of knowledge in medical terminology, insurance procedures, and exceptional interpersonal skills. With a strong commitment to excellence, I provide innovative solutions that bridge the gap between technical disciplines and healthcare operations. My track record of effectively managing projects, collaborating with diverse teams, and delivering outstanding results highlights my ability to thrive in dynamic environment

Overview

9
9
years of professional experience

Work History

Insurance Specialist

Swedish Medical Group
07.2021 - Current
  • Conduct targeted training: Design and deliver comprehensive training sessions in person and through virtual platforms like Teams to educate front-end caregivers on efficient insurance registration procedures within the EPIC system.
  • Effectively communicate updates: Ensure staff awareness by clearly communicating updates and changes in insurance contracts, ensuring alignment with the latest industry regulations and guidelines.
  • Enhance data accuracy: Contribute to the improvement of data quality and accuracy through meticulous analysis and present findings to clinic managers, providing valuable insights that drive informed decision-making and process improvements.
  • Champion process optimization: Collaborate with cross-functional teams to identify areas for process improvement within clinical registration and authorization workflows.
  • Support caregivers: Act as a knowledgeable resource for front-end caregivers, addressing inquiries, clarifying doubts, and offering expert guidance to ensure seamless insurance registration procedures.

Insurance Follow-Up Representative II

Swedish Medical Group
07.2018 - 07.2021
  • Proactively identify aged insurance claims: Utilize online work lists to meticulously identify insurance claims with outstanding payments, effectively managing a high volume of cases.
  • Champion claim appeals: Demonstrate in-depth knowledge of insurance protocols to successfully appeal claims that have been erroneously denied or incorrectly paid.
  • Maintain meticulous documentation: Ensure accurate and comprehensive record-keeping of all interactions, appeals, and resolutions, contributing to efficient tracking and reporting of claim statuses.
  • Sustain strong rapport: Cultivate positive relationships with third-party payers through effective communication and dispute resolution, fostering a collaborative working environment.

Customer Service Representative

Swedish Medical Group
07.2014 - 07.2018
  • Proficiently handle patient inquiries: Effectively manage incoming phone inquiries related to patient accounts, demonstrating strong communication skills and a customer-centric approach.
  • Analyze and resolve discrepancies: Conduct detailed investigations into discrepancies in patient accounts, employing analytical skills to identify and rectify billing errors.
  • Create and manage payment plans: Collaborate with patients to set up customized payment plans, addressing their financial needs while adhering to established guidelines.
  • Contribute to process improvements: Actively participate in process enhancement initiatives, sharing insights and suggestions that optimize workflow efficiency.

Education

Bachelor of Science - Computer Science

Western Governors University
07.2023

Skills

  • Project Management
  • Data analysis
  • Problem Solving
  • Organization and Time-Management
  • Staff Training
  • SQL
  • Python
  • C
  • Java

Timeline

Insurance Specialist

Swedish Medical Group
07.2021 - Current

Insurance Follow-Up Representative II

Swedish Medical Group
07.2018 - 07.2021

Customer Service Representative

Swedish Medical Group
07.2014 - 07.2018

Bachelor of Science - Computer Science

Western Governors University

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Kathleen Mccraw