Kathryn Wilson
Summary
I am a multifaceted customer service representative skilled in coding and billing claims, accounts resolution, processing payments, appeals and authorization or claim denials. I have the experience proven to resolve issues in a timely manner in order to enhance workflows which ensures exceptional client experiences in the healthcare industry.
Overview
14
14
years of professional experience
Work History
Provider Customer Service Representative
ResultsCX
REMOTE
12.2021 - Current
- Responded to customer inquiries regarding healthcare services and benefits.
- Assisted customers in navigating provider networks and scheduling appointments.
- Educated clients on claims processes and resolution procedures to facilitate understanding and resolution of issues.
- Collaborated with team members to streamline customer service workflows, enhancing overall service efficiency.
- Documented customer interactions accurately in CRM systems.
- Resolved issues by coordinating with healthcare providers and internal teams.
- Provided feedback on service trends to enhance customer support strategies.
- Maintained up-to-date knowledge of company policies and industry regulations.
- Performed troubleshooting activities for technical problems related to products or services.
- Assisted customers with billing issues and payment processing.
- Proposed process improvements to refine customer service delivery and better meet client needs.
Account Resolution Specialist
RRV MANAGEMENT
Paris
01.2016 - 11.2021
- Processed medical claims using billing software to ensure accurate submissions.
- Reviewed accounts receivable reports for discrepancies, resolving issues to maintain cash flow.
- Coordinated with healthcare providers to validate patient information and services rendered.
- Managed follow-up communications with insurance companies regarding claim status.
- Maintained organized records of patient accounts for compliance and auditing purposes.
- Trained new staff on billing procedures and software functionalities effectively.
- Analyzed billing trends to identify process improvement opportunities, enhancing accuracy in claim submissions.
- Maintained records of all billing activities in a timely manner.
- Processed credit card payments and other forms of payment received from patients or insurance companies.
- Audited patient files for accuracy prior to submitting claims to ensure maximum reimbursement rates were obtained.
- Reconciled daily deposits with bank statements and posted payments into appropriate accounts.
- Analyzed medical coding issues, identified errors, and made corrections.
- Tracked aging reports of unpaid claims, implementing corrective actions to reduce outstanding balances.
- Reviewed patient accounts for accuracy and completeness, and submitted claims to insurance companies.
- Generated invoices for services rendered and sent out monthly statements to customers.
- Prepared financial reports related to accounts receivable activity.
- Identified areas where cost savings could be achieved through improved efficiency in processing bills.
- Applied HIPAA privacy and security regulations while handling patient information.
Medical Biller
LEWISVILLE NEUROLOGY
Lewisville
05.2012 - 01.2016
- Processed patient insurance claims for timely reimbursement.
- Collaborated with healthcare providers to resolve claim discrepancies.
- Maintained billing software to ensure data accuracy and integrity.
- Monitored accounts receivable to ensure timely follow-up on outstanding payments.
- Trained new staff on billing procedures and systems usage.
- Updated patient information in the electronic health record system.
- Submitted electronic claims to various insurance carriers.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Reviewed patient insurance information for accuracy and completeness to facilitate successful claims submission.
- Communicated with insurance representatives to resolve claims processing issues and expedite approvals.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Performed daily reconciliation of accounts receivable with payment postings on the computer system.
- Assisted in auditing process by verifying accuracy of submitted claim forms against documentation provided by physicians' offices.
- Maintained accurate records of all billing activity in accordance with departmental standards.
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
- Created monthly aging reports to identify delinquent accounts for review by management team.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Generated reports in order to track payments due from insurance companies or other third party payers.
- Collaborated with managers to develop strategies for improving revenue cycle processes.
- Maintained billing software by updating rate change, cash spreadsheets and current collection reports.
Education
BILLING AND CODING CERTIFICATE - MEDICAL BILLING AND CODING
PENN FOSTER ONLINE
ONLINE09-2025
CERTIFIED MEDICAL ASSISTANT - Medical Technology
PCI HEALTH TRAINING
Richardson, TX05-2012
Skills
- Medical coding
- Claims processing
- Customer service
- Healthcare regulations
- Data management
- Problem resolution
- Billing software
- Remote work capabilities
- CRM software
- Email management
- Typing speed
- De-escalation techniques
- Call center experience
- Customer retention
- Effective communication
- Policies and procedures adherence
- Project management
- Trained in Salesforce
- Excellent communication
- Call documentation
- Complaint resolution
- Document and records management
- Calm and professional under pressure
- Quality assurance controls
- Reliability
- Multitasking
- Microsoft office
- Analytical thinking
- Issue and complaint resolution
- Account reconciliation
- Billing procedures
- Policy adherence
- Organizational skills
Timeline
Provider Customer Service Representative
ResultsCX
12.2021 - Current
Account Resolution Specialist
RRV MANAGEMENT
01.2016 - 11.2021
Medical Biller
LEWISVILLE NEUROLOGY
05.2012 - 01.2016
BILLING AND CODING CERTIFICATE - MEDICAL BILLING AND CODING
PENN FOSTER ONLINE
CERTIFIED MEDICAL ASSISTANT - Medical Technology
PCI HEALTH TRAINING