Overview
Work History
Education
Skills
Timeline
Generic

Kathy Zamora

San Antonio,TX

Overview

28
28
years of professional experience

Work History

Senior Manager Revenue Cycle

MPower Health
01.2023 - Current
  • Provided strong leadership to enhance team productivity and morale.
  • Led cross-functional teams to achieve goals and deliver quality results.
  • Established strong relationships with leadership and team members..
  • Collaborated closely with peers from other departments to drive organizational success jointly as one cohesive unit.
  • Mentored staff members for skill development and career progression within the organization.
  • Implemented and developed operational standards, policies and procedures.
  • Achieved operational excellence by streamlining processes and implementing best practices.
  • Demonstrated exceptional adaptability in navigating complex situations or rapidly changing environments with ease.
  • Conducted performance evaluations, compensations and hiring to maintain appropriate staffing requirements.
  • Balanced competing priorities efficiently while maintaining focus on critical tasks requiring immediate attention.
  • Implemented innovative solutions to overcome challenges, leading to enhanced productivity levels.
  • Reviewed and analyzed reports, records and directives to obtain data required for planning department activities.
  • Boosted team member productivity by enhancing performance monitoring and instituting motivational approaches.
  • Evaluated hiring, firing, and promotions requests.
  • Led strategic planning sessions to align departmental goals with overall company vision, fostering cohesive growth strategy.
  • Enhanced team performance with regular coaching sessions, focusing on individual strengths and areas for improvement.
  • Established performance goals for employees and provided feedback on methods for reaching those milestones.
  • Established team priorities, maintained schedules and monitored performance.
  • Leveraged data and analytics to make informed decisions and drive business improvements.
  • Defined clear targets and objectives and communicated to other team members.
  • Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
  • Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
  • Improved team performance by providing comprehensive training and fostering a collaborative work environment.

Manager Revenue Cycle

MPower
06.2022 - Current
  • Managed and motivated employees to be productive and engaged in work.
  • Accomplished multiple tasks within established timeframes.
  • Cross-trained existing employees to maximize team agility and performance.
  • Developed a strong company culture focused on employee engagement, collaboration, and continuous learning opportunities.
  • Achieved departmental goals by developing and executing strategic plans and performance metrics.
  • Built high-performing teams through effective recruitment, onboarding, and talent development initiatives.
  • Established team priorities, maintained schedules and monitored performance.
  • Evaluated employee performance and conveyed constructive feedback to improve skills.
  • Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
  • Defined clear targets and objectives and communicated to other team members.
  • Established performance goals for employees and provided feedback on methods for reaching those milestones.
  • Assisted in organizing and overseeing assignments to drive operational excellence.

Senior AR Specialist

MPower Health
04.2022 - Current
  • Analyzed trends in payment patterns and insurance behavior, identifying opportunities for process enhancements that would improve overall AR performance.
  • Assisted in the development of departmental policies and procedures to improve overall efficiency within the AR team.
  • Facilitated cross-functional collaboration between the AR team and other departments, promoting a unified approach to financial management within the organization.
  • Implemented process improvements that led to reduced errors in invoicing and increased effectiveness in collections efforts.
  • Provided ongoing training for team members on best practices related to accounts receivable management, increasing overall departmental knowledge and expertise.
  • Managed complex problem-solving for upper management in order to complete projects on-time.

Reimbursement Specialist

MPower
11.2021 - Current
  • Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
  • Advanced internal communication channels by sharing best practices among colleagues, fostering an environment of continuous learning and improvement.
  • Maintained comprehensive knowledge of healthcare billing practices, staying current on industry updates and changes in regulations.
  • Followed up on denied and unpaid claims to resolve problems and obtain payments.
  • Delivered timely information to insurance representatives to resolve common and complex issues.
  • Managed multiple priorities effectively under high-pressure deadlines without compromising accuracy or quality of work output.

Patient Service Representative

Gonzaba Medical Group
07.2020 - 11.2021
  • Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
  • Verified insurance eligibility and coverage for patients.
  • Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
  • Filed and maintained patient records in accordance with HIPAA regulations.
  • Scheduled appointments.
  • Facilitated patient registration by accurately entering demographic and insurance information into electronic health record systems.
  • Served as a reliable source of information for patients regarding appointment scheduling, insurance coverage inquiries, and general office policies.
  • Assisted with insurance verification tasks, ensuring accurate billing and timely reimbursement for services rendered.
  • Handled complex insurance pre-authorization processes accurately, enabling timely delivery of necessary medical services.
  • Coordinated referrals efficiently between primary care providers and specialists, ensuring a seamless patient experience.
  • Stayed calm under pressure to and successfully dealt with difficult situations.
  • Resolved customer complaints using established follow-up procedures.

Practice Administrator

Orthopedic Practice
06.2018 - 04.2020
  • Improved patient wait times by streamlining check-in processes and optimizing appointment scheduling procedures.
  • Oversaw daily practice operations to guarantee seamless service delivery for patients and providers alike.
  • Managed financial aspects of the practice, including budgeting, billing, and insurance claims processing.
  • Boosted practice growth through the development of marketing initiatives and community outreach efforts.
  • Coordinated facility maintenance to ensure a clean, comfortable environment for patients and staff members alike.
  • Negotiated contracts with vendors for cost-effective procurement of medical supplies and equipment.
  • Ensured compliance with industry regulations and best practices to maintain a safe and efficient work environment.
  • Increased staff productivity by providing training, guidance, and performance evaluations.
  • Identified areas for cost reduction by conducting regular audits of operational expenses.
  • Established strong relationships with referral sources to increase patient volume at the practice consistently over time.
  • Partnered with local healthcare organizations to facilitate networking events aimed at raising awareness about available specialty services provided at our clinic.
  • Enhanced patient satisfaction with timely appointment scheduling and organized recordkeeping.
  • Collaborated with physicians to develop strategic plans for expanding the scope of services offered by the practice.
  • Handled human resources tasks such as hiring, onboarding, payroll management, and employee relations issues resolution.
  • Assessed processes and procedures, complying with OSHA, and HIPAA regulations.
  • Developed and implemented strategies to improve patient access, satisfaction and care quality.
  • Supervised team of 15 office personnel.
  • Ordered all office supplies and kept check on inventory levels.
  • Addressed and remedied all patient or team member issues.
  • Oversaw accounting, budgeting, and financial reporting.
  • Provided outstanding support to entire staff which helped improve process flow and boosted efficiency.
  • Provided supervision and management to team of support personnel.
  • Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.
  • Developed close working relationships with front office and back office staff.
  • Created and implemented organizational policies and procedures.
  • Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
  • Successfully negotiated client contract renewals to create increased revenue.
  • Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
  • Scheduled surgeries, managed pre-certifications and verified insurance coverage.
  • Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.

Regional Coding Manager

Christus Physician Group
02.2011 - 06.2018
  • Organized regular team meetings to foster collaboration, share updates on project status, and address any challenges or concerns as they arose.
  • Led regular code review sessions to maintain high-quality output and identify areas for further development.
  • Collaborated with cross-functional teams to optimize the coding process, resulting in improved accuracy and quality.
  • Created a centralized repository for coding resources, including industry updates, best practices, and educational materials to support the ongoing development of staff expertise.
  • Resolved complex billing issues by conducting root cause analysis and working closely with stakeholders involved.
  • Developed comprehensive documentation to ensure consistency in coding practices across the team.
  • Established clear performance metrics to monitor progress and drive continuous improvement within the department.
  • Performed coding quality reviews and tracked, trended and managed coding quality performance.
  • Attended facility meetings and reported on performance.
  • Streamlined workflow processes for increased productivity and reduced turnaround time on projects.
  • Reduced coding errors significantly by implementing a rigorous quality assurance process to catch discrepancies before final submission.
  • Mentored junior coders, enhancing their skills and knowledge through targeted coaching and guidance.
  • Conducted thorough audits of coding practices, identifying opportunities for optimization and streamlining processes.
  • Facilitated communication between coders, billers, clinicians, and administrative staff for seamless information exchange across departments.
  • Participated in hiring and training coding team.
  • Implemented ongoing training initiatives to keep staff up-to-date on industry trends and best practices in medical coding.
  • Ensured compliance with relevant regulations by staying current on updates related to ICD-10-CM/PCS guidelines, CPT codes, HCPCS Level II codes, modifiers usage rules.
  • Coordinated with IT support teams to troubleshoot system issues, minimizing downtime and disruption to daily operations.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Monitored changes in coding regulations to provide recommendations for compliance.
  • Communicated with insurance companies to research and resolved coding discrepancies.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
  • Generated reports to identify coding trends and discrepancies.
  • Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
  • Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
  • Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
  • Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility.

Medical Coding Team Leader

San Antonio Gastroenterology Associates
06.2004 - 02.2011
  • Participated in cross-functional initiatives aimed at improving organizational efficiency, leveraging medical coding expertise to inform broader decision-making processes where appropriate.
  • Maintained up-to-date knowledge of evolving medical coding regulations, disseminating relevant information to the team as necessary.
  • Resolved complex billing discrepancies by conducting thorough research and working closely with insurance carriers to achieve timely resolution of outstanding claims.
  • Mentored new hires in medical coding processes, resulting in a more cohesive and effective team dynamic.
  • Optimized workloads by analyzing staffing needs, reallocating assignments accordingly based on individual strengths and areas of expertise.
  • Contributed to the development of departmental policies and procedures by providing expert insight into industry best practices and regulatory requirements.
  • Served as a key liaison between the coding team and other departments, fostering open communication channels for optimal collaboration.
  • Developed comprehensive training materials to enhance team members'' understanding of medical coding guidelines and industry best practices.
  • Reduced claim denials through meticulous attention to detail and adherence to established regulatory compliance standards.
  • Conducted regular audits of coded data, ensuring consistency within the department''s output while minimizing potential errors or oversights.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Utilized electronic medical record systems to store, retrieve and process patient data.
  • Verified accuracy of patient information in medical records.
  • Scanned and uploaded medical records into electronic medical records system.
  • Input data into computer programs and filing systems.
  • Researched and resolved medical record discrepancies.

Coder

South Texas Radiology Group
01.1997 - 06.2004
  • Maintained high coding standards by adhering to industry best practices and staying current with emerging technologies.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments.
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Delivered consistent results under pressure by prioritizing tasks effectively during periods of high workload or tight deadlines.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Input data into computer programs and filing systems.
  • Verified accuracy of patient information in medical records.
  • Utilized electronic medical record systems to store, retrieve and process patient data.
  • Researched and resolved medical record discrepancies.
  • Scanned and uploaded medical records into electronic medical records system.

Education

Certification Multi Specialty - Multiple Specialties

American Academy of Professional Codes
AAPC

Associate of Science - Community Health

Alamo Community College
San Antonio, TX

Medical Assistant Certification - Medical Assistant

Texas Careers Trade School
San Antonio, TX

Advanced Diploma -

John F. Kennedy High School
San Antonio, TX

Skills

  • Strategic planning
  • Cross-functional collaboration
  • Operations management
  • Cross-functional team coordination
  • Troubleshooting and problem resolution
  • Data-driven decision making
  • Documentation and reporting
  • Operations planning
  • Data analytics
  • Cross-functional communication
  • Talent development
  • Organizational improvement
  • Partnership development
  • Human resources management
  • Reporting management
  • Logistics operations management
  • Corporate communications
  • Reporting oversight
  • Logistics support services
  • Business performance management
  • Cross-functional team leadership
  • Innovation management
  • Influencing and negotiating
  • Teamwork and collaboration
  • Team leadership
  • Process improvement
  • Problem-solving
  • Training and development
  • Project planning
  • Problem resolution
  • Team development
  • Decision-making
  • Work Planning and Prioritization
  • Employee development
  • Multitasking
  • Employee coaching and mentoring
  • Performance tracking and evaluation
  • Managing operations and efficiency
  • Staff management
  • Team building

Timeline

Senior Manager Revenue Cycle

MPower Health
01.2023 - Current

Manager Revenue Cycle

MPower
06.2022 - Current

Senior AR Specialist

MPower Health
04.2022 - Current

Reimbursement Specialist

MPower
11.2021 - Current

Patient Service Representative

Gonzaba Medical Group
07.2020 - 11.2021

Practice Administrator

Orthopedic Practice
06.2018 - 04.2020

Regional Coding Manager

Christus Physician Group
02.2011 - 06.2018

Medical Coding Team Leader

San Antonio Gastroenterology Associates
06.2004 - 02.2011

Coder

South Texas Radiology Group
01.1997 - 06.2004

Certification Multi Specialty - Multiple Specialties

American Academy of Professional Codes

Associate of Science - Community Health

Alamo Community College

Medical Assistant Certification - Medical Assistant

Texas Careers Trade School

Advanced Diploma -

John F. Kennedy High School

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