Katie McClymont
Puyallup
Summary
Results-driven professional with expertise in denial resolution and claim management. Known for strong analytical skills and effective communication, contributing to timely reimbursements and streamlined financial operations.
Overview
13
13
years of professional experience
Work History
Medical Billing Specialist Insurance A/R
Olympic Sports and Spine
Tacoma, WA
04.2024 - Current
- Managed patient account entries to ensure adherence to Medicare compliance standards.
- Implemented strategies to reduce accounts receivable aging, achieving a consistent average of under 30 days.
- Evaluated patient financial records to uphold adherence to payer standards and rectify financial coding discrepancies.
- Achieved high accuracy in claim form audits, leading to successful submissions through payer portals and direct-entry systems.
- Investigated unpaid claims to determine appropriate follow-up measures, ensuring prompt reimbursement.
- Coordinated outreach efforts to patients and payers for resolution of outstanding account balances.
- Composed detailed written communications regarding account issues to facilitate resolution.
- Analyzed delinquent accounts and recommended strategic next steps based on established departmental criteria.
- Analyzed and resolved credit balances by applying necessary adjustments or issuing refunds to maintain financial accuracy.
- Utilized payer systems to obtain and analyze eligibility, claim status, and processing specifics for effective claims management.
- Managed responses to inquiries from patients, payers, agencies, and internal departments to facilitate information flow.
Medical Biller
MD Commerce
Tacoma, WA
01.2013 - 04.2024
- Analyzed and interpreted explanation of benefits to identify errors, denials, and adjustments for accurate reimbursement.
- Submitted accounts to insurance accounts receivable team following thorough review of denial or inaccurate payment from insurance.
- Managed the accurate entry of physician charges and facilitated claim submissions to optimize revenue cycle efficiency.
- Reviewed and corrected ICD-10 and CPT codes, incorporating necessary modifiers to enhance billing precision.
- Verified patient balances and demographic details to maintain data integrity before statement generation.
- Clarified patient statements by providing detailed answers to inquiries and questions.
- Analyzed patient accounts to verify balance correctness prior to issuing collection letters and engaging collection agencies for debt resolution.
- Managed preparation and billing of secondary insurance claims to address rejections stemming from balancing discrepancies.
- Assured accurate verification of patient eligibility and claim status to facilitate seamless insurance processing.
- Executed daily and monthly payment balancing to ensure accurate financial records.
- Drafted and structured detailed documentation to ensure accurate and timely refunds for overpaid accounts to both insurers and patients.
Education
Medical Billing Certificate - Medical Reimbursement
Tacoma Community College
Tacoma, WA01-2013
Skills
- HIPAA regulation adherence
- Understanding of CPT guidelines
- Denial resolution expertise
- Proficient in ICD-10 classification
- Experience with Medicare and Medicaid systems
- Efficient payment reconciliation
- Efficient claim management
- Insurance coverage assessment
- Proficient in utilizing multiple electronic billing systems
- Expertise in navigating insurance payer websites
- Detail-oriented approach
- Effective solution developer
Timeline
Medical Billing Specialist Insurance A/R
Olympic Sports and Spine
04.2024 - Current
Medical Biller
MD Commerce
01.2013 - 04.2024
Medical Billing Certificate - Medical Reimbursement
Tacoma Community College