Kaylena Williams
Spring,TX
Summary
Dedicated and meticulous Medical professional bringing more than 8 years of experience readying patients for invasive and non-invasive tests, procedures, and outlining cost. Proficient in HIPAA, Epic software standards, and competent in operating in high-volume, high-stress. Highly trained professional with a background in Medical Claims, Wound care, and Hospital Admin with strong attention to detail and juggles multiple tasks.
Overview
4
4
years of professional experience
Work History
Wound Care Specialist
Curitec
02.2023 - Current
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Identified patients requiring debridement procedures and alerted attending physician.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Demonstrated dressing techniques to educate and orient in-services nurses.
- Instructed patients and caregivers on how to clean and dress wounds and how to prevent infections.
Patient Care Coordinator
TEGRIA
07.2021 - 01.2023
- Identified, investigated and documented compliance violations and recommended corrective measures.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Collected payments and applied to patient accounts.
- Developed procedures and strategies for quality assurance, patient services, departmental activities and public relations.
- Communicated with doctors, nurses, patients and other employees to identify and resolve healthcare needs.
Veterans Service Representative
Veterans Evaluation Services
09.2020 - 11.2021
- Assisted veterans and dependents in preparing forms and documents to present claims for benefits.
- Conducted in-person and telephone interviews with veterans and advocates to explain benefits and related programs.
- Reviewed and requested medical records, military personnel records and service verification records to determine eligibility status.
- Analyzed claims to determine percentage of disability, permanent and total disability and entitlement to compensation.
Claims Specialist
ACCESS HEALTH SERVICES
06.2019 - 08.2020
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Submitted electronic/paper claims documentation for timely filing.
- Monitored and updated claims status in claims processing system.
- Managed large volume of medical claims on daily basis.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Researched and resolved billing discrepancies to enable accurate billing.
Education
High School Diploma -
Nimitz High School
Houston, TX06.2011
Skills
- MEDITECH EHR Software
- Hospice and Palliative Care
- Payment Processing
- Complaint Management
- Medical Terminology
- Insurance Fraud Expertise
Timeline
Wound Care Specialist
Curitec
02.2023 - Current
Patient Care Coordinator
TEGRIA
07.2021 - 01.2023
Veterans Service Representative
Veterans Evaluation Services
09.2020 - 11.2021
Claims Specialist
ACCESS HEALTH SERVICES
06.2019 - 08.2020
High School Diploma -
Nimitz High School
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