Keisha Thompson
Los Angeles,CA
Summary
Experienced medical administrative professional with over 10 years of expertise in medical billing coding, credentialing services, PSR scheduling, and front office administration. Collaborates effectively with facilities, provider groups, and individual professionals to ensure productive outcomes. Meticulous attention to detail and exceptional organizational skills developed through 10+ years of experience in government and healthcare facilities. Demonstrates a proven track record of delivering strong administrative support.
Overview
18
18
years of professional experience
Work History
Patient Service Representative I
Children's Hospital of Los Angeles
10.2024 - Current
- Select correct billing and coding to process insurance claims and visits reducing errors.
- Assist patients with registration processes, verifying personal information and insurance details.
- Operate KIDS scheduling software to coordinate patient appointments, optimizing daily workflow and minimizing wait times.
- Exhibited empathy and active listening during patient interactions, enhancing patient satisfaction and trust.
- Assist patients in filling out check-in and payment/billing information utilizing a IPAD.
- Use KIDS scheduling system to check in patient appointments.
- Enter patient demographic and insurance data into electronic medical record system STAR.
- Roll over Pre-reg accounts to active OP1 accounts.
- Handle 35-40 calls a day, i.e from Patients, Pharmacies, Hospitals, and Insurance companies.
- Deliver support to medical staff in completion of patient paperwork.
Senior Medical Office Representative
Providence Saint John's Health Center
09.2022 - 10.2023
- Responsible for patient management, the flow of patients through the front office in an efficient and professional manner.
- Accurate coding of services rendered, over the counter cash management.
- Verifying and communicating insurance and demographic information.
- Knowledge of the practice management system, including formatting, scheduling matrix, and inventory management.
- Processed patient payments and managed billing inquiries with attention to detail.
- Scheduled and confirmed patient appointments with patients and healthcare professionals.
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
- Scheduled patient appointments and procedures utilizing EPIC system EMR.
- Documented patient counters in hospital system and initiated follow-up actions.
- Handled insurance verification and provided assistance with forms and documentation.
- Managed 30-35 calls a day.
CVO Credentialing Coordinator
UnityPoint Health/Remote
02.2022 - 08.2022
- Accountable to provide timely and accurate records for all provider information in the system of record
- Responsible for the electronic initial and re-credentialing,reappointment, and revalidation application processing
- Initiate and follow through on all aspects of provider credentialing including: initial and re-credentialing process for all practitioners including performance of primary source verification in accordance with Medimore, Inc
- Policies and procedures, hospital medical staff bylaws and requirements, NCQA, Joint Commission, DNV, CMS and other regulatory agency guidelines
- Responsible for the timely processing and tracking of credentialing file
- Responsible for responding to requests for provider credentialing information timely
- Review credentialing files for accuracy and completeness
- Develop, maintain and distribute reporting as required
- Work with UnityPoint Health Medical Staff offices and physician practice administrative staff to support credentialing needs
- Manage and Prepare initial credentialing and recredentialing files for the Medical Director of PHO and/or the Credentials Committee
- Establish a method for regular communication and respond to health professionals, provider representatives, or other essential departments the status of applications, the status in the credentialing process and the status of participation with health plans
- Enter and maintain accurate provider data in the organization credentialing database
- Maintain confidential credentialing files and electronic credentialing database
- Audit, correct and communicate to all appropriate parties, corrections of provider data in the credentialing database
Credentialing Specialist
UCLA Health-CVO
06.2019 - 10.2021
- Assist physicians and practitioners in taking the necessary steps in order to maintain their credentials
- Coordinate completion and ensure timely processing of New Appointment and Reappointment Applications
- Monitor expiring medical licenses and DEA
- Track the status of new and reappointment applications and provisional status requirements
- Monitor of health and tracking of training for practitioners
- Serve as a delegate for physician and practitioner applications and notifications
- Managed credentialing database in MD Staff
- Process Initial and Reappointments
- Review applications for accuracy and completeness
- Liaison between MSO and with Administrator Officers
- Convey Information and correspondences in a clear, concise and timely manner
- Maintain confidentiality when handling sensitive information and documents
- Maintain proficiency in MSOWVerityStream systems
- Managed Medical Insurance Verifications
- Performed primary source verifications such as criminal histories, licenses and board certifications.
- Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access.
- Interpret procedure privileging and criteria
- Stay up to date on the regulations, standards, and procedures involved in obtaining and maintaining licensure and other credentials.
Credentialing & Privileging Medical Staff Office
Department Veterans Affairs
11.2010 - 05.2019
- Review applications and documents for completion and accuracy
- Review primary source verification documents to ensure compliance with VHA Directives and The Joint Commission standards
- Follow up on errors in applications and verification documents to ensure compliance with policies, directives, and The Joint Commission standards
- Compose letters in order to obtain verification of credentials for initial appointment, in order to renew privileges and modify privileges
- Assist in maintaining automated systems that track the expiration of time-limited credentials and the renewal of privileges
- Organized records to prepare for site visits by Joint Commission representatives and associated audits.
- Manage and Process Initials, Re appointments
- Analyze and review Risk Management Issues
- Complete reports relative to credentialing and privileging as needed
- Recruited and trained new employees to meet job requirements.
- Prepare correspondence to outside credentialing inquiries
- Follow up on verification requests and other credentialing requests via verbal and written correspondence
- Create letters with VetPro in order to correspond with outside institutions for legitimacy following (JCAHO) standards requiring primary source verification of physicians
- Conduct background and reference checks, license verification, evaluate reference letters, compose and types related correspondence as liaison acts with healthcare centers, both VA and Private Practices and Professional Organizations, National and International Institutions
- Managed various administrative duties, processing forms, maintaining databases, coordinating training and contacts, maintaining office protocols, delegating on behalf of management and timekeeping via VATAS
- Serve as point of contact for the VA Greater Los Angeles Healthcare System staff for submitting applications to Credentialing and Privileging and the Professional Standards Boards and Medical Executive Committee.
Patient Services Assistant Billing
Department of Veterans Affairs
11.2006 - 08.2010
- Responsible for billing using EHR using Vista health systems.
- Registering new patients and request.
- Billing and coding for Orthopedics and specialty clinics.
- Update and verify Patient Demographics and Insurance Information.
- Follow up calls with private healthcare Insurance medicare supplemental health Insurance, or Tricare.
- Claims submissions with thorough understanding of ICD-10, CPT coding systems.
- Enter no-show reports, monitoring and utilized electronic wait lists accurately
- Documented and managed patient information in VISTA
- Obtained insurance verification and authorization to submit financial clearance of patient accounts.
Education
Medical Coding -
American Career College
Los Angeles, CA01.1998
High School Diploma -
Santa Monica High School
Santa Monica, CA06.1992
Skills
- Epic Systems (EMR)
- Medical Terminology
- Medical/Billing Coding
- Data Entry
- Customer Service
- Goal-Oriented, time efficient and accurate
- HIPPA
- CPT and ICD-9, 10 Coding
- Typing
- Strong medical office skills
- Knowledge Insurance Blue Cross, LA Care, Healh-Net, Medi-Cal, Medicare
- Team oriented
- Excellent Verbal and Written Communication skills
- Analytical and Organization
- Experience Insurance verification and Authorization
- Knowledge in Microsoft Word, Excel, Teams, One Note and Outlook
Timeline
Patient Service Representative I
Children's Hospital of Los Angeles
10.2024 - Current
Senior Medical Office Representative
Providence Saint John's Health Center
09.2022 - 10.2023
CVO Credentialing Coordinator
UnityPoint Health/Remote
02.2022 - 08.2022
Credentialing Specialist
UCLA Health-CVO
06.2019 - 10.2021
Credentialing & Privileging Medical Staff Office
Department Veterans Affairs
11.2010 - 05.2019
Patient Services Assistant Billing
Department of Veterans Affairs
11.2006 - 08.2010
Medical Coding -
American Career College
High School Diploma -
Santa Monica High School
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