Kelli Singleton
Rosenberg,TX
Summary
Efficient medical billing professional with 10 years of experience. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Expert in debt collections, repayment negotiations and repayment plan development. Successful in managing escalated accounts and producing aging reports to cut down delinquent invoices. Passionate about perpetuating company values through impeccable work ethic and drive.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Medical Billing and Collections Specialist
Universal Surgical Assistants
08.2023 - Current
- Identify payer trends and make daily collections calls
- Maintaining an accurate Aging Report
- Handling Out-of-Network provider claims
- Use coded data to produce and submit claims to insurance companies
- Working directly with the insurance company, healthcare provider, and patients to process claims and ensure payment
- Reviewing and appealing unpaid and denied claims
- Obtain/ Follow up with Medical Necessity Forms, and or Prior authorization
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Prevented unnecessary loss of revenue due to late or incomplete billing by meticulously tracking all accounts and ensuring timely submission of accurate claim forms.
- Trained new employees on medical billing software, policies, and procedures, ensuring accuracy in claims submission from day one.
- Verified accuracy of accounts payable payments, resulting in 40% reduction in payment errors and check reissues.
Technical Information Specialist
Blue Cross Blue Shield
10.2019 - 05.2023
- Maintained of records and processing of claims in medical review along with any and/or all of following: processes ingoing/outgoing mail and prepares work for nursing staff
- Troubleshoots claims prior to nurse review and after review
- Monitored timeliness of claims processing and adjusts claims keyed incorrectly
- Performed quality control of work processes
- Processed adjustment claims for both pre-pay and post-pay departments
- Investigated and analyzed adjustment claim history and denial records
- Prescreened records for review and maintains accurate records of all claims
- Communicated with provider community and assists provider service department in responding to inquiries
- Generated educational correspondence to providers regarding denials
- Assisted manager with special projects
- Strong analytical, organizational, and customer service skills
- Managed data entry tasks to ensure accurate information recording.
- Improved data retrieval processes by organizing digital archives.
Customer Service Representative
Assurant Specialty and Property Insurance
04.2018 - 06.2019
- Made determinations on the application of insurance proceeds
- Thoroughly research customer's accounts to determine the correct direction funds should be applied
- Communicated with various individuals involved in the claims process such as homeowners, adjusters, mortgage companies, etc
- Handled property damage claim requirements
- Efficiently and accurately entered information into company proprietary systems
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Claims Customer Service Advocate II
Kelly Services/Tricare South
07.2017 - 04.2018
- Obtained and secured ADP II government security through Department of Health Agency
- Processed Institutional and Professional Claims within call center environment for Tricare South contract within PGBA Subsidiaries
- Researched and reviewed assigned claims by navigating multiple computer systems and platforms
- Accurately captured date/information necessary for processing and communicating extensively with members and providers regarding adjustments to resolve claim errors
- Collaborated with various business units to resolve claims issues to ensure prompt and accurate claim adjudication
- Met and maintained quality assurance standards as determined by government contact
- Served as point of contact for beneficiary imitated appeals in Florence office
- Responded to documents, investigates and facilitates resolution of member complaints and grievance, including writing, review and approval or resolution letters
- Successfully completed requirements for International Organization for Standardization (ISO)
Claims Customer Service Advocate I
Kelly Services/Veteran's Choice
05.2015 - 07.2017
- Functioned as a primary resource in handling Veteran Affairs (VA) customer contacts via telephone, ranging from routine to complex.
- Provided clear and concise education concerning the VA medical benefits and government policies and procedures
- Assisted beneficiaries with benefit information, referral and authorization requirements, claims, provider locations and all other routine VA issues
- Forwarded escalated or crisis calls to appropriate staff members
- Demonstrated regular, reliable and predictable attendance
- Answered phones and researches inquiries concerning benefits, enrollment.
- Researched and documents/updates databases such as net to net changes, CCM documentation.
- Provided information to internal and external customers
- Processed additional assignments, such as PCM changes, address changes, ID card replacements, RAOC status calls and data entry.
Administrative Assistant
MDCBDSN
02.2011 - 02.2015
- Ensured extraordinary customer experience by facilitating coordination of patients being welcomed in, prioritizing transactions and advising of any wait time
- Ensured that customer needs are addressed promptly, accordingly and efficiently
- Provided office services by implementing administrative systems, procedures, and policies while monitoring administrative projects
- Created and revised systems and procedures by analyzing operating practices, recordkeeping systems, forms control, office layout, and budgetary and personnel requirements; implementing changes
- Assisted with patient behavioral issues
- Maintained professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
CNA/Caregiver
MDCBDSN
05.2012 - 08.2012
- Enabled patients to stay in their homes by monitoring and recording patient condition; providing support and personal services; teaching families
- Supported patients by providing housekeeping and laundry services; Shopping for food and other household requirements; preparing and serving meals and snacks; running errands
- Monitored patient condition by observing physical and mental condition, intake and output, and exercise
- Helped family members care for patient by teaching appropriate ways to lift, turn, and re-position patient; advising on nutrition, cleanliness, and housekeeping
- Maintained safe, secure, and healthy patient environment by following asepsis standards and procedures; maintaining security precautions; following prescribed dietary requirements and nutrition standards
- Assisted patients with daily living activities, promoting independence and dignity.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
Education
Certificate - Medical Billing
Martinsburg College
Martinsburg, WV11.2024
Diploma -
Nursing Training Center
Florence, SC12.2012
High School -
Mullins High School
Mullins, SC12.2012
Skills
- Clerical experience
- Microsoft Office
- Medical Terminology
- Organizational skills
- Insurance verification
- Medical billing
- ICD-10
- Revenue cycle management
- ICD-9
- EMR systems
- HIPAA compliance
- Denial resolution
- Data entry
- Medical billing software proficiency
- Claims processing proficiency
- Analysis skills
Accomplishments
- Documented and resolved claim denials which led to proper reimbursement.
Certification
- Life Insurance License, 08/01/23, 10/01/25, Licensed in Texas and SC for life insurance
- Health Insurance License, 08/01/23, 10/01/25, Licensed Health insurance agent in Texas
- Certified Coding Specialist
- CNA
- Epic Certification
- Medical Billing Certification
Personal Information
- Relocation: Anywhere
- Work Permit: Authorized to work in the US for any employer
Timeline
Medical Billing and Collections Specialist
Universal Surgical Assistants
08.2023 - Current
Technical Information Specialist
Blue Cross Blue Shield
10.2019 - 05.2023
Customer Service Representative
Assurant Specialty and Property Insurance
04.2018 - 06.2019
Claims Customer Service Advocate II
Kelly Services/Tricare South
07.2017 - 04.2018
Claims Customer Service Advocate I
Kelly Services/Veteran's Choice
05.2015 - 07.2017
CNA/Caregiver
MDCBDSN
05.2012 - 08.2012
Administrative Assistant
MDCBDSN
02.2011 - 02.2015
Diploma -
Nursing Training Center
High School -
Mullins High School
- Life Insurance License, 08/01/23, 10/01/25, Licensed in Texas and SC for life insurance
- Health Insurance License, 08/01/23, 10/01/25, Licensed Health insurance agent in Texas
- Certified Coding Specialist
- CNA
- Epic Certification
- Medical Billing Certification
Certificate - Medical Billing
Martinsburg College
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