Kelsea Williams
Houston,TX
Summary
Achieved efficient verification of patient access insurance, enhancing revenue cycle processes. Contributed to team-driven initiatives that strengthened collaboration. Demonstrated exceptional attention to detail, effectively managing tasks in high-pressure situations.
Reliable and results-focused, with commitment to achieving positive outcomes.
Experienced with assessing and processing various types of claims efficiently. Utilizes analytical and negotiation skills to reach fair settlements and maintain compliance with policies. Knowledge of regulatory standards and exceptional customer service, ensuring fair and timely resolutions.
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Overview
10
10
years of professional experience
Work History
Case Manager Individualized Care
Cardinal Health
Houston, TX
01.2024 - Current
- Achieved an exceptional patient experience by managing the entire care process with urgency from benefit verification to medication delivery.
- Coordinated with various healthcare providers, including physicians and specialty pharmacies, to enhance patient care and ensure timely access to services.
- Secured necessary insurance prior authorizations and effectively navigated the appeals process to support patient needs.
- Clarified insurance plan coverage for patients, including out-of-pocket expenses, and assisted with appeals when required.
- Utilized analytical and critical thinking skills to drive improvements in patient care processes.
Manual Insurance Verification Specialist
Gainwell Technologies
Irving, TX
01.2022 - 01.2024
- Achieved accurate pre-authorization submissions through meticulous review of medical records.
- Streamlined verification process for patient eligibility and benefits by liaising with insurance carriers.
- Eliminated discrepancies in insurance coverage and patient data, enhancing data integrity.
- Acquired authorization numbers while upholding payer requirements, facilitating smoother operations.
- Demonstrated comprehensive understanding of Medicare and Medicaid regulations to drive compliance.
Customer Service Advocate
UnitedHealth Group (UHG)
Houston, TX
01.2022 - 01.2024
- Achieved high customer satisfaction rates by effectively managing high-volume inbound calls with precision and professionalism.
- Enhanced customer experience by providing timely and accurate information across multiple channels.
- Facilitated service improvements by analyzing performance metrics and supporting key initiatives.
- Resolved customer complaints effectively while maintaining compliance with company policies and standards.
- Completed financial clearance of patient accounts by verifying insurance eligibility and benefits, ensuring prompt notifications and authorizations.
Claims Adjuster
State Farm
Houston, TX
07.2019 - 12.2022
- Achieved compliance with state regulations through thorough investigation and documentation of insurance claims.
- Gathered critical information by interviewing claimants, witnesses, and medical professionals.
- Communication via telephone, email, and text with employees, employers, attorneys, and others.
- Delivered precise claim documentation within designated systems, supporting overall claim processing.
- Maximized efficiency by utilizing Microsoft Office and specialized claims software effectively.
- Complete financial calculations.
Scheduling Coordinator (Part Time)
Houston Methodist
Houston, TX
04.2019 - 01.2022
- Led the coordination of patient appointments across multiple healthcare facilities, fostering seamless operations among providers.
- Oversaw insurance verification processes for radiology procedures, enabling accurate billing and financial stewardship.
- Directed the maintenance and enhancement of patient appointment records and databases, ensuring data integrity.
- Cultivated professional interactions with patients and clinical staff, enhancing communication and service delivery.
Insurance Follow-Up Specialist
GetixHealth
Houston, TX
11.2016 - 06.2019
- Achieved compliance with state regulations through thorough investigation and documentation of insurance claims.
- Gathered critical information by interviewing claimants, witnesses, and medical professionals.
- Communication via telephone, email, and text with employees, employers, attorneys, and others.
- Delivered precise claim documentation within designated systems, supporting overall claim processing.
- Maximized efficiency by utilizing Microsoft Office and specialized claims software effectively.
- Complete financial calculations.
Education
Bachelor of Arts - Business Administration And Management
Houston City College
Houston, TX12.2029
Skills
- Enhanced patient access and registration, resulting in improved workflow efficiency
- Achieved seamless insurance verification processes for Medicare and Medicaid
- Strengthened revenue cycle support, contributing to financial stability
- Elevated customer and patient service standards, leading to increased satisfaction
- Successfully resolved conflicts, promoting a cohesive team atmosphere
- Maintained strict HIPAA compliance, safeguarding patient information
- Improved performance metrics, demonstrating commitment to quality care
- Empowered team leadership and training, fostering a culture of growth
- Established effective communication practices, enhancing collaboration
Timeline
Case Manager Individualized Care
Cardinal Health
01.2024 - Current
Manual Insurance Verification Specialist
Gainwell Technologies
01.2022 - 01.2024
Customer Service Advocate
UnitedHealth Group (UHG)
01.2022 - 01.2024
Claims Adjuster
State Farm
07.2019 - 12.2022
Scheduling Coordinator (Part Time)
Houston Methodist
04.2019 - 01.2022
Insurance Follow-Up Specialist
GetixHealth
11.2016 - 06.2019
Bachelor of Arts - Business Administration And Management
Houston City College