Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Kemaly Moreland

Fort Wayne,IN

Summary

Skilled professional with experience in medical billing, customer service and data entry. Exceptional interpersonal and problem-solving skills. Effectively mediates customer disputes and collects payment in timely manner. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Patient Financial Services Representative

Banner Health
09.2023 - Current
  • Improved patient satisfaction by providing timely and accurate financial information.
  • Streamlined billing processes for increased efficiency and accuracy in payment collections.
  • Enhanced revenue recovery with diligent follow-up on outstanding accounts and insurance claims.
  • Assist cash posting department with posting lockbox postings.

Claims Examiner

Allegiance Benefit Plan Management
02.2023 - 09.2023
  • Review, research, analyze, and process complex healthcare claims by navigating multiple computer systems and platforms and accurately capturing the data/information for processing (e.g
  • Verify pricing, prior authorizations, applicable benefits)
  • Escalates claim and/or system issues to Team Lead or Supervisor
  • Creates and supports a professional environment which fosters teamwork, cooperation, respect and diversity
  • Meet department quality and production requirements
  • Process claims for multiple Lines of Business as requested by management
  • Understands processing rules for multiple lines of business and supports other lines of business as needed to meet business needs.

Patient Qualification Specialist

Apria Healthcare Sleep Center
01.2021 - 01.2023
  • Responsible for supporting hundreds of local branch offices across the country by reviewing new patients orders and documentation submitted by referral sources in order to obtain required documentation and clinical requirements of individual health insurance plans, allowing patients to maximize their available health plan benefits and to receive the much-needed care as soon as possible.
  • Requests health plan authorizations/information as required; either electronically or verbally
  • Demonstrates and ability to develop business relationships within the field leadership through close collaboration, partnership, engagement and communication.
  • Performs other duties as required.

Customer Service Representative

All Around Support
01.2016 - 01.2021
  • Answered 60-100 customer calls promptly to avoid long wait times on hold.
  • Provided primary customer support to internal and external customers in a fast-paced environment.
  • Kept customers happy by implementing forward-thinking strategies that focused on meeting their needs and resolving their concerns
  • Maintained a high level of professionalism and calmness with all personnel even in high-stress situations.

Education

Bachelor of Science - Business Administration and Management

Colorado Technical University
Colorado Springs, CO
01.2022

Skills

  • Fast learner
  • Claims Examiner experience
  • Personable
  • Quality assurance
  • Time management
  • Attention to detail
  • Medical ICD-10, HCPC, CPT knowledge
  • Call Center Experience
  • Cash posting
  • HIPAA Compliance
  • Insurance Verification
  • Verbal and Written Communication
  • Medical Terminology
  • Medical Billing Knowledge
  • Data Entry Proficiency
  • Issue Research

Accomplishments

  • Select for the President's and Dean's List every semester
  • Member, Delta Mu Delta (National Honor Society)

Certification

CRCR, Certified Revenue Cycle Representative 11.05.23 Expires 5.31.26 HFMA

CSPR, Certified Specialist Payment & Reimbursement 12.27.23 Expires 5.31.26 HFMA


Timeline

Patient Financial Services Representative

Banner Health
09.2023 - Current

Claims Examiner

Allegiance Benefit Plan Management
02.2023 - 09.2023

Patient Qualification Specialist

Apria Healthcare Sleep Center
01.2021 - 01.2023

Customer Service Representative

All Around Support
01.2016 - 01.2021

Bachelor of Science - Business Administration and Management

Colorado Technical University

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Kemaly Moreland