Kenya Gilbert
Madison
Summary
Successful track record of handling complicated assignments and administrative/clerical requests with 19 yrs of office and billing and coding health information management. Proven ability to readily master new technology. Dedicated to maintaining strict patient confidentiality.
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Experienced in revenue cycle management for medical facilities. Proficient in reducing debt, collecting payments, and collaborating with insurance companies to resolve concerns. Talented communicator and practiced multitasker.
Overview
19
19
years of professional experience
Work History
Revenue Cycle Specialist III (Remote)
Eating Recovery Center
Denver
06.2021 - Current
- Perform billing processes to include, but not limited to: charges capture, claims submission, adjudication, transaction reviews, payment/adjustment posting, identification and management of patient responsibility.
- Research and resolve discrepancies in a timely manner.
- Demonstrate a high level of organization, time management, and delegation skills to prioritize and adjust workflow as volume deadlines mandate.
- Provide formal reports on audits, fostering ongoing communication and collaboration with supervisors to highlight key findings and trends.
- Consistently engage in self-development, new learning and knowledge advancement.
- Research and resolved incorrect payments, EOB rejections, and other issues with outstanding accounts.
- Create and maintain detail administrative processes and procedure to drive efficiency and accuracy.
- Build and maintain excellent client services through timely response and going above and beyond for a resolution.
- Maintained professional and productive working relationships to promote teamwork and boost rapport.
- Remained composed and highly professional in fast-paced and constantly changing environments, effectively handling challenging situations.
- Maintained Complies with HIPPA regulations.
Billing Specialist III
Ascension St Vincent
Indianapolis
05.2016 - 06.2021
- Resubmission and reprocessing of denied or rejected insurance claims.
- Contact payers to obtain prior authorizations, by gathering additional clinical and coding information.
- Verifying authorizations, eligibility, and benefits verification for treatment hospitalizations, and procedures.
- Accurately apply payments to patient accounts.
- Make outbound phone calls to resolve denial issues.
- Responsible for processing adjustments and denials according to established guidelines.
- Working independently and making decisions on routine problems and non-routine issues.
- Contact insurance companies regarding any discrepancy in payment if necessary.
- Follow up on unpaid claims within standard billing cycle timeframe.
- Participates in ongoing communication and documentations with team regularly about approvals, denial and appeals.
- Researching and appealing denied claims.
- Preparing, reviewing and transmitting claims using billing software, including electronic and paper claim processing.
- Maintains patient demographic information and data collection systems.
- Responsible for generating patient's statement and follow up on unpaid bills.
- Submit accurate medical records and document patient case history in detail.
- Ensure strict confidentiality of financial records and adhere to all HIPAA guidelines and regulations.
Patient Account Representative II
Eskenazi Health Services
Indianapolis
11.2006 - 05.2016
- Accurately applied payments to patient accounts, itemized charges.
- Researched and resolved incorrect payments, EOB rejections, and other issues with outstanding accounts.
- Review billing edits and provide insurance providers with corrected information.
- Provided tenacious follow-up to ensure proper payments were fully collected.
- Codes information about procedures performed and codes the diagnosis on charges.
- Establish priorities and meet deadlines, follow written and verbal instructions.
- Maintained inventory, company files, and insurance records via computer tracking system.
- Greeted clients in a professional, courteous manner.
- Enter correct carrier/plan code(s) into registration system and identify the patient eligibility status.
- Accountability for accuracy of data collected and data entry.
- Accurately handled financial transactions and processed credit transactions.
- Utilizes ECW to perform essential job functions.
- Complies with HIPPA regulations.
- Accountability for accuracy of data collected and stored in systems.
- Enters charge information into charge line entry procedures to produce billing for services performed.
- Researches all information needed to complete billing process including retrieving charge entry information from multiple information system and from office personnel.
- Process and distributes copies of billing according to policy.
- Review all documents submitted for billing, assigning procedure and diagnosis codes and modifiers to properly support medical services rendered.
- Access the information systems resources to obtain necessary patient information.
Education
Sociology -
Ivy Tech Community College
Indianapolis, IN01.2018
Skills
- Problem Resolution
- Verbal and Written Communications
- Analytical
- MultiTasking
- Self Mgt
- Scheduling
- Appointments
- Filing
- Pre Register
- Registration
- Inpt/outpt Routing Calls
- Customer Relations
- Data Entry
- Cashier
- ICD-9
- CPT codes
- Type 60 wpm accuracy
- Medical Terminology
- Medical Insurance Bill
- Online Claim Submission
- Medical Confidentiality
- Indiana Navigator Certified
- Physicians /AR Billing
- Medical Software
- McKesson/STAR
- Epic
- Indiana/Medicaid
- Connex Medicare
- Health Advantage
- Cigna
- Care web
- XenApp
- Advance MD
- UHC
- WPS
- Athena
- Anthem
- Mdwise
- Availity
- Kramer
- IUMG
- SMS
- ADP
- PHS
- RTE
- & Microsoft Word
- Excel
- Access
- PowerPoint
Timeline
Revenue Cycle Specialist III (Remote)
Eating Recovery Center
06.2021 - Current
Billing Specialist III
Ascension St Vincent
05.2016 - 06.2021
Patient Account Representative II
Eskenazi Health Services
11.2006 - 05.2016
Sociology -
Ivy Tech Community College