Summary
Overview
Work History
Education
Skills
Timeline
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Kia Horton

Bronx,NY

Summary

Compassionate and attentive Intake Specialist with over 10 years of experience in the healthcare industry, specializing in client assessment management. Demonstrates a solid foundation in medical records, insurance verification, and authorization processes, with proficiency in Precision Care, 3M coding, EPIC, eClinicalWorks, and reimbursement software. Recognized for exceptional organizational skills and the ability to provide detailed support during the intake process. Currently preparing for the AHIMA RHIT exam while actively contributing as a member of the National Society of Leadership and Success.

Overview

17
17
years of professional experience

Work History

Clinical Support Coordinator

Healthfirst
New York, NY
05.2024 - Current
  • Verified patient eligibility and benefits coverage with insurance companies.
  • Organized and maintained patient records in accordance with HIPAA regulations.
  • Provided administrative support to clinical team members.
  • Answered incoming calls from patients regarding their care plans, or inquiries about authorizations.
  • Reviewed medical charts for accuracy and completeness.
  • Coordinated patient appointments, including scheduling tests and procedures.
  • Performed data entry into electronic health record systems.
  • Demonstrated excellent customer service skills when interacting with patients and their families.
  • Answered high volume of incoming calls to assist patients.
  • Documented medical records by entering patient interactions and information.
  • Coordinated patient scheduling to optimize clinical workflow and improve patient care.
  • Facilitated communication between patients, families, and healthcare teams to ensure coordinated care.
  • Implemented patient satisfaction surveys to gather feedback and identify areas for improvement in clinical services.

Intake Coordinator

Emblem Health Insurance
REMOTE, NY
09.2022 - 02.2024
  • Received inbound calls to obtain clinical information from providers to create authorizations and referrals.
  • Answered and logged incoming inquiries via phone, fax, and email.
  • Made outbound calls to providers to obtain the information necessary to create or update authorization.
  • Verified insurance eligibility, benefits, and patient liabilities for defined services.
  • Maintained a positive attitude and effectively de-escalated clients during crisis situations.
  • Processed paperwork, obtained billing forms, and secured confidential information.
  • Scanned and stored files and records electronically to reduce paper files, and secure data.
  • Responded to daily inquiries and requests within the mandated time frame to meet deadlines.
  • Identified and corrected data entry errors to prevent duplication across systems.
  • Proofread and edited documents to correct errors.
  • Detected flaws in customer and account data, resolving issues, and communicating with supervisors.
  • Executed data verification to ensure expedient error detection.

Care Coordinator

Cosan Group
Remote, NJ
06.2022 - 09.2023
  • Coordinates patient care with patient/caregiver, home health agency and physician's office establishing current response to therapy, obtaining supply needs and documenting ADR/Adherence occurrence
  • Encourages Enrollee to follow treatment recommendations through support, health and wellness education, and advocacy
  • Maintains up-to-date scheduling/testing status boards in eClinicalWorks
  • Request clinical information, as necessary.
  • Investigated and reported issues relating to patient care and conditions which might hinder patient well-being.
  • Monitored vital signs and medication use, documenting variances and concerning responses.

Patient Services Specialist

Modernizing Medicine
Remote
05.2021 - 06.2022
  • Served as primary contact for all inbound and outbound patient calls regarding patient's balance inquiries, claims processing, insurance updates and payment collections
  • Initiated outbound calls to patients of RCM clients to understand and address any account/payment issues such as demographic and insurance updates
  • Accurately input and update patient account information and document calls into PM
  • Ensure department targets & Key Performance Indicator benchmarks are met.
  • Coordinated insurance authorizations, collected co-payments and resolved discrepancies.
  • Answered over 90 telephone calls per day to schedule appointments and answer patient questions.
  • Obtained insurance verification and authorization to submit financial clearance of patient accounts.

Day Habilitation Counselor / Front Desk

United Cerebral Palsy Association of New York State
New York, NY
04.2008 - 04.2021
  • Arrange appointments and transportation for patients via the telephone
  • Scan medical and insurance files into the individual's electronic file
  • Verify individual's insurance coverage and obtain authorization
  • Update patient account information and enter into medical record
  • Collect medical/behavioral data and enter into computer system
  • Call Pharmacies to obtain medical prescription refills; document medications into medical records.
  • Maintained comprehensive clinical records and documentation of activities performed.
  • Assessed effectiveness of treatment plans and made adjustments to achieve service plan goals.
  • Modeled behaviors, educated patients and motivated change to improving life skills and coping mechanisms.
  • Assisted clients with identifying treatment and recovery goals and provided services for implementation.
  • Documented and filed patient health reports and charts.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
  • Performed assessments to determine individual limitations and strengths.

Education

Associate of Applied Science - MEDICAL BILLING AND CODING

DeVry University - Online
New York, NY

Skills

  • Call Handling Expertise
  • Insurance Eligibility Confirmation
  • Electronic Medical Records
  • Client Appointment Coordination
  • Accurate Data Entry
  • Payment Collection
  • Authorization Management
  • Clinical Record Management
  • Eligibility Evaluation
  • Intake Assessment
  • Appointment Scheduling
  • Medical records management
  • Patient services management

Timeline

Clinical Support Coordinator

Healthfirst
05.2024 - Current

Intake Coordinator

Emblem Health Insurance
09.2022 - 02.2024

Care Coordinator

Cosan Group
06.2022 - 09.2023

Patient Services Specialist

Modernizing Medicine
05.2021 - 06.2022

Day Habilitation Counselor / Front Desk

United Cerebral Palsy Association of New York State
04.2008 - 04.2021

Associate of Applied Science - MEDICAL BILLING AND CODING

DeVry University - Online

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Kia Horton