Kiara Skinner
Florissant,MO
Summary
Business owner, licensed esthetician and passionate healthcare professional. Extensive background in pharmacy billing, authorizations and denials, billing and financial assistance healthcare options.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Patient Financial Navigator
Elevance Health
12.2023 - Current
- Provided excellent customer service to patients and medical staff.
- Streamlined financial assistance application process for patients, resulting in reduced wait times and increased approval rates.
- Established strong relationships with multidisciplinary teams to ensure seamless coordination of care from financial perspective.
- Conducted thorough assessments of patient eligibility for charity care programs, securing vital financial support for those in need.
- Collaborated with insurance providers to verify coverage and resolve billing disputes, improving patient trust and ensuring timely payments.
- Facilitated prompt resolution of patient billing inquiries by coordinating with internal departments and external agencies as needed.
- Answered incoming calls, scheduled appointments and filed medical records.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Educated patients on available resources, payment options, and insurance benefits to promote informed decision making.
- Maintained up-to-date knowledge of relevant federal and state regulations, ensuring compliance in all financial counseling activities.
- Verified patient insurance eligibility and entered patient information into system.
- Followed document protocols to safeguard confidentiality of patient records.
- Learned and adapted quickly to new technology and software applications.
- Proven ability to learn quickly and adapt to new situations.
Business Owner/ Esthetician
Kouture Kosmetics
04.2016 - Current
- Performs facials, body treatments, and waxing procedure following guidelines provided by state of Missouri.
- Makeup application
- Microblading
- Bonds individual eyelash extensions to natural eyelash with liquid adhesive with proper isolation.
- Educates client on aftercare procedures to ensure preservation of natural eyelash health, longevity of eyelash extensions and infection control.
- Adhere to strict scheduling guidelines
- Schedules Appointments
- Bookkeeping
- Maintains proper sanitation of building
- Sole Proprietor
Accounts Receivable Follow Up Representative
Envision Physician Services
05.2017 - 03.2018
- Reviews EOB/EOMB's for proper reimbursement.
- Responsible for all collection activities on identified accounts.
- Resolves electronic claim rejections and Explanation of Benefits denials in timely manner.
- Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment.
- Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed.
- Provides insurance carriers with requested information to facilitate payment.
- Performs claim appeals as required.
Appeals Coordinator
Essence Healthcare
04.2016 - 10.2016
- Responsible for processing appeals for Medicare Parts B, C and D.
- Direct contact with physicians, members, skilled nursing facilities, DME providers, etc.
- Gather clinical information from physicians for review to ensure denial is according to Medicare guidelines.
- Medical Terminology.
- ICD9/10 and CPT codes.
- Review of claims to ensure payment was processed properly.
- Streamlined appeals process for increased efficiency through consistent tracking and monitoring of cases.
- Participated in regular meetings with management to provide updates on case status and discuss potential improvements in processes.
Clinical Pharmacy Technician
Magellan Healthcare
10.2013 - 05.2016
- Responsible for entering, reviewing and documenting request on both claims processing and tracking database.
- Provide drug information to physicians, nurses and health care professionals to ensure appropriate claims will adjudicate.
- Assist retail pharmacy in troubleshooting while following Medicaid guidelines according to appropriate state.
- Process claims and clinical prior authorizations and appeals.
- Direct contact with members, physicians and retail pharmacy representatives.
- Call Center environment processing more than 90 prior authorizations daily.
- Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
Certified Pharmacy Technician
Walgreens
09.2012 - 01.2014
- Operated automated counting machinery and manually filled large number of prescription orders.
- Interpreted medical terminology and instructions.
- Resolved third party rejections using pharmacy specific computer program.
- Managed Production queue deadlines on hourly basis.
- Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits.
- Implemented all corporate, state, and federal laws pertaining to pharmacy code and ethics.
Education
High School Diploma -
Greenfield High School
Greenfield, TN05.2007
Esthiology - Aesthetics
Crave Beauty Academy
St Louis, MO2019
Skills
- Claims Processing & Bookkeeping
- Medical Billing & Coding
- Customer Service
- Benefits, Billing
- Data Entry
- Medical Terminology
- Accounts payable and receivable
- Case tracking and follow up
- Drug utilization review
- Medical billing knowledge
- Patient Intake
- Claims Processing
- Insurance Verification
Affiliations
Who's Who American Highschool Student 2007
Who's Who American College Student 2010
Additional Information
- Authorized to work in the US for any employer.
Certification
- Classic Eyelash Extensions
- Volume Eyelash Extensions
- Eyebrow Extension
- Microblading
- Body Sugaring
- Microdermabrasion
- LED facial
- Cellulite Treatments/ Body Contouring
- Medical Billing and Coding
- Pharmacy- CPhT
- Leadership Essentials Certificate
Timeline
Patient Financial Navigator
Elevance Health
12.2023 - Current
Accounts Receivable Follow Up Representative
Envision Physician Services
05.2017 - 03.2018
Business Owner/ Esthetician
Kouture Kosmetics
04.2016 - Current
Appeals Coordinator
Essence Healthcare
04.2016 - 10.2016
Clinical Pharmacy Technician
Magellan Healthcare
10.2013 - 05.2016
Certified Pharmacy Technician
Walgreens
09.2012 - 01.2014
High School Diploma -
Greenfield High School
Esthiology - Aesthetics
Crave Beauty Academy
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