KiAsia Hayes
Huntington,WV
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Dedicated Reimbursement Specialist with exemplary analyzation and negotiation abilities. Highly skilled in customer service and coverage evaluation. Specializing in medical insurance claims with a well-established knowledge of the general industry. Experienced Reimbursement Specialist dedicated to ensuring clients receive due compensation for medical insurance claims. Confident and competent in negotiations and policy analysis.
Overview
14
14
years of professional experience
Work History
Reimbursement Analyst Manager
Probill
07.2018 - Current
- Responsible for managing the daily functions of the Reimbursement Department in accordance with ProBill billing standards and reimbursement policy and procedures
- Responsible for timely submission of all adjustments; directly supervises accounts receivable(s) actions to ensure timely and accurate productivity; generates and analyses monthly reports and ensures their accuracy; maintains benchmark metrics, solves problems identified based on metrics and AR reviews, and improves efficiency within the AR department operation while ensuring cash goals are obtained and the lowest possible accounts receivable aging.
- Ensured compliance with government regulations through thorough documentation review and adherence to established protocols.
- Served as a subject matter expert on specific payers or types of claims, contributing specialized knowledge during internal meetings or presentations aimed at improving overall team effectiveness in handling reimbursement matters.
- Participated in cross-functional teams focused on continuous improvement initiatives within the organization''s revenue cycle operations department.
- Conducted audits of patient accounts to identify errors or inconsistencies that could impact timely reimbursements.
- Streamlined claims processing for increased efficiency and accuracy in reimbursements.
- Supported team members by sharing expertise in reimbursement methodologies and payer contracts analysis.
- Provided exceptional customer service, assisting patients with inquiries related to their insurance coverage and reimbursement status.
- Developed training materials for new hires, expediting the onboarding process for Reimbursement Analysts in a fast-paced environment.
- Maintained updated knowledge on insurance policies, coding guidelines, and industry regulations to maximize reimbursement potential.
- Improved reimbursement processes by analyzing and resolving payment discrepancies.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Prevented delays and claim denials by correcting information prior to submission.
Customer Experience Coordinator
Marshalls
02.2010 - 05.2021
- Monitored Customer Experience Coordinator team performance, providing constructive feedback and coaching when needed.
- Resolved escalated customer issues, ensuring timely resolution and maintaining high levels of satisfaction.
- Trained new team members on company guidelines and best practices for exceptional customer service delivery.
- Introduced personalized follow-up procedures after resolving complaints, increasing positive feedback from customers about their experiences.
- Helped customers understand return policies and processed items.
- Handled all escalated complaints and implemented timely, knowledgeable and effective solutions balancing customer and business needs.
- Oversaw front register operations and maintained exceptional levels of customer service in all interactions.
- Collected and returned unpurchased or returned items to correct shelf locations and arranged displays to promote sales.
- Responded proactively and positively to rapid change.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Education
Bachelor of Science - Health Science
Marshall University
Huntington12.2015
Skills
Appeals Handling
HIPAA Compliance
Healthcare Reimbursement
Claims Processing
Insurance Verification
Microsoft Excel proficiency
Denial Management
Revenue Cycle Management
Medical Billing
Microsoft Office
Data Recording
Bookkeeping
Clerical writing
Eligibility Verification
Teamwork and Collaboration
Customer Service
Attention to Detail
Organizing and Prioritizing Work
Critical Thinking
Decision-Making
Documentation skills
Data Entry
Claims adjustment
Excellent administrative abilities
Medical Terminology
Jobdescription
Responsible for managing the daily functions of the Reimbursement Department in accordance with ProBill billing standards and reimbursement policy and procedures. Responsible for timely submission of all adjustments; directly supervises accounts receivable(s) actions to ensure timely and accurate productivity; generates and analyses monthly reports and ensures their accuracy; maintains benchmark metrics, solves problems identified based on metrics and AR reviews, and improves efficiency within the AR department operation while ensuring cash goals are obtained and the lowest possible accounts receivable aging.
Timeline
Reimbursement Analyst Manager
Probill
07.2018 - Current
Customer Experience Coordinator
Marshalls
02.2010 - 05.2021
Bachelor of Science - Health Science
Marshall University
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