KIM DUNCANS
Fort Lauderdale,FL
Summary
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. . Seeking entry-level opportunities to enhance abilities while contributing to company growth.
Overview
20
20
years of professional experience
Work History
(LEAD) ACCOUNTING SPECIALIST/OFFICE SUPPORT/MEDICAL RECORDS
BROWARD ADDICTION RECOVERY CENTER
FORT LAUDERDALE
2016.01 - Current
- Completeness of medical records for end of daily process utilizing client management system
- Maintains sign out system of client records pertinent to request made; Participates in DCF and Accreditation audits meeting legal requirements within HIPAA Compliance; Assisting clients in navigating treatment, coordinating related resources available; Provide information on and assist eligible clients with funding options, including grant programs available patient information to finance and other key staff; Provide support for clinical and administrative staff; Ensure daily assembles and receipt of client current and discharged record keep; Knowledgeable in financial intakes, assessment, and payment assistance determination; Verification of health insurance benefits, eligibility, coverage and communicating billing related issues to clients, their family, and staff; Coordinate flow of insurance and other vital components needed for admissions; Proficient in training onboarding staff on their specified job functions.
- Assisted in developing strategies to increase customer satisfaction levels.
- Reviewed documents for accuracy prior to submission or publication.
- Provided technical support for customers in resolving complex issues.
- Analyzed customer needs and recommended appropriate products or services.
- Maintained accurate records of customer interactions and feedback.
- Coordinated with other departments to ensure efficient workflow processes.
BENEFITS LEAD COORDINATOR/Accounts Receivable Clerk
RELIABIL SOLUTIONS LLC SUBSTANCE ABUSE FACILITY
DELRAY BEACH , FL
2014.01 - 2016.01
- Verified benefits through Availity, Navinet, Cigna and UHC Online services, handling the process according to the organization’s policies, procedures and State and Federal regulations; Overseen contract employee trainings; Utilized CPT-4 HCFA coding (Med-soft) CMD (Collaborate MD), KIPU and Salesforce software for tracking and batching commercial/private pay submissions; Evaluated status of claims, batching amounts from 1K to 100K submissions by set deadlines.
- Provided guidance, training, and support to junior staff members on various aspects of the project lifecycle.
- Acted as a liaison between internal teams and external vendors when needed.
- Monitored progress on multiple projects, identifying potential issues and developing solutions.
- Ensured compliance with applicable regulations throughout the duration of each project.
- Reviewed deliverables for accuracy prior to release or distribution.
- Maintained records of activities, decisions made, and changes requested during the execution phase.
ADMISSION COORDINATOR
PALM PARTNERS LLC SUBSTANCE ABUSE FACILITY
DELRAY BEACH , FL
2012.01 - 2014.01
- Verified benefits through Availity, Navinet and Commercial carrier’s online services in accordance with the organization’s policies, procedures and State and Federal regulations; Utilized CPT-4 HCFA coding (Med-soft) CMD (Collaborate MD), KIPU and Salesforce software for tracking and batching commercial/private pay submissions; Training benefits staff prior to going live; Staying knowledgeable of BCBS, AETNA, CIGNA, Medicare/Medicaid & private insurance policies including EOB and benefit information in accordance with HIPPA regulations; Prescreening clients for admission; Providing accurate and timely answers to queries with client/provider relations; Educating callers of Medicare Part A, B and D policy coverage.
- Answered inquiries from prospective clients about admission requirements and procedures.
- Handled insurance claim duties and verified that each met standards of admissions.
- Managed sensitive information with discretion and in compliance with confidentiality policies.
(LEAD) PHARMACY TECHNICIAN/ACCOUNTS RECEIVABLE/CASH POSTING
ACCESS DIABETIC SUPPLY PHARMACY D/B/A AOM PHARMACY
POMPANO BEACH , FL
2007.01 - 2010.01
- Assisted with the data entry of prescriptions, dispensing, and packing of medication and supplies; Verified type and dosage of the medications prior to shipment and alerted pharmacist of discrepancies with incoming prescriptions; Made outgoing calls to patients to review medications and discuss any copayments due; Verified and submitted individual credit card payments as well as batches for final authorization; Interpreted Explanation of Benefits and applied cash to correct accounts; Informed members of provider changes/locations; Provided prior authorizations and benefit eligibility via Datapoint System.; Assisted members in special enrollment.
PHARMACY TECHNICIAN/ACCOUNTS RECEIVABLE/CASH POSTING
ACCESS DIABETIC SUPPLY PHARMACY D/B/A AOM PHARMACY
POMPANO BEACH , FL
2005.01 - 2007.01
- Supplied customer service, answering Medicare part A, B and D inquiries and relaying explanations of catastrophic amounts and coverage gaps; Provided insurance verification for third-party vendors and customers; Informed members of provider changes/locations; Providing prior authorizations and benefit eligibility via Datapoint System; Assisting members in special enrollment.
Health Benefits Coordinator
SPHERION CORPORATE
FT LAUDERDALE , FL
- Processed and enrolled benefits for new and existing employees. Provided EOBs for Aetna, BCBS, and Cigna benefits to members. Utilized Templink for payroll deductions to comply with benefits. Completed quality control for department use. Maintained reports and logs for month-end reviews.
- Processed claims for reimbursement from insurance providers according to established guidelines.
- Conducted audits of existing plans in order to identify potential areas for improvement or cost savings opportunities.
Education
PHARMACY TECHNICIAN -
National School of Technology
FL01.2008
DIPLOMA -
Dillard Community School
FL01.2001
Skills
- Customer Care
- Problem/Conflict Resolution
- Group/Individual Training
- Prescription Data Entry
- Medical Records Clerk
- Pharmacy Operations
- Pharmacy Reimbursement
- Claims Transmission
- Skilled Leadership & Training
- Medical/Pharmacy Accounts
- Receivable Cash Posting
- Dispensing Medications
- Insurance Verification
- Admission Benefits Lead Coordinator
- Pharmacy Technician
- Accounts Receivable/Cash Posting
- Benefits Specialist
Timeline
(LEAD) ACCOUNTING SPECIALIST/OFFICE SUPPORT/MEDICAL RECORDS
BROWARD ADDICTION RECOVERY CENTER
2016.01 - Current
BENEFITS LEAD COORDINATOR/Accounts Receivable Clerk
RELIABIL SOLUTIONS LLC SUBSTANCE ABUSE FACILITY
2014.01 - 2016.01
ADMISSION COORDINATOR
PALM PARTNERS LLC SUBSTANCE ABUSE FACILITY
2012.01 - 2014.01
(LEAD) PHARMACY TECHNICIAN/ACCOUNTS RECEIVABLE/CASH POSTING
ACCESS DIABETIC SUPPLY PHARMACY D/B/A AOM PHARMACY
2007.01 - 2010.01
PHARMACY TECHNICIAN/ACCOUNTS RECEIVABLE/CASH POSTING
ACCESS DIABETIC SUPPLY PHARMACY D/B/A AOM PHARMACY
2005.01 - 2007.01
Health Benefits Coordinator
SPHERION CORPORATE
PHARMACY TECHNICIAN -
National School of Technology
DIPLOMA -
Dillard Community School
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