Kim Muehlhausen
Rockton,IL
Summary
Dynamic Financial Resources Specialist with a proven track record, excelling in insurance verification, prior authorizations's and patient advocacy. Recognized for achieving high quotas while providing compassionate support to patients. Skilled in claims processing and adept at problem-solving, ensuring regulatory compliance and fostering positive patient experiences.
Overview
15
15
years of professional experience
Work History
Financial Resources Specialist
Mercy Health Hospital
Rockford, IL
08.2022 - 03.2025
- Assisted patients with billing inquiries and with the resolution of outstanding balances by reviewing available options for payment, including payment plans, Care Credit, and financial assistance for those who qualify, in a warm, helpful, understanding way without judgment.
- Liaison between the patients and other departments, such as Case Management, Workers' Compensation, and Third Party Liability, to obtain information necessary for billing and authorization purposes.
- Responsible for obtaining prior authorizations for inpatient admissions via websites, phone calls, and fax.
- Worked with Utilization Management for clinical requests for authorizations and denials.
- Verified insurance coverage through EPIC, OneSource, Availity, and various provider portals.
- Followed newborn patients until insurance coverage was active.
- Recipient of the WOW award's from co-workers and patients.
Secondary Billing Representative
Scheck and Siress
Oakbrook Terrace, IL
03.2017 - 03.2020
- Processed all secondary claims and followed up to ensure claims were processed correctly by communicating with policyholders to acquire missing information for claims processing.
- Worked on all denials of secondary claims by communicating with insurance companies via phone, fax, or provider portals.
- Accomplished multiple tasks such as verifying insurance and eligibility, computing accounts receivables, defining coding methods based on physicians' notation, billing out claims to insurance companies, and ensuring strict regulations compliance.
- Met and exceeded daily and monthly account quotas by 97%.
- Exemplified strong organizational skills and flexibility in processing confidential information in a fast-paced environment.
Medical Claims Processor
Coram Healthcare
Machesney Park, IL
04.2013 - 05.2016
- Prepared documents for submission to insurance companies for review and approval for payment of claims.
- Processed a high volume of claims on a daily basis using established time frames.
Claims Processor
McKesson
Wheeling, IL
03.2010 - 09.2012
- Managed, updated, and organized files/records while delivering exceptional guest relations through welcoming visitors warmly, offering immediate assistance, and providing quality support for other claims activities as needed.
- Researched denied claims and processed appropriate appeals for resubmission.
Education
Associate of Applied Science - Business Managment
Robert Morris College
Orland Park, IL08-1994
Skills
- Insurance verification
- Claims processing
- Prior authorization
- Regulatory compliance
- Financial assistance
- Patient advocacy
- Communication skills
- Billing inquiries
- Problem solving
- Organizational skills
- Attention to detail
- Customer service
- Adaptability
- Multitasking
- EPIC
Timeline
Financial Resources Specialist
Mercy Health Hospital
08.2022 - 03.2025
Secondary Billing Representative
Scheck and Siress
03.2017 - 03.2020
Medical Claims Processor
Coram Healthcare
04.2013 - 05.2016
Claims Processor
McKesson
03.2010 - 09.2012
Associate of Applied Science - Business Managment
Robert Morris College