Summary
Overview
Work History
Education
Skills
Accomplishments
Work Availability
Work Preference
Quote
Software
Languages
Interests
Timeline
CustomerServiceRepresentative
Kimberley Maerker

Kimberley Maerker

Springfield,OH

Summary

Dynamic Payment Resolution Specialist with proven expertise at Trinity Health, excelling in claim resolution and proactive follow-up. Skilled in problem-solving and communication, I effectively address billing discrepancies and enhance revenue cycle efficiency. Recognized for meticulous attention to detail and the ability to build strong team collaborations, ensuring timely payments and optimal patient satisfaction.

Overview

9
9
years of professional experience

Work History

Payment Resolution Specialist Billing/Insurance Follow-Up Representative

Trinity Health
01.2020 - Current
  • Performed daily activities as part of the billing and follow up team in Livonia Michigan
  • Documents claims billed, paid, settled and follow up in appropriate systems(s)
  • Identifies and escalates issues affecting accurate billing and follow up activities
  • Adheres to proactive practices which include contacting the payer directly for payment due on accounts and reviewing and responding to all mail correspondences in a timely manner
  • Communicates with appropriate hospital departments to clarify billing discrepancies and obtain demographic, clinical, financial and insurance information for patient's
  • Performs all routine follow up and functions which include the investigation of overpayments, under payments, credit balances and payment delays
  • Research claim rejections, makes corrections, take corrective actions, and/or refers claims to appropriate departments/coworkers to ensure timely and accurate claim resolution
  • Proactively follow up on delayed payments by contacting patient's third party payers determining the cause for delay and supplying additional date as required
  • Prepares appeals via appropriate means according to carrier guidelines for all claims that require reconsideration for appropriate additional payments



Medical Billing Analyst

MedComm Billing Consultants
11.2016 - 01.2020
  • Performs a through and consistent research of and follow up on accounts with outstanding claims using periodic and regular aging report
  • Contacts the patient and/or third party payer as appropriate
  • Prepares appeals via the appropriate means according to carrier guidelines for all claims that require reconsideration for appropriate additional payments
  • Identifies and reassigns financial responsibility as appropriate
  • Evaluate patient's financial status and establishes a budget payment plan as needed
  • Prepares and approves statements for services that become the patient's responsibility
  • Performs various collections actions as necessary
  • Documents all activity taken in each patient's account
  • Processes all non payment correspondence, underpayments or overpayments
  • Participates in educational activities and attends regular team meetings as well as all company wide meetings
  • Maintains knowledge of multiple practice management systems that Medcomm uses to manage the revenue cycle process for its clients
  • Assists and completes other duties as assigned by team lead or billing manager

Education

Associate of Science - Insurance Billing And Coding

Colorado Technical University
Colorado Springs, CO
09-2008

Skills

  • Document preparation
  • Information collection
  • Team building
  • Teamwork
  • Problem-solving
  • Time management
  • Attention to detail
  • Problem-solving abilities
  • Multitasking
  • Excellent communication

Accomplishments

  • Documented and resolved unpaid medical insurance claims which led to payment for medical care/treatment rendered to the patient's.
  • Conflict Resolution - Responsible for handling customer account inquiries, accurately providing information to ensure resolution of product/service complaints and customer satisfaction.

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference

Work Type

Full Time

Location Preference

Remote

Important To Me

Work-life balanceHealthcare benefitsWork from home optionCareer advancement

Quote

There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins

Software

EPIC

NEXTGEN

Microsoft Office

Teams

Languages

English
Native language
English
Proficient (C2)
C2

Interests

Crafting and being creatrive

Cincinnati Bengals Football

My grandchildren and great grandson

Timeline

Payment Resolution Specialist Billing/Insurance Follow-Up Representative

Trinity Health
01.2020 - Current

Medical Billing Analyst

MedComm Billing Consultants
11.2016 - 01.2020

Associate of Science - Insurance Billing And Coding

Colorado Technical University

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