Kimberlin Cabrera
Tomball,TX
Overview
9
9
years of professional experience
Work History
Medical Billing Clerk
Therapy for life
Houston , TX
05.2023 - Current
Medical Biller and Coder/Authorization Specialist
Therapy for life
Houston , TX
05.2023 - Current
- Submitted claims to insurance companies electronically or by mail.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Prepared financial statements that summarize account activity over a period of time.
- Monitored the progress of outstanding appeals and escalated unresolved cases as necessary.
- Compiled evidence to support appeals, including medical records, bills, and other documentation.
- Assessed denial reasons for accuracy and completeness.
- Identified trends in denied claims that may require further investigation.
- Coordinated with other departments within the organization to ensure timely resolution of claims issues.
- Maintained accurate records of all communications with insurance companies and healthcare providers.
- Reviewed appeal documents and identified discrepancies in claim information.
- Interpreted policies to determine coverage eligibility for appeals.
- Drafted letters to insurance companies regarding appeals and claims status.
- Provided updates on appeal statuses to patients as requested.
- Prepared reports for management detailing collection efforts and outcomes.
- Reviewed documentation and accounts to gain full picture.
- Verified details with policyholders and requested additional information.
- Analyzed claims data to identify trends and recommend changes to reduce risk and prevent fraud.
- Reviewed and processed authorization requests for medical services efficiently.
- Communicated with insurance providers to verify patient coverage and eligibility.
- Maintained accurate records of authorizations in electronic health systems.
- Educated patients on authorization processes and required documentation.
- Resolved discrepancies in authorizations through effective problem-solving techniques.
- Researched patient eligibility, coverage information, and benefit levels.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Coordinated communication between providers, patients, payers, and other departments as needed.
- Reviewed authorization requests for accuracy and completeness.
Billing Clerk
Spring Branch Community Health Center
Houston , TX
09.2022 - 05.2023
- Processed invoice payments and recorded information in account database.
- properly code services, procedures, diagnosis, and treatments.
- sending off claims and invoices for payment.
- posting payments.
- Submitted clean claims to insurance companies electronically to secure payments.
- Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- take phone calls from patients, with any concerns regarding their bill.
- keeping track of payments.
- Investigated rejected and denied claims, correcting applicable coding.
- Experience with IMS,ECW,MEDFORMIX.
- Medicare,Medicaid, and private insurance claims.
- use EOB to explain how insurance is processed for the claim for the services the patient received.
- Familiar with Community health choice and United Healthcare
Health Care Advocate
Accolade
Houston, TX
03.2022 - 08.2022
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Developed strong customer relationships to encourage repeat business.
- inform patients of benefits included in their insurance.
- educate patient on 2nd md.
- listen closely to every concern related to their health
Customer Service
FMA Alliance
Tomball, TX
08.2017 - 02.2022
- Answer all questions and guide borrowers through the application process.
- Assist customers with completing loan applications and other related loans documentation.
- update consumer's account information during and after each call.
- Identify payment options: set up payment arrangements as appropriate.
- Follows policies and procedures; complete administrative task correctly and on time.
Clerk/Cashier
Honda of Tomaball
Tomball, TX
06.2016 - 07.2017
- Operated cash register or POS system to receive payment by cash, check and credit card.
- Accepted cash and credit card payments, issued receipts and provided change.
- Answered customer questions and provided store information.
- Delivered high level of customer service to patrons using active listening and engagement skills.
- Completed daily recovery tasks to keep areas clean and neat for maximum productivity.
Education
Certified Medical Biller And Coder -
Collage of Health Care Professions
Houston 03.2022
Skills
- Healthcare claim coding
- Data entry
- Medical terminology
- Medical record security
- Account updating
- Appeals
- explanation of benefits
- customer service
- know how to read EOBS
- fast learner
- experience with ECW,IMS,MEDFORMIX EMR systems
- Bilingual
Additional Information
- Willing to Relocate.
Timeline
Medical Billing Clerk
Therapy for life
05.2023 - Current
Medical Biller and Coder/Authorization Specialist
Therapy for life
05.2023 - Current
Billing Clerk
Spring Branch Community Health Center
09.2022 - 05.2023
Health Care Advocate
Accolade
03.2022 - 08.2022
Customer Service
FMA Alliance
08.2017 - 02.2022
Clerk/Cashier
Honda of Tomaball
06.2016 - 07.2017
Certified Medical Biller And Coder -
Collage of Health Care Professions