Kimberly Bester

Performs adjustments prepares researches and collects from various contracted health insurance payers and getting prior authorization.

Researches remits an EOBs for complete accurate payments or denials. Provides or arranges for additional information when needed.

Submits corrected claims or appeals. Request appropriate adjustments, when required and correct diagnosis codes.

• Improved claim resolution times by consistently following up on outstanding insurance claims and diligently addressing any discrepancies.
• Supported team members in claim follow-up efforts, contributing to overall departmental success through proactive collaboration and information sharing.
• Investigated and resolved customer inquiries and complaints quickly.

Works on behalf of the lender assembles and verifies all the closing documents require by Title company

Make sure to update if needing extending days for closing and funding.

• Maintained high level of customer satisfaction by providing prompt and accurate loan status updates.
• Assisted clients in selecting correct loan product and terms to meet needs and financial goals.
• Followed up with clients on missing loan documents, providing guidance on best way to complete application process.
• Communicated with clients, processing teams and other third parties to achieve prompt loan closings.
• Reviewed loan files and updated to match current standards.

Audits and monitors outstanding claims to resolve outstanding balances, Secure accurate and timely payments from Medicare, Medicaid, secondary to Medicare, Commercial , Tricare and Workers comp.

• Collaborated with team members to achieve monthly targets, promoting a positive work environment and boosting overall productivity.
• Improved customer satisfaction by effectively resolving delinquent accounts through negotiation and payment plans.
• Negotiated to collect balance in full.
• Contacted customers to discuss payment schedules and set up or immediately process payments.

Review patient accounts for incorrect billing, research insurance payments to identify and correct posting errors.

Reviews accounts to ensure prior authorization, process refunds to patients and insurance companies.

• Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
• Contributed to team success by participating in regular training sessions, sharing best practices, and mentoring new adjusters.
• Examined claims forms and other records to determine insurance coverage.

Review and process Insurance claims, verify all insurance information resolve billing issues and claim edits.

• Increased departmental accuracy by implementing quality control measures for claim submissions and reimbursements.
• Provided exceptional customer service, addressing inquiries regarding coverage, benefits, and claim statuses promptly and professionally.
• Verified patient insurance coverage and benefits for medical claims.
• Monitored and updated claims status in claims processing system.
• Paid or denied medical claims based upon established claims processing criteria.
• Managed large volume of medical claims on daily basis.
• Served as an expert resource for colleagues on medical coding systems such as ICD-10, CPT, and HCPCS Level II coding conventions.