KIMBERLY BRUNSON
Eugene,OR
Summary
Professional in healthcare administration with strong background in managing authorization processes. Adept at ensuring compliance, streamlining workflows, and mitigating risks. Consistent track record of fostering team collaboration and achieving results in dynamic environments. Skilled in navigating complex systems, prioritizing tasks, and maintaining high standards of accuracy and efficiency.
Overview
11
11
years of professional experience
Work History
Prior Authorization Specialist
Keiper Spine PC
02.2024 - Current
- Reviewed medical records thoroughly before submitting them for preauthorization review process
- Maintained up-to-date knowledge of insurance policies and procedures related to prior authorization requirements
- Managed incoming calls from providers regarding status updates of pending authorizations
- Review and audit claims submitted by outside billing company
- Review medical records for ourside billing company
- Analyzed provider contracts for specific information related to prior authorizations or benefit coverage details
- Communicated with others to obtain and verify eligibility information
- Submit contracts and Re-credentialing for providers with insurance companies
Medical Billing Specialist
Two Rivers Surgery Center
06.2022 - 02.2024
- Maintained up-to-date records of payments received from insurance companies, patients, and other sources
- Utilized electronic billing systems to submit claims to insurance providers in a timely manner
- Researched denied or rejected claims for accuracy and took appropriate action to resolve discrepancies
- Adhered to HIPAA regulations when handling confidential patient information
- Answered all patient or insurance telephone inquiries pertaining to assigned accounts
- Provided excellent customer service when responding to inquiries from patients regarding their bills or other related matters
- Developed detailed knowledge of CPT coding system, insurance regulations, and medical terminology
Medical Billing Specialist
Eugene Gastroenterology
10.2021 - 06.2022
- Maintained up-to-date records of payments received from insurance companies, patients, and other sources
- Researched denied or rejected claims for accuracy and took appropriate action to resolve discrepancies
- Adhered to HIPAA regulations when handling confidential patient information
- Answered all patient or insurance telephone inquiries pertaining to assigned accounts
Medical Receptionist
Oregon Lung Specialist
12.2013 - 09.2021
- Managed patient check-ins by verifying insurance coverage, collecting payments, and updating accounts accordingly
- Answered phones promptly and directed calls appropriately
- Screened incoming phone calls, taking messages or forwarding to appropriate staff
- Scanned and documented new patient information in electronic health records for registration purposes
- Greeted patients immediately upon arrival, providing excellent customer service
- Collected co-payments and co-insurance and issued appropriate receipts during check-in
- Scheduled appointments, managed calendars, and coordinated meetings efficiently
Education
High School Diploma -
Thurston High School
Springfield, OR06.1995
Skills
- Legal Standards
- Strategic Initiatives
- Collection Calls
- Client Inquiries
- Diagnostic Codes
- Medicare and Medicaid Processes
- Healthcare Terminology
- CPT Code Modifiers
- Accounts Payable and Accounts Receivable
- Prior Authorization Process
- Medical Appeals Handling
- Insurance Verification
- Medicare and Medicaid knowledge
- CPT coding knowledge
- Electronic Health Records Proficiency
Timeline
Prior Authorization Specialist
Keiper Spine PC
02.2024 - Current
Medical Billing Specialist
Two Rivers Surgery Center
06.2022 - 02.2024
Medical Billing Specialist
Eugene Gastroenterology
10.2021 - 06.2022
Medical Receptionist
Oregon Lung Specialist
12.2013 - 09.2021
High School Diploma -
Thurston High School
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