Summary
Overview
Work History
Education
Skills
Timeline
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Kimberly Diaz

Phenix City,AL

Summary

Service-oriented Claims Analyst, skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.

Overview

12
12
years of professional experience

Work History

Claims Analyst

East Alabama Health
06.2022 - Current
  • Viewed reports regularly to make sure processing was conducted efficiently.
  • Maintained strict confidentiality with all personal data as per company guidelines.
  • Interacted with clients and employees, which helped cultivate positive working relationships.
  • Identified key areas not performing well and implemented effective, new processes.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.

Patient Registration Representative

East Alabama Health
05.2021 - 06.2022
  • Explained financial responsibilities to patients as well as payment options and potential collection procedures imposed upon patients and other responsible parties.
  • Secured patient privacy by learning and following HIPAA regulations to keep organization compliant with relevant laws.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Maintained clean and organized workspaces to promote smooth operation and easy access to patient information.
  • Collected payments and co-pays from customers using large variety of insurance programs, adjusting amounts based on specific plan directives.
  • Accurately inputted patient and insurance information into company's computer system using (Cerner).
  • Set up patients in system by documenting key data, confirming eligibility, and verifying insurance benefits.
  • Gathered demographic and insurance information to register patients for medical appointments.
  • Verified insurance coverage to confirm patient coverage for necessary medical services.
  • Provided counseling to help patients navigate financial assistance programs for uncovered bills.
  • Obtained payments from patients and scanned identification and insurance cards.

Operations Manager

Men's Wearhouse
01.2014 - 04.2021
  • Supervised operations staff and kept employees compliant with company policies and procedures.
  • Developed systems and procedures to improve operational quality and team efficiency.
  • Managed inventory and supply chain operations to achieve timely and accurate delivery of goods and services.
  • Led hiring, onboarding and training of new hires to fulfill business requirements.
  • Developed and maintained relationships with external vendors and suppliers.
  • Established positive and effective communication among unit staff and organization leadership, reducing miscommunications, and missed deadlines.
  • Trained new employees on proper protocols and customer service standards.
  • Trained and guided team members to maintain high productivity and performance metrics.
  • Scheduled employees for shifts, taking into account customer traffic and employee strengths.
  • Observed each employee's individual strengths and initiated mentoring program to improve areas of weakness.
  • Monitored daily cash discrepancies, inventory shrinkage and drive-off.
  • Implemented business strategies, increasing revenue and effectively targeting new markets.

Certified Nursing Assistant

Orchardview Nursing Home
09.2017 - 03.2019
  • Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
  • Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
  • Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
  • Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
  • Oversaw and maintained patients' rooms, group living areas, and nurse stations.
  • Helped clean and prepare patient consultation rooms to maintain hygiene standards
  • Documented patient information and care activities in electronic health record.
  • Helped patients with self-feeding and assisted feeding, based on individual needs.
  • Reduced risks of patient infection and cross-contamination by cleaning and sterilizing equipment.
  • Transported patients between rooms and appointments or testing locations.

General Packer

Synder-Lance
10.2011 - 10.2013
  • Collaborated with team members to achieve daily goals and meet company objectives.
  • Maintained neat and organized work area to safeguard items and comply with cleanliness standards.
  • Inspected items to identify discrepancies and damages and reported to supervisor.
  • Completed daily orders with expert picking and packing of shipments.
  • Picked and packed order items.
  • Managed timely and effective replacement of damaged or missing products.
  • Prepared and checked outbound shipments for accuracy.

Education

Bachelor of Science - Health Administration

University of Phoenix
Tempe, AZ
05.2020

Skills

  • Document Workflow
  • Claims Review
  • Interpersonal and Written Communication
  • Proficient in [Software]
  • Claims
  • Dispute Tracking
  • Problem Solving
  • Multitasking
  • Active Listening
  • Customer Service
  • Computer Proficiency
  • Claim Investigation
  • Attention to Detail
  • Claims Analysis
  • Time Management

Timeline

Claims Analyst

East Alabama Health
06.2022 - Current

Patient Registration Representative

East Alabama Health
05.2021 - 06.2022

Certified Nursing Assistant

Orchardview Nursing Home
09.2017 - 03.2019

Operations Manager

Men's Wearhouse
01.2014 - 04.2021

General Packer

Synder-Lance
10.2011 - 10.2013

Bachelor of Science - Health Administration

University of Phoenix

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Kimberly Diaz