Kimberly Everett
Milton,FL
Summary
Detail-oriented professional with focus on deadlines and able to function in a multi-task environment.
Driven Medical Biller motivated to perform beyond expectations, reliable, and competent with exceptional data entry skills.
Overview
10
10
years of professional experience
Work History
Research Claims Expert - DSNP
BCBST
Chattanooga, TN
04.2013 - 08.2021
- Can work both independently and collaboratively in fast-paced environment.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Process DME, inpatient and outpatient services.
- Located errors and promptly refile rejected claims.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Review prior authorization information via nurse notes.
- Adhered to established standards to safeguard patients' health information.
- Delivered timely and accurate charge submissions.
- Evaluated accuracy and quality of data entered into claim management system.
- Calculate claim adjustments and overpayments.
- Process corrected claims.
- Maintain and ensure appropriate turn around time of 30 days on CSR provider inquiries.
Claims Processor - Host
BCBST
Chattanooga, TN
03.2011 - 04.2013
- Maintained knowledge of benefits claim processing, claims principles, procedures and HIPAA regulations.
- Process corrected claims.
- Maintain timely filing criteria as set by insurance guidelines.
- Located errors and promptly refiled rejected claims.
- Processed required per day number of claims in order to achieve required company quota of 100.
Education
Associate of Applied Science - Medical Secretary
Mckenzie Business
Chattanooga, TN06.1986
Skills
- Billing Data Verification
- Problem Sensitivity
- Discrepancy Resolution
- Team Collaboration
- Conflict Resolution
- Work Planning and Prioritization
- Work Coordination
- Charges and Rates Documentation
- Decision Making
- Deadline Adherence
- 10-Key Data Entry
- Inquiry Handling
Timeline
Research Claims Expert - DSNP
BCBST
04.2013 - 08.2021
Claims Processor - Host
BCBST
03.2011 - 04.2013
Associate of Applied Science - Medical Secretary
Mckenzie Business