Kimberly Forbes
Medical Biller
San Antonio,TX
Summary
Dedicated Medical Billing Specialist with 12 years of experience in handling wide variety of medical background specialized billing and collections. Worked front and back office in private specialty practice including workman's compensation. Excellent customer service and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in re-bills, collection, appeals and denials. Focused Billing Clerk with seven years of experience. Skilled in education, building client and vendor rapport, inventory and storage management for office and retail products. Account management and collection specializing in outstanding balance receivables. Hardworking, goal oriented and energetic with a passion for accuracy and efficiency.
Overview
11
11
years of professional experience
1
1
Certification
Work History
MEDICAL BILLER & COLLECTION-Workman Comp
American Medical Rehab & D.M.E-Contract
01.2024 - 05.2024
- Reviewed accident and injury reports and Doctors First Report of Injury forms to determine proper actions under Workers Compensation laws and regulations; obtain background information as part of claim investigation; review and pay related medical bills, disability benefits and expenses.
- Responsible for DME billing, negotiation & reimbursement issues of equipment and supplies for third party payment, i.e.
- Analyzed aging reports, audited patient accounts, and followed up on past due balances.
- Meticulously prepared electronic and paper claims and sent to various PPO, Workers' Compensation & Medicare payors.
- Received, reviewed, and processed all insurance re-bills, denials and appeals.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted charges for practice providers.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Managed billing calendar and scheduled claims for payments.
- Posted payments and collections on regular basis.
- Liaised between patients, insurance companies and billing office.
- Verified insurance of patients to determine eligibility.
- Filed and updated patient information and medical records.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
Medical Billing and Collections Specialist
Sports Medicine ,Orthopedics And Surgery -Contract
10.2023 - 02.2024
- Meticulously prepared electronic and paper claims and sent to various PPO, Workers' Compensation, School claims & Medicare payors.
- Received, reviewed, and processed all insurance re-bills, denials and appeals.
- Posted payments for 5 satellite offices
- Located errors and promptly refiled rejected claims.
- Prepared billing correspondence and maintained database to organize billing information.
- Managed billing calendar and scheduled claims for payments.
- Liaised between patients, insurance companies and billing office.
- Checked modifiers, appeals,collections,called insurance companies
Medical Billing & Medical Assistance
DR V SPARKS,LLC
01.2013 - 05.2020
- Orchestrated medical coding, payment posting, accounts receivables and collections.
- Filed and updated patient information and medical records.
- Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
- Liaised between patients, insurance companies and billing office.
- Created weekly, monthly and quarterly expense reports.
- Handled electronic court filings and coordinated court activities.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Verified insurance,referrals, authorizations.
- Maintained professional demeanor while communicating with patients or insurance companies to resolve payment issues, fostering positive relationships.
- Prepared billing correspondence and maintained database to organize billing information.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Delivered timely and accurate charge submissions.
- Workman Comp
- Back office duties , Medical Assistant,labs,vitals
Education
Medical Insurance Billing
UTSA
San Antonio, United States05.2024
Medical Assistant, Medical Administration
Kennesaw State University
Kennesaw, GA01.2011
Skills
- Billing systems and software: eClinical Works, Office Ally, NexGen, Amazingcharts, BrightTree, Salesforce
- Month-end closing procedures, Referrals, Authorization
- Insurance Knowledge
- Payor Portals: TriZetto, Availity, Medicare, Optum360, Navinet, Medicare, Medisoft, Tricare, UHC
- Revenue Cycle Management
- Workers' Compensation and DME
- A/P and A/R expertise
- Calls center
- Networking
- Enthusiasm
- Professionalism
- Communication Skills
- Teamwork
- Problem Solving and Critical Thinking
- Medical Assistant, vitals, skincare, Medical Spa
Certification
CCS-P - Certified Coding Specialist - Physician - Based
CPB - Certified Professional Biller
Timeline
MEDICAL BILLER & COLLECTION-Workman Comp
American Medical Rehab & D.M.E-Contract
01.2024 - 05.2024
Medical Billing and Collections Specialist
Sports Medicine ,Orthopedics And Surgery -Contract
10.2023 - 02.2024
Medical Billing & Medical Assistance
DR V SPARKS,LLC
01.2013 - 05.2020
Medical Insurance Billing
UTSA
Medical Assistant, Medical Administration
Kennesaw State University
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