Kimberly Hernden

Medical Billing Supervisor

Cardiology Associates of Port Huron

Port Huron, MI

02.2024 - 01.2025

Created monthly financial reports summarizing revenue cycle performance metrics such as denials, payment lag time.
Reviewed claims prior to submission to determine accuracy and completeness.
Resolved any billing issues that arose in a timely manner.
Responded promptly to inquiries from patients or insurance companies regarding bills or payments.
Recommended solutions related to staffing issues and proposed procedural changes to managers.
Guided employees in handling difficult or complex problems.
Resolved customer complaints or answered customers' questions.
Posting electronic insurance payments.
Reviewed employees' work to check adherence to quality standards and proper procedures.
Posting paper checks.
Working on front-end rejections from the clearinghouse.
Credentialing.
Data entry for procedure and hospital billing.

Account Representative Par III

McLane CBO

Shelby, MI

06.2016 - 12.2023

Responsible for Billing, Follow-Up, Reporting and Denials
Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
Communicated with insurance providers to resolve denied claims and resubmitted.
Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others
Analyzed accounts for delinquencies and other ongoing issues.

Medical Coding and Billing Specialist

Best Medical Billing

Cottrellville , MI

01.2001 - 01.2018

Collected payments and applied to patient accounts.
Liaised between patients, insurance companies, and billing office.
Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
Printed and reviewed monthly patient aging report and solicited overdue payments.
Communicated with insurance providers to resolve denied claims and resubmitted.
Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
Filed and updated patient information and medical records.
Managed collections claims for unpaid bills against estates of debtors.
Located errors and promptly refiled rejected claims.
Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
Evaluated patients' financial status and established appropriate payment plans.
Prepared billing correspondence and maintained database to organize billing information.
Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Precisely completed appropriate claims paperwork, documentation and system entry.
Precisely evaluated and verified benefits and eligibility.
Posted and adjusted payments from insurance companies.
Identified and resolved patient billing and payment issues.
Maintained and updated collections tracking spreadsheet to help organize payment information.
Printed and reviewed monthly patient aging report and solicited overdue payments
Communicated with insurance providers to resolve denied claims and resubmitted
Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
Filed and updated patient information and medical records
Liaised between patients, insurance companies, and billing office
Collected payments and applied to patient accounts
Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy
Maintained and updated collections tracking spreadsheet to help organize payment information
Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts
Communicated effectively and extensively with other departments to resolve claims issues
Precisely evaluated and verified benefits and eligibility
Pre-certified medical and radiology procedures, surgeries and echocardiograms
Managed collections claims for unpaid bills against estates of debtors
Evaluated patients' financial status and established appropriate payment plans
Posted and adjusted payments from insurance companies
Located errors and promptly refiled rejected claims
Precisely completed appropriate claims paperwork, documentation and system entry
Prepared billing correspondence and maintained database to organize billing information
Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers
Identified and resolved patient billing and payment issues
Input data into computer programs and filing systems.
Followed exact procedures for handling transfers and other releases of medical records.
Transcribed and entered patient medical information into electronic medical records systems.
Correctly coded and billed medical claims for various hospital and nursing facilities.
Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Utilized electronic medical record systems to store, retrieve and process patient data.
Tracked and monitored requests for medical records release.
Identified new methods to optimize medical records management.
Generated and maintained statistical data related to medical records.
Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement
Attained up-to-date knowledge of coding requirements through continuing education courses and certification renewal
Verified signatures and checked medical charts for accuracy and completion
Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others
Input data into computer programs and filing systems
Followed exact procedures for handling transfers and other releases of medical records
Reviewed medical records for completeness and filed records in alphabetic and numeric order
Communicated effectively with staff, patients, and insurance companies by email and telephone
Transcribed and entered patient medical information into electronic medical records systems
Assisted in preparation of medical reports for external parties
Tracked and monitored requests for medical records release
Generated and maintained statistical data related to medical records
Used classification manuals to gain additional knowledge of disease and diagnoses processes

Summary

Overview

Work History

Medical Billing Supervisor

Account Representative Par III

Medical Coding and Billing Specialist

Education

CPC - CPC

CMRS Certification - Medical Billing Specalist

Skills

Education

Contact

Personal Information

Timeline

Medical Billing Supervisor

Account Representative Par III

Medical Coding and Billing Specialist

CPC - CPC

CMRS Certification - Medical Billing Specalist

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