Summary
Overview
Work History
Education
Skills
Timeline
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Kimberly Higgs

Woodbridge,VA

Summary

Compassionate leader with 6+ years of experience in patient registration, insurance verification, and strict adherence to HIPAA compliance. Skilled in direct patient care, appointment scheduling, and medical terminology, consistently optimizing workflows for improved operational efficiency. Dedicated to driving continuous improvement and innovation in healthcare administration, prioritizing superior patient experiences and maintaining high-quality standards.

Overview

16
16
years of professional experience

Work History

Physician Insurance Analyst 3

Inova
04.2023 - Current
  • Company Overview: Works in a fast-paced, multi-million-dollar Level 1 trauma center with 923 beds
  • Submits over 100 clean claims daily with required attachments, ensuring timely processing
  • Resolves 50-100 pending claims within allowable timeframes, adhering to System Response Guidelines
  • Leads meetings weekly productivity and quality expectations for assigned tasks and special projects
  • Completes and submits write-off requests daily for supervisor review
  • Identifies and report payer rejection issues, providing feedback to management
  • Manages and streamlines claims submission process, ensuring 100% of clean claims are submitted daily, significantly reducing processing times
  • Ensures strict compliance with HIPAA regulations, as well as standards set by The Joint Commission (TJC), state, local, and federal guidelines pertaining to medical records, patient access procedures, and the revenue cycle
  • Identifies and resolved pending claims within defined time frames, enhancing efficiency and adherence to System Response Guidelines
  • Maintains comprehensive knowledge of payer requirements and policies, ensuring accurate and timely documentation of all account activities
  • Collaborates with management to resolve complex issues, ensuring continuous improvement in claims processing and adherence to quality standards
  • Identifies opportunities for Revenue Cycle performance improvement, contributing to enhanced departmental productivity and quality
  • Analyzes claims trends to identify root causes of rejections, implementing corrective actions to minimize future denials
  • Has an accuracy rate of over 95% to ensure all claims are processed correctly
  • Works with cross-functional teams to address payer issues, ensuring seamless claims processing and improved departmental communication
  • Ensures all claims documentation meets payer requirements, maintaining a 98% accuracy rate in claims submissions
  • Developed automated report generation tool, streamlining data analysis and enhancing decision-making efficiency
  • Works in a fast-paced, multi-million-dollar Level 1 trauma center with 923 beds

Patient Access Rep 3

Inova
01.2022 - 04.2023
  • Managed patient registration process, ensuring precise data entry and thorough insurance verification
  • Collected copayments and communicated clinic policies in adherence to HIPAA regulations
  • Addressed patient inquiries and efficiently directed calls, significantly boosting patient satisfaction
  • Coordinated appointment scheduling and streamlined insurance verification procedures, resulting in heightened operational efficiency
  • Conducted thorough reviews and updates of patient records to maintain data accuracy and completeness
  • Oversaw the seamless registration of over 500 patients monthly, enhancing both patient satisfaction and operational effectiveness
  • Verified insurance details meticulously, leading to a 15% reduction in claim rejections due to improved data accuracy
  • Optimized patient check-in protocols, reducing wait times by 20% and enhancing overall clinic workflow
  • Achieved a 99% accuracy rate in entering patient demographics, ensuring compliance with HIPAA standards and preserving data integrity
  • Collaborated closely with medical staff to facilitate appointment scheduling, improving coordination and patient care delivery
  • Implemented procedures that decreased patient wait times by 20%, thereby enhancing clinic efficiency and elevating patient satisfaction levels

Patient Coordinator

Fairfax Radiology
10.2023 - 02.2023
  • Performing account management, including patient registration using practice management software and all steps necessary to create a patient record
  • Reviewing and maintaining patient accounts accurately
  • Understanding the purpose of all clinic forms as they relate to patient care (i.e., patient records, financial forms, and insurance contracts)
  • Understanding and implementing patient flow process, including registration process
  • Performing patient management, including check in and check out procedures; assisting other departments as needed
  • Managing incoming phone calls and delivering and returning messages
  • Coordinating primary and secondary insurance plans benefits with patient treatment
  • Increased efficiency of the front office operations through effective multitasking, attention to detail, and organization skills.
  • Provided excellent customer service to all patients, addressing concerns and answering questions promptly and professionally.
  • Handled sensitive situations with empathy when dealing with distressed patients or those facing serious health challenges.
  • Maintained up-to-date knowledge on insurance policies, medical terminology, and clinic protocols in order to provide accurate information and assistance to patients.

Patient Access Rep 2

Inova
01.2021 - 01.2022
  • Embraced patients and meticulously gathered demographic and insurance data, ensuring precise recordkeeping
  • Efficiently entered patient information into electronic medical records while maintaining strict confidentiality standards
  • Adhered to HIPAA, TJC, state, local, and federal regulations governing medical records, patient access, and the revenue cycle
  • Verified insurance coverage and eligibility using online portals and direct phone communication
  • Supported appointment scheduling and conducted benefit verifications for various medical procedures
  • Managed incoming faxes concerning admissions, discharges, and authorizations with efficiency
  • Implemented effective strategies for patient data entry and insurance verification, resulting in a 15% decrease in error rates and heightened patient satisfaction
  • Collaborated closely with medical personnel to optimize patient admissions, ensuring accurate records and streamlined patient flow
  • Updated patient demographic details with meticulous care to prevent treatment errors and uphold HIPAA compliance
  • Expedited patient procedures by verifying insurance benefits and securing authorizations, thereby reducing administrative delays
  • Assisted patients in scheduling appointments and provided responsive answers to their inquiries, enhancing their overall center experience
  • Facilitated seamless patient check-in processes, contributing to a 20% reduction in wait times and boosting overall patient satisfaction levels

Patient Access Rep 1

Inova
01.2018 - 01.2021
  • Welcomed patients and meticulously entered data into the hospital database to maintain accuracy
  • Verified insurance details and handled patient concerns with a professional approach
  • Supported team members during busy periods to elevate customer service standards
  • Managed incoming calls, directed inquiries, and consistently met performance targets
  • Improved workflow efficiency by 20% through effective data management and collaboration in-patient admissions
  • Ensured precise insurance verification and data entry, resulting in a 15% reduction in billing errors and increased patient confidence
  • Contributed to a cohesive team environment by assisting colleagues during peak times, surpassing patient satisfaction goals
  • Successfully resolved patient issues with a 90% resolution rate, fostering a positive patient experience
  • Demonstrated strong problem-solving abilities in addressing complex patient inquiries, ensuring accurate information dissemination
  • Optimized insurance verification processes, reducing patient wait times by 20% and enhancing departmental efficiency

Cashier’s Assistant

Costco
12.2012 - 02.2020
  • Handled cash transactions efficiently using electronic scanners and registers, ensuring accuracy and speed
  • Processed credit/debit card payments and validated checks, maintaining a high level of customer satisfaction
  • Assisted in packing merchandise, adapting to customer preferences for optimal service
  • Trained new employees on cash handling procedures, contributing to team effectiveness
  • Implemented process improvements that enhanced transaction speed and accuracy, leading to measurable results
  • Supervised team to ensure efficient checkout processes, boosting customer satisfaction and reducing wait times by 20%
  • Led cashiering operations, ensuring accurate financial transactions and compliance with company policies, fostering a secure work environment
  • Assisted in training new hires on cash handling and customer service, enhancing team performance and cohesion
  • Streamlined packing procedures for members' merchandise, improving packing speed and reducing errors, resulting in higher customer satisfaction
  • Processed credit and debit card transactions with precision, maintaining a 99.9% accuracy rate and ensuring financial integrity

Cashier/ Customer Service

Sam's Club
11.2011 - 01.2012
  • Processed payments and issued receipts, refunds, credits, or change to customers, ensuring accuracy
  • Counted cash drawer funds at shift start to verify correct amounts and sufficient change
  • Welcomed customers, maintaining a clean and organized checkout area
  • Identified prices and tabulated bills using calculators, cash registers, or scanners
  • Delivered exceptional customer service by assisting customers with transactions, enhancing their shopping experience and ensuring satisfaction
  • Accurately processed payments and managed cash drawer, ensuring 100% accuracy in transactions and minimal discrepancies
  • Worked closely with team members to maintain a clean and organized checkout area, improving efficiency and customer flow
  • Resolved customer issues promptly, leading to increased customer retention and positive feedback

Cashier/ Accounting Associate

Wegmans
07.2010 - 07.2011
  • Fostered a welcoming environment, enhancing customer satisfaction and retention
  • Engaged with customers to identify needs, boosting product recommendations and sales
  • Ensured quality service by addressing customer concerns, improving future experiences
  • Educated on products through various training methods, enhancing service knowledge
  • Maintained loss prevention standards, reducing store losses through vigilance
  • Handled cash management tasks, ensuring accurate tills and deposits

Cashier

Safeway
10.2008 - 01.2010
  • Scanned bar codes and processed payments, ensuring accurate transactions and customer satisfaction
  • Efficiently managed customer transactions, boosting checkout speed and enhancing customer satisfaction through meticulous attention to detail
  • Implemented accurate cash handling procedures, ensuring zero discrepancies and maintaining a balanced register
  • Collaborated with team members to optimize checkout processes, improving overall store efficiency and customer experience.

Education

Associate of Science - Accounting And Finance

Northern Virginia Community College
Annandale, VA

High School Diploma -

Freedom High School
Woodbridge, VA

Skills

  • Insurance Verification
  • Payment Collection
  • Patient confidentiality
  • Eligibility Determination
  • Appointment Scheduling
  • Electronic Recordkeeping
  • Healthcare industry understanding
  • Professionalism and Ethics
  • EPIC
  • EMR System
  • Direct Patient Care
  • HIPPA Compliance
  • Clearinghouse Knowledge
  • Revenue Cycle Systems
  • Payment Collection

Timeline

Patient Coordinator

Fairfax Radiology
10.2023 - 02.2023

Physician Insurance Analyst 3

Inova
04.2023 - Current

Patient Access Rep 3

Inova
01.2022 - 04.2023

Patient Access Rep 2

Inova
01.2021 - 01.2022

Patient Access Rep 1

Inova
01.2018 - 01.2021

Cashier’s Assistant

Costco
12.2012 - 02.2020

Cashier/ Customer Service

Sam's Club
11.2011 - 01.2012

Cashier/ Accounting Associate

Wegmans
07.2010 - 07.2011

Cashier

Safeway
10.2008 - 01.2010

Associate of Science - Accounting And Finance

Northern Virginia Community College

High School Diploma -

Freedom High School

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Kimberly Higgs