Summary
Overview
Work History
Education
Skills
Timeline
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Kimberly Jackson

Broken Arrow,OK

Summary

Cordial Patient Access Representative with 10 year track record of successfully handling busy medical office tasks to serve diverse populations. Career-minded and organized professional skillful in maintaining patient accounts, arranging immediate medical care and verifying insurance claims. Familiar with medical and clinical terminology coupled with proficiency in MS Office.

Overview

11
11
years of professional experience

Work History

Patient Access Lead

OSU Medical Center
06.2024 - Current
  • Maintained strict adherence to HIPAA regulations, protecting sensitive patient information from unauthorized access or disclosure.
  • Improved revenue cycle management by verifying insurance eligibility and obtaining necessary authorizations.
  • Promoted a positive workplace culture by demonstrating respect, empathy, and professionalism in all interactions with patients, colleagues, and other stakeholders.
  • Conducted regular audits of patient accounts to identify discrepancies, resulting in improved financial outcomes for the organization.
  • Resolved complex billing issues, working closely with insurance companies to ensure prompt payment for services rendered.
  • Stayed calm under pressure to and successfully dealt with difficult situations.
  • Verified patient insurance eligibility and entered patient information into system.
  • Followed document protocols to safeguard confidentiality of patient records.
  • Collaborated with healthcare providers to ensure proper documentation for successful authorizations.
  • Achieved higher accuracy rates in authorizations, utilizing attention to detail and organizational skills.
  • Streamlined insurance authorization processes by implementing efficient workflow strategies.
  • Coordinated pre-authorization requirements for medical treatments or services, enhancing overall patient experience before appointments.
  • Managed high-volume caseloads to meet strict submission deadlines, prioritizing tasks accordingly.
  • Maintained comprehensive knowledge of various insurance plans, ensuring accurate information was provided during the authorization process.
  • Assisted billing department in resolving outstanding claims-related issues leading to increased revenue collection.
  • Contributed to revenue growth, securing necessary authorizations for medical procedures promptly and accurately.

Customer Service Representative

OSU Medical Center
09.2023 - 07.2024
  • Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
  • Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
  • Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
  • Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
  • Maintained accurate records of customer interactions, ensuring proper documentation within the company''s database.
  • Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
  • Developed strong relationships with clients by providing empathetic support and understanding during challenging health situations.
  • Negotiated payment plans with patients, maintaining a high rate of successful payments.
  • Enhanced patient satisfaction by effectively explaining financial options and answering billing inquiries.
  • Provided compassionate assistance to financially challenged patients, identifying potential sources of funding or discounts when applicable.
  • Developed customized payment solutions based on individual patient needs, promoting long-term account sustainability.

Patient Access Representative Supervisor

OSU Medical center
01.2022 - 09.2023
  • Applied HIPAA privacy and security regulations while handling patient information
  • Verified demographics and insurance information to register patients in computer system
  • Organized and maintained records by updating and obtaining both personal and financial information from patients
  • Obtained necessary signatures for privacy laws and consent for treatment
  • Assembled registration paperwork and placed identification bands on patient
  • Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations
  • Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans
  • Explained various admission forms and policies, acquiring signatures for consent
  • Checked stock to determine inventory level and placed orders for needed supplies
  • Communicated financial obligations to patients and collected fees at time of service
  • Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information
  • Responded to patient concerns and inquiries professionally and efficiently
  • Called insurance companies and verified patient coverage
  • Interviewed patients upon entrance to hospital, gathered appropriate information and entered data into electronic system
  • Delegated work to staff, setting priorities and goals
  • Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs
  • Guided employees in handling difficult or complex problems
  • Reviewed reports on employee attendance, productivity and effectiveness to evaluate performance
  • Issued work schedules, duty assignments and deadlines for office or administrative staff
  • Coordinated with other supervisors, combining group efforts to achieve goals
  • Consulted with managers to resolve problems relating to employee performance, office equipment and work schedules
  • Discussed job performance problems with employees, identifying causes and issues to find solutions
  • Resolved customer complaints or answered customers' questions
  • Developed work schedules according to budgets and workloads, covering priority tasks
  • Reviewed employees' work to check adherence to quality standards and proper procedures
  • Trained employees on best practices and protocols while managing teams to maintain optimal productivity.

Patient Access Representative

OSU Medical center
05.2021 - 01.2022
  • Applied HIPAA privacy and security regulations while handling patient information
  • Verified demographics and insurance information to register patients in computer system
  • Organized and maintained records by updating and obtaining both personal and financial information from patients
  • Obtained necessary signatures for privacy laws and consent for treatment
  • Assembled registration paperwork and placed identification bands on patient
  • Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations
  • Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans
  • Explained various admission forms and policies, acquiring signatures for consent
  • Checked stock to determine inventory level and placed orders for needed supplies
  • Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information
  • Reviewed eligibility responses to assess patient benefit level and prepare estimates
  • Responded to patient concerns and inquiries professionally and efficiently
  • Called insurance companies and verified patient coverage
  • Interviewed patients upon entrance to hospital, gathered appropriate information and entered data into electronic system.

Bartender

Chuys Tulsa
05.2020 - 05.2021
  • Handled complaints and disputes from customers to promote customer satisfaction
  • Managed bar area, cocktail design and menu and handled inventory, regulation compliance and customer relationships
  • Upsold customers from shelf to premium brands to help boost sales
  • Recommended food and drinks to patrons based on preference, pairings and special promotions
  • Ordered and maintained inventory of bar products, alcohol, soft drinks and supplies to drive high volume of sales
  • Offered seating and other special accommodations to customers according to preferences and dining area volume
  • Managed high volume of shift customers and simultaneously assisted restaurant servers with diverse needs
  • Collected and organized daily till totals and tips
  • Kept track of bar tabs and transferred open tabs to dining area for wait staff
  • Stayed up-to-date on latest mixology trends, bar equipment and sanitation standards
  • Maintained knowledge of bar and menu options to prepare drinks and make food recommendations
  • Completed regular bar inventories and daily requisition sheets
  • Trained new bartenders on drink preparation and upselling techniques
  • Displayed and retained extensive knowledge of liquors, wines and entrees
  • Checked identification of guests to verify age requirements for alcohol purchase.

Appeals Specialist

BCBS of Okalhoma
06.2018 - 05.2020
  • Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions
  • Monitored reports to identify claims issues and worked with adjusters to resolve problems
  • Acted as intermediary between insurance companies and customers by researching and assessing information to determine claim validity
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
  • Checked documentation for appropriate coding, catching errors and making revisions
  • Transcribed data to worksheets and entered data into computer to prepare documents and adjust accounts
  • Checked computations of interest accrued, premiums due and settlement surrender on loan values
  • Coordinated and planned investigations of claims to confirm compensability and coverage
  • Prepared and reviewed insurance-claim forms and related documents for completeness
  • Assisted claimants, providers and clients with problems or questions regarding claims
  • Drafted statements of loss to summarize payments, underlying policy coverages and damages
  • Used insurance rate standards to calculate premiums, refunds, commissions and adjustments
  • Corresponded with insured or agent to obtain information or inform of account status or changes
  • Processed claims for payment or forwarded to appropriate personnel for further investigation
  • Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance
  • Organized information by using spreadsheets, databases or word processing applications
  • Precisely calculated refunds, premiums and adjustments.

Medical Receptionist

APEX Family Medicine
11.2017 - 04.2018
  • Entered insurance, demographics and health history into patient database
  • Called patients to confirm scheduled appointments and obtain additional details
  • Checked patients in and out for appointments and collected co-payments
  • Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files
  • Processed patient payments and scanned identification and insurance cards
  • Protected patients by observing strict HIPAA guidelines
  • Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments
  • Took messages from patients and promptly relayed to appropriate staff
  • Answered multi-line phone system and directed callers to requested personnel and departments
  • Greeted each patient pleasantly and offered desk sheet for easy sign-in
  • Delivered high-quality administrative and customer service to sustain patient and work flows
  • Carried out daily tasks by professionally communicating with physicians, nursing staff, technicians and medical assistants
  • Retrieved faxes and uploaded documents to patient charts to assist clinical staff
  • Straightened up waiting room to maintain neat and organized space
  • Managed office phone lines by checking voicemail, returning calls and directing messages to team members
  • Informed patients of financial responsibilities prior to rendering services
  • Conducted patient intake interviews to collect medical information and insurance details
  • Gathered, transcribed and typed medical information into charts
  • Compiled physical and digital documents, charts and reports
  • Greeted patients and visitors to answer questions or refer inquiries to appropriate personnel
  • Trained new staff on office procedures, insurance processes and medical terminology
  • Scheduled appointments, optimizing patient satisfaction, provider time and treatment room utilization
  • Maintained patient accounts by obtaining, recording and updating personal and financial information
  • Applied knowledge of medical terminology and insurance processes to support office administration productivity.

Patient Administration Coordinator

06.2013 - 01.2017
  • Confirmed patient information, collected copays and verified insurance
  • Stayed current on community-based resources and services useful to patients
  • Counseled patients on potential financial liabilities and payment requirements
  • Organized timely and accurate referrals to help patients obtain health care services and access available resources
  • Compiled information from patients and caregivers or family members to identify care concerns
  • Cultivated positive relationships with patients to help facility meet satisfaction scores and patients obtain best possible care
  • Collaborated with clinical and administrative staff to meet patient needs
  • Instructed patients on policies and required actions for different types of appointments and procedures
  • Initiated application processes to add patients to assistance programs at bedside and followed through until completion
  • Screened patients for eligibility for state, local and federal assistance programs
  • Documented patient counters in hospital system and initiated follow-up actions
  • Received patient inquiries or complaints and directed to appropriate medical staff members
  • Taught volunteers how to relate to guests, uphold patients' rights and respond to specific issues
  • Drafted educational brochures and informative newsletters for patients and staff
  • Verified patients' insurance and payment methods during admissions or check-in processes
  • Reported liabilities and risk management concerns to supervisor for review
  • Obtained informed consent and payment documentation from patients and filed in system
  • Explained policies, procedures and services to patients
  • Completed registration procedures for patients, expertly inputting information to meet provider, facility and legal requirements
  • Accessed programs and set up correct payment strategies based on patient means and needs
  • Verified documentation methodically to avoid critical errors impacting care delivery and payments for services.

Education

Bachelors of Science in Health Care Management -

Oral Roberts University
Tulsa, OK
05-2027

High school diploma -

Brighton charter school
05.2004

Skills

  • Insurance company knowledgeable
  • Regulatory compliance
  • Appointment scheduling
  • Payment processing
  • Appointment confirmation
  • Patient interviewing skills
  • Medical billing
  • Bookkeeping support
  • Recording histories
  • Medical filing
  • Organization
  • Conflict resolution
  • Good work ethic
  • Troubleshooting
  • Multitasking
  • Critical thinking
  • Team building
  • Scheduling and calendar management
  • File and data retrieval systems
  • Data entry
  • PPE use
  • Decision-making
  • Communication
  • People skills
  • Planning & organizing
  • Organizational skills
  • Team management
  • Relationship building
  • Negotiation
  • Administrative management
  • Friendly, positive attitude
  • Supervision & leadership
  • Reliable & trustworthy
  • Problem resolution

Timeline

Patient Access Lead

OSU Medical Center
06.2024 - Current

Customer Service Representative

OSU Medical Center
09.2023 - 07.2024

Patient Access Representative Supervisor

OSU Medical center
01.2022 - 09.2023

Patient Access Representative

OSU Medical center
05.2021 - 01.2022

Bartender

Chuys Tulsa
05.2020 - 05.2021

Appeals Specialist

BCBS of Okalhoma
06.2018 - 05.2020

Medical Receptionist

APEX Family Medicine
11.2017 - 04.2018

Patient Administration Coordinator

06.2013 - 01.2017

Bachelors of Science in Health Care Management -

Oral Roberts University

High school diploma -

Brighton charter school

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Kimberly Jackson