KIMBERLY JACKSON-CEBALLOS

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• Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
• Reviewed patient charts to better understand health histories, diagnoses, and treatments.
• Reviewed patient diagnosis codes to verify accuracy and completeness.
• Resourcefully used various coding books and procedure manuals.
• Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
• Communicated with insurance companies to research and resolved coding discrepancies.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
• Audit professional charges to be billed for all clinic locations.
• Entered surgery and anesthesia charges.
• Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
• Utilized electronic medical record systems to store, retrieve and process patient data.
• Followed up with medical staff regarding missing information in patient records.
• Verified accuracy of patient information in medical records.
• Used classification manuals to gain additional knowledge of disease and diagnoses processes.
• Maintained accuracy, completeness, and security for medical records and health information.
• Accurately posted payments and adjustments to patient accounts both electronically and manually on a regular basis via EOB.
• Processed payment via telephone and in person with focus on accuracy and efficiency.
• Identified overpayments and processed refunds for insurance carriers and patients.
• Managed large volumes of data efficiently and with great care on daily basis.
• Contacted patients with past due accounts to formulate payment plans and discuss restructuring options..
• Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
• Negotiated payment arrangements with patients to establish timely receipt of payments.
• Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
• Daily used online banking portal to download all payments and correspondence from lockboxes and basic banking accounts.
• Responsible for processing desktop deposits and credit cards payments that came into the billing office.
• Upload all payments and correspondence to shared files.
• Negotiated and signed proposals.
• Generated monthly billing and posting reports for management review.

• Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
• Answered telephone calls to offer office information, answer questions, and direct calls to staff.
• Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
• Registered and verified patient records before triage with most up-to-date information.
• Verified patient demographic information, copied documentation and directed to provided information.
• Assured timely verification of insurance benefits prior to patient procedures or appointments.
• Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
• Made contact with insurance carriers to discuss policies and individual patient benefits.
• Maintained strong knowledge of basic medical terminology to better understand services and procedures.
• Achieved insurance pre-authorizations to enable timely patient procedures.
• Updated patient records with accurate, current insurance policy information.
• Pulled consultation reports, diagnostic reports and procedure reports from transcriptionist.
• Posted payments to patient accounts and maintained records.
• Obtained payments from patients and scanned identification and insurance cards.
• Assisted with medical coding and billing tasks.
• Entered surgery center and provider charges.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Complied with HIPAA guidelines and regulations for confidential patient data.
• Assisted patients with understanding personalized insurance coverage and benefits.
• Prepared financial agreements for patients for non-covered services.
• Responded to patient concerns and questions on daily basis.
• Prepared billing statements for patients with outstanding balances.

• Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
• Obtained client medical history, medication information, symptoms, and allergies.
• Collected and documented patient medical information such as blood pressure and weight.
• Documented vital signs and health history for patients in clinic and hospital environments.
• Called and faxed pharmacies to submit prescriptions and refills.
• Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
• Completed clinical procedures and gathered patient data for interpretation by physician.
• Taught patients about medications, procedures, and care plan instructions.
• Answered telephone calls to offer office information, answer questions, and direct calls to staff.
• Completed EKGs and other tests based on patient presentation in office.
• Prepared lab specimens for diagnostic evaluation.
• Explained procedures to patients to reduce anxieties and increase patient cooperation.
• Oriented and trained new staff on proper procedures and policies.
• Updated inventory, expiration and vaccine logs to maintain current tracking documentation.
• Measured patient pulse oximetry.
• Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.
• Liaised with patients and addressed inquiries, appointment requests and billing questions.
• Performed medical records management, including filing, organizing and scanning documents.
• Sanitized, restocked, and organized exam rooms and medical equipment.
• Scheduled f/u appointments and distributed sample pharmaceuticals as prescribed.
• Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
• Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.