Summary
Overview
Work History
Education
Skills
Timeline
Hi, I’m

Kimberly Luoma

Stow,OH
Kimberly Luoma

Summary

Organized team leader builds positive rapport, inspires trust and guides teams toward achievement of organizational goals. Strong facilitator adept at working cross-departmentally with co-management and top-level leadership. Excellent trainer and mentor. Efficient billing professional with 19 years of experience. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Pragmatic Insurance Verification Specialist touting 19 years of expertise in benefits explanation and coverage tracking. A team player with a vast knowledge of medical terms and working with all types of personalities effectively. Offering dynamic organizational skills and attention to detail.

Overview

19
years of professional experience

Work History

Edgepark Medical Supplies

Medical Device Team Lead
02.2004 - 03.2023

Job overview

  • Trained new team members by relaying information on company procedures and safety requirements.
  • Coached team members in techniques necessary to complete job tasks.
  • Worked different stations to provide optimal coverage and meet production goals.
  • Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
  • Complied with HIPAA guidelines and regulations for confidential patient data.
  • Assisted patients with understanding personalized insurance coverage and benefits.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • 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.
  • Trained new staff on current, correct insurance verification procedures.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Established and maintained relationships with insurance providers for productive communications.
  • Posted payments to accounts and maintained records.
  • Performed various administrative tasks by filing, copying and faxing documents.
  • Assisted with medical coding and billing tasks.
  • Organized and maintained patient chart filing system to promote quick data finding for staff.
  • Input all patient data regarding claims and prior authorizations into system accurately.
  • Analyzed medical records and other documents to determine approval of requests for authorization.
  • Responded to inquiries from healthcare providers regarding prior authorization requests.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Reached out to insurance carriers to obtain prior authorization for testing and procedures.
  • Researched denied claims and contacted insurance companies to resolve these issues.
  • Fielded telephone inquiries on authorization details from plan members and medical staff.
  • Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
  • Evaluated clinical criteria for approval or denial of services requiring pre-authorization.

Education

Harbor High School
Ashtabula, OH

N/A

GED

04.2001

Skills

  • Team Meetings
  • Leadership
  • Collaborative Environments
  • Team Monitoring
  • Continuous Improvement Process
  • Call Transfers
  • Performance Improvement
  • Production Monitoring
  • Quality Control
  • Job Assignments
  • UAT Support
  • Team Member Motivation
  • Team-Building Exercises
  • Workload Delegation
  • User Acceptance Testing (UAT)
  • Software Application Testing
  • Insurance Requirements

Timeline

Medical Device Team Lead

Edgepark Medical Supplies
02.2004 - 03.2023

Harbor High School

N/A

GED

Kimberly Luoma