Kimberly Malone
North Richland Hills,TX
Summary
Diligent medical billing experience with solid background in credentialing processes and compliance management. Successfully managed credentialing for diverse healthcare providers, ensuring adherence to regulatory standards. Demonstrated expertise in meticulous documentation and effective communication with credentialing entities.
Reliable Medical Biller with coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills.
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Owner/General Manager
Precise Precision General Services
03.2012 - Current
- Managed day-to-day business operations.
- Developed and maintained strong relationships with clients, resulting in repeat business and referrals.
- Trained and motivated employees to perform daily business functions.
- Interacted well with customers to build connections and nurture relationships.
- Cultivated and strengthened lasting client relationships using strong issue resolution and dynamic communication skills.
- Handled problematic customers and clients to assist lower-level employees and maintain excellent customer service.
- Scheduled employees for shifts, taking into account customer traffic and employee strengths.
- Managed purchasing, sales, marketing and customer account operations efficiently.
Medical Staff Credentialing Coordinator
IntelliCentrics
08.2021 - 10.2024
- Reduced turnaround time for medical staff applications through effective communication with applicants and thorough document reviews.
- Maintained confidentiality of sensitive information while handling large volumes of physician applications and records.
- Ensured compliance with regulatory standards by regularly updating and maintaining physician credentials files.
- Conducted thorough primary source verifications, ensuring accuracy and validity of physician qualifications.
- Successfully managed high volume of workload while maintaining attention to detail and accuracy in all tasks performed as Credentialing Coordinator.
- Managed the reappointment process for medical staff members, ensuring continuity of care for patients.
- Provided exceptional customer service to physicians during the application process, addressing concerns promptly and professionally.
- Conducted primary source verifications such as background checks and board certifications.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Expedited the onboarding process for new providers, ensuring timely completion of all required documentation and verifications.
- Enhanced credentialing processes by streamlining documentation and verification procedures.
- Assisted in training new employees on proper credentialing procedures, contributing to their rapid integration into the team environment.
Medicare Billing Specialist
Quest Diagnostics
06.1998 - 04.2008
- Provided exceptional customer service by promptly addressing patient inquiries or concerns related to their Medicare bills.
- Trained new staff members on Medicare billing procedures and best practices, improving team efficiency.
- Collaborated with healthcare providers to obtain necessary documentation for accurate Medicare billing.
- Facilitated educational sessions for patients to better understand their Medicare benefits and responsibilities associated with their insurance coverage.
- Assisted in maintaining HIPAA compliance, safeguarding patient information during the billing process.
- Managed a high volume of Medicare claims, ensuring timely submission and payment for medical services rendered.
- Posted payments and collections on regular basis.
- Filed and updated patient information and medical records.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Monitored outstanding invoices and performed collections duties.
- Handled account payments and provided information regarding outstanding balances.
- Verified insurance of patients to determine eligibility.
- Collaborated with customers to resolve disputes.
- Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Collected payments and applied to patient accounts.
Education
High School Diploma -
Trimble Technical High School
Fort Worth, TX06-1989
Skills
- Customer Relations
- Small business operations
- Relationship Building
- Verbal and written communication
- Client Service
- Operations Management
- Bidding processes
- Human Resources
- Hiring and staffing
Certification
- OSHA Certified
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Medical Staff Credentialing Coordinator
IntelliCentrics
08.2021 - 10.2024
Owner/General Manager
Precise Precision General Services
03.2012 - Current
Medicare Billing Specialist
Quest Diagnostics
06.1998 - 04.2008
- OSHA Certified
High School Diploma -
Trimble Technical High School
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