Kimberly Mardis
Altadena,CA
Summary
I’m currently seeking to work for a highly competitive goal-oriented medical company fueled by an experienced management and staff dedicated to training, motivate, coach and mentor employees to meet the various challenges necessary to complete all company goals, objectives and tasks in a timely manner. Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service.
Overview
14
14
years of professional experience
Work History
Patient Communication Rep
UCLA Health
01.2020 - Current
- Utilizing our Electronic Medical Records system to communicate patient care and schedule appointments effectively and efficiently
- Maintain a high level of customer service, a sense of urgency, reliability, data entry, active listening, and proper phone etiquette
- Serve the doctors, nurses, and, other assistants by keeping the daily schedule current, while communicating any changes.
- Answer multi-line phones, transfer calls to the correct contact, and take messages as appropriate.
- Finalize patient checkout in the course of scheduling for testing, imaging, and follow up appointments both with other specialist and within the office
- Perform all other duties as assigned
- Confirm accuracy of patient history and demographics
- Assisted in the development of departmental policies and procedures by providing valuable input based on experience and best practices within patient communication.
- Reduced wait times by implementing effective call management strategies such as prioritizing urgent matters while maintaining excellent service standards.
Claims Examiner I
Health Net Inc.
01.2015 - 10.2017
- Reviewed appeals and complaints; researches any missing or required information, matched authorizations to claims, maintains current desk procedural and reference materials
- Determined level of reimbursement based on established criteria, provider contract, plan and employer group provisions, processed all claims eligible or ineligible for payment accurately and conforming to quality, production standards and specification
- Developed and maintained effective business relationships with internal and external clients, researched/adjusted all difficult, complex requests for overpayment, underpayment, refund, contract issues, and stop loss to ensure compliance with departmental and company policies and procedures
- Conducts cost containment analyses
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
Medical Biller/Front Desk
Advanced Pain Management
01.2014 - 01.2015
- Billing for medical and all commercial carriers, following up on unpaid accounts or denied claims status, heavy data entry, answering phones, filing, faxing, and copying documents
- Develop spreadsheets and for tracking payments, insurance verification online and by telephone.
- Corresponding with other employees through email or by phone
- Set up new patient accounts, retrieve ERA's, send secondary claims upon processing primary insurance, monthly processing of patient statements, answer and resolve patient billing inquires, follow up on insurance and patient aging, and re-submit insurance claims as necessary.
- We verified the insurance of patients to determine eligibility.
- I communicated with insurance providers to resolve denied claims and resubmitted them.
Front Desk/Receptionist
North American
01.2011 - 01.2014
- Greeting and directing all patients to proper location, also beginning registration process for all patients who have scheduled appointments
- Reconcile and recommend resolution for report discrepancies and problems
- Prepare and mail report
- Type letters, memos and other materials
- Coordinate team meetings/schedules
- Answer phones and provide customer support
- Set up new client accounts
- Compile new hire, termination, and employee kits
- Administrative functions as needed
- Assist with and interface with outsourced Human Resources duties as assigned
- Maintained continuous communication channels with supervisors and workers to sort their work related issues and doubts
- Estimated workforce requirement and equipment needed to complete particular projects
Education
Medical Billing Certificate & BLS -
University of Antelope Valley
Lancaster, CA01.2015
Diploma -
Baton Rouge High School
Baton Rouge, LA01.2004
Skills
- ICD-9/ICD-10
- Typing (45 WPM)
- Filing
- Faxing
- Scanning
- Xeroxing
- Collections
- HIPAA Compliant
- Medical Insurance (TRICARE, Medicare, Medicaid, Workers Compensation and Private)
- CPT/HCPCS Level II
- Claim Preparation and On-line Submission
- MS Word
- Excel
- Outlook
- PowerPoint
- IBM Lotus Notes
- Medical Terminology
- Anatomy and Physiology
- Medical Software (Omni, ABS & EXP Macess, Cisco, CareConnect)
- 10-Key (8500 KPH)
Maintaining confidentiality
Verbal Communication
Appointment Scheduling
Complaint Handling
References
- Estella R. Latu, Medicare Claims Supervisor, (818) 676-6790, Health Net, Inc.
- Michelle Edwards, Medical Billing and Coding Professor, (661) 802-1996, University of Antelope Valley
- Airreka Mcknight, Referral Coordinator, (323) 275-8051, UCLA Health
Timeline
Patient Communication Rep
UCLA Health
01.2020 - Current
Claims Examiner I
Health Net Inc.
01.2015 - 10.2017
Medical Biller/Front Desk
Advanced Pain Management
01.2014 - 01.2015
Front Desk/Receptionist
North American
01.2011 - 01.2014
Diploma -
Baton Rouge High School
Medical Billing Certificate & BLS -
University of Antelope Valley
Similar Profiles
Adriana MartinezAdriana Martinez
Surgical Technologist at UCLA HealthSurgical Technologist at UCLA Health
Victoria UribeVictoria Uribe
Hospital Billing Customer Service Representative at UCLA HealthHospital Billing Customer Service Representative at UCLA Health
Martha SanchezMartha Sanchez
Medical Assistant Externship at UCLA HealthMedical Assistant Externship at UCLA Health
Rylee TerraRylee Terra
Receptionist at UCLA HealthReceptionist at UCLA Health
Finn Alexander OliverFinn Alexander Oliver
Sales Associate at Old NavySales Associate at Old Navy