Kimberly May
Care Coordinator
Fayetteville,NC
Work Preference
Summary
Dedicated healthcare administration professional committed to enhancing patient experiences by coordinating care, resolving insurance barriers, and ensuring timely access to therapy.
Overview
1
1
Language
13
13
years of professional experience
1
1
year of post-secondary education
Work History
Care Coordinator
Iconma
05.2025 - 08.2026
- Guided patients through the full therapy journey, ensuring smooth transitions from referral to treatment access
- Executed patient referral intake, verifying required clinical and insurance documentation to facilitate timely treatment access.
- Resolved complex payer and pharmacy issues to remove barriers and support timely medication dispensing.
- Maintained expert knowledge of therapy requirements, prior authorization processes, and reimbursement pathways.
- Conducted detailed investigations of patient insurance benefits, including coverage, copay, and prior authorization requirements.
- Completed patient referral intake and verified all required clinical and insurance documentation.
- Handled high-volume queue of technical and complex therapy/reimbursement inquiries, ensuring accuracy and professionalism in responses.
- Achieved KPIs related to service levels, call volume, adherence, and quality standards, contributing to overall operational success.
- Met or exceeded KPIs, including service levels, call volume expectations, adherence, and quality standards
Sitter
Focused Interventions
06.2025 - 11.2025
- Supervised daily activities to ensure a safe and engaging environment for clients.
- Developed individualized care plans based on client needs and preferences.
- Monitored behavioral progress, documenting changes and adjusting strategies accordingly.
- Coordinated communication between families, caregivers, and multidisciplinary teams.
Reimbursement Specialist
Mercalis
09.2016 - 04.2025
- Review patient insurance plans to determine coverage, prior authorization requirements, copay details, and out-of-pocket costs.
- Assist providers with gathering documentation, submitting PA requests, and following up with payers to ensure timely approval.
- Coordinated appeal letters and additional documentation for coverage denials, facilitating timely resolutions.
- Guided patients in accessing financial assistance programs, copay cards, and bridge programs to alleviate out-of-pocket costs.
- Collaborated with healthcare providers, pharmacies, payers, and internal teams to identify and resolve reimbursement barriers effectively.
- Maintain accurate records, follow HIPAA guidelines, and ensure all interactions meet regulatory and program standards.
Customer Service Representative
BCBS
04.2013 - 01.2014
- Resolved customer inquiries and complaints, ensuring high satisfaction levels.
- Utilized CRM systems to track interactions and follow up on outstanding issues.
- Collaborated with cross-functional teams to enhance service delivery processes.
- Trained new team members on policies, procedures, and best practices for customer service.
Education
Associate of Science - Health Sciences
Ultimate Medical Academy
Tampa 03.2025 - 07.2026
Skills
- Medical Billing
- Reimbursement Processing
- Insurance Verification
- Insurance Claim Processing
- Revenue Cycle Management
- Medicare/Medicaid expertise
- CPT & ICD-10 Coding
- Patient Documentation
- Medical Records
- Medical Practice Management Systems
- Medical Terminology
- HIPAA Compliance
- Proficiencies: MS Excel; MS Word; MS PowerPoint
- Task completion
- Patient Registration
- Medical administration
Accomplishments
Completed my Degree in Health Science with Billing and Coding. Graduated with a 3.69.
Languages
English
Full Professional
Timeline
Sitter
Focused Interventions
06.2025 - 11.2025
Care Coordinator
Iconma
05.2025 - 08.2026
Associate of Science - Health Sciences
Ultimate Medical Academy
03.2025 - 07.2026
Reimbursement Specialist
Mercalis
09.2016 - 04.2025
Customer Service Representative
BCBS
04.2013 - 01.2014