KIMBERLY PHILLIPS
CONCORD,US
Summary
Healthcare specialist with over 28 years of experience in healthcare support, leveraging skills in data entry, process improvement, and project management to ensure seamless operations. Proficient in medical terminology and training development, enhancing compliance and operational efficiency, resulting in reduced errors and improved patient satisfaction. Passionate about utilizing data-driven strategies to foster informed decision-making and drive future business success. Experienced leader with a strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, maintaining high standards, and aligning efforts with organizational goals. Known for a collaborative approach and unwavering commitment to excellence.
Overview
28
28
years of professional experience
Work History
PROVIDER EDUCATION REPRESENTATIVE
Noridian Healthcare Solutions
03.2023 - 08.2024
- Educates, coordinates, and facilitates provider/supplier education opportunities via teleconference, online venues, leading in-person work groups, or group settings as the Subject Matter Expert (SME).
- Provides quality education in a timely manner to meet internal and external standards as outlined by the Centers for Medicare Services (CMS).
- Analyzes data and tracks trends in claim submission errors, appeals, telephone and written inquiries, or other data from operational teams, and educates as appropriate.
- Maintains extensive knowledge of CMS rules, regulations, processing guidelines, and online reference information.
- Communicates and coordinates with internal departments and senior leadership for educational opportunities that will help improve the workloads (volume, content, promotion of updates/changes, etc.) for each operational team, as applicable.
- Researches, problem solves, and responds to complex inquiries from internal and external customers within specified timeframes.
- Participates in and actively supports internal/external committee meetings such as Medicare Carrier Advisory Committee (CAC), Coverage meetings, and Ask the Contractor Teleconferences (ACTs), etc.
- Creates and updates written publications, 508 accessibility compliant content for web pages, presentations, and proposals for national speaking opportunities.
- Coaches and mentors peers/employees on the education process, Medicare policies, standards, requirements, metrics, etc.
- Actively contributes or takes the initiative to plan the upcoming years’ education events, such as onsite travel, webinars, ask the contractor, etc.
PATIENT ACCESS SPECIALIST
AmerisourceBergen
07.2015 - 03.2023
- Streamlined patient access processes, reducing wait times and enhancing satisfaction
- Implemented efficient workflows, resulting in improved care delivery
- Fostered strong relationships with healthcare providers and insurance companies, ensuring seamless patient care coordination and optimal resource utilization
- Pioneered digital solutions for patient registration and insurance verification, significantly reducing administrative bottlenecks and enhancing operational efficiency
- Guided patients through complex healthcare processes, providing compassionate support and clear communication to alleviate concerns and improve overall experience
- Meticulously managed patient records and insurance information, ensuring accuracy and compliance with healthcare regulations and privacy standards
- Implemented digital solutions for registration, enhancing operational efficiency.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
BILLING/ENROLLMENT LEAD
UnitedHealth Group
03.1996 - 07.2015
- Led billing and enrollment team, enhancing accuracy and efficiency in processing
- Resolved complex billing issues, improving customer satisfaction and retention
- Developed training programs, boosting team productivity and skills
- Spearheaded team initiatives to optimize billing cycles, reducing processing time and minimizing errors
- Achieved measurable improvements in customer satisfaction scores
- Pioneered new enrollment systems, integrating cutting-edge technologies to streamline operations
- Developed innovative solutions for complex billing challenges
- Implemented rigorous quality control measures, significantly reducing discrepancies
- Integrated cutting-edge technologies to streamline operations.
Education
CERTIFICATE IN MEDICAL ASSISTANT -
King's College
Charlotte, NCBACHELORS IN HEALTHCARE MANAGEMENT -
Florida Metropolitan University-South Orlando
Orlando, FLSkills
- Medical Coding
- Data Entry
- Insurance Verification
- Medical Billing
- EMR Systems
- Epic
- Microsoft Office
- Claims Processing
- Medical Records
- CPT Coding
- Medical Terminology
- HCPCS
- DME
- Quality Assurance
- Computer Skills
- Prior Authorization
- ICD-10
- Salesforce
- Typing
- Research
- Medicare
- Data Analysis
- Patient Advocacy
- Healthcare Compliance
- Project Management
- Cross-Functional Collaboration
- Training Development
- Process Improvement
- Problem Solving
- Analytical Thinking
- Team Leadership
- Risk Management
- Regulatory Compliance
- Strong presentation skills
- Project management experience
- Critical thinking proficiency
- Product Demonstration
- CRM Software
- Team Collaboration
- Team building
- Presentation Skills
- Organizational Skills
- Problem-solving aptitude
- SQL reporting
- Strategic Planning
- Windows Server
- Microsoft Excel and PowerPoint
- CRM Integration
Additionalinformation - Professionalachievements
- Streamline data analytics to boost efficiency
- Develop targeted training programs to minimize claim errors
- Facilitate high-quality webinars for provider education
- Uphold CMS guidelines to ensure provider compliance
- Spearheaded patient service enhancement, boosting satisfaction by 20%
- Streamlined billing and coding, slashing claim rejections by 15%
- Implemented authorization tracking, escalating approval rates by 25%
- Oversaw billing and enrollment, swiftly resolving critical issues
- Implemented robust enrollment policies, streamlining onboarding and terminations
- Enhanced financial precision through meticulous billing and payment applications
- Led innovative billing solutions, slashing processing time by 15%
- Cultivated productivity by 10% through effective team training sessions
Timeline
PROVIDER EDUCATION REPRESENTATIVE
Noridian Healthcare Solutions
03.2023 - 08.2024
PATIENT ACCESS SPECIALIST
AmerisourceBergen
07.2015 - 03.2023
BILLING/ENROLLMENT LEAD
UnitedHealth Group
03.1996 - 07.2015
CERTIFICATE IN MEDICAL ASSISTANT -
King's College
BACHELORS IN HEALTHCARE MANAGEMENT -
Florida Metropolitan University-South Orlando
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