Summary
Overview
Work History
Education
Skills
Other Experience
References
Timeline
Generic

Kimberly Sands

Rutledge,TN

Summary

To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

24
24
years of professional experience

Work History

Billing Specialist

Providence-HP
10.2022 - 03.2024
  • Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims
  • Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
  • Remains knowledgeable and current on third party requirements, and regulatory guidelines at the federal, state, and local levels
  • Research missing EOBs and other documents as needed
  • Takes ownership of special projects, researches data and follows through with detailed action plans
  • Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes
  • Accurately documents all follow up on the account to ensure there is an accurate record of the steps taken to collect on an account
  • Perform audits on accounts when needed to review for accuracy
  • Ability to communicate and collaborate effectively with other internal as well as external resources to achieve desired results and resolve issues
  • Verify patient information using links to hospitals and web based sites
  • Maintains a working knowledge and understanding of CPT and ICD-10 codes
  • Keeps current with healthcare practices and laws and regulations related to claims collections
  • Performs other job-related duties within the job scope as requested by Management.
  • Maximized revenue potential by identifying and resolving under-billed accounts.
  • Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.
  • Monitored customer accounts to identify and rectify billing issues.
  • Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
  • Continuously updated billing policies and procedures, ensuring that the department remained agile in response to evolving business needs.
  • Audited and corrected billing and posting documents for accuracy.
  • Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
  • Responded to customer concerns and questions on daily basis.
  • Identified, researched, and resolved billing variances to maintain system accuracy and currency.
  • Identified payment trends and adjusted billing processes accordingly to retain customers.
  • Implemented dispute resolution protocols that resulted in faster resolution times while preserving positive business relationships with clients.
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Provided excellent customer service, developing and maintaining client relationships.
  • Adaptable and proficient in learning new concepts quickly and efficiently.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Worked effectively in fast-paced environments.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Gained strong leadership skills by managing projects from start to finish.
  • Participated in team projects, demonstrating an ability to work collaboratively and effectively.
  • Managed time efficiently in order to complete all tasks within deadlines.
  • Proven ability to learn quickly and adapt to new situations.
  • Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
  • Demonstrated respect, friendliness and willingness to help wherever needed.
  • Skilled at working independently and collaboratively in a team environment.
  • Resolved problems, improved operations and provided exceptional service.
  • Strengthened communication skills through regular interactions with others.
  • Paid attention to detail while completing assignments.
  • Excellent communication skills, both verbal and written.
  • Learned and adapted quickly to new technology and software applications.

RCM Billing Specialist Ll

Envision Healthcare
01.2022 - 10.2022
  • Coordinates, monitors, and manages the follow-up on unpaid claims
  • Ensures follow-up and reimbursement appeals of unpaid and inappropriately paid claims
  • Review and work all daily correspondence
  • Appeals denied claims via mail, telephone, or websites
  • Remains knowledgeable and current on third party requirements, and regulatory guidelines at the federal, state, and local levels
  • Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
  • Meets the current productivity standard of 36 which include both quantity and quality metrics
  • Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes
  • Accurately documents all follow up on the account to ensure there is an accurate record of the steps taken to collect on an account
  • Verify patient information using links to hospitals and web based sites
  • Takes ownership of special projects, researches data and follows through with detailed action plans
  • Performs other job-related duties within the job scope as requested by Management.

A/R Representative. II

North American Partners in Anesthesia
10.2019 - 01.2022
  • Communicates with providers regarding verification of patient and insurance demographic information
  • Investigates and responds to errors generated from electronic claim submissions
  • Assists in researching eligibility submissions problems/new client submissions
  • Interfaces with other departments, external providers or clients, as may be required to resolve errors
  • Initiates verbal and written correspondence to internal and external sources to verify patient and claim information
  • Verify patient information using links to hospitals and web based sites
  • Coordinates activities with other team members to insure timely distribution of work to outside locations
  • Remains knowledgeable and current on third party requirements, and regulatory guidelines at federal, state, and local levels
  • Assist in evaluation of reports, decisions, and results of department in relation to established goals
  • Recommends new approaches, policies, and procedures to effect continual improvements in efficiency of department and services performed
  • Takes ownership of special projects, researches data and follows through with detailed action plans
  • Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
  • Performs other related duties as required and assigned.
  • Maintained client confidentiality while handling sensitive financial information and adhering to privacy regulations.
  • Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
  • Provided excellent customer service, developing and maintaining client relationships.
  • Identified payment trends and adjusted billing processes accordingly to retain customers.
  • Contributed to successful audits, providing detailed documentation and records as needed.
  • Managed complex problem-solving for upper management in order to complete projects on-time and within budget.
  • Ensured compliance with internal controls, policies, and procedures related to accounts receivable management.
  • Entered figures using 10-key calculator to compute data quickly.
  • Coordinated with cross-functional teams for accurate revenue recognition and contract compliance.
  • Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
  • Developed strong communication and organizational skills through working on group projects.
  • Applied effective time management techniques to meet tight deadlines.
  • Participated in team projects, demonstrating an ability to work collaboratively and effectively.
  • Learned and adapted quickly to new technology and software applications.
  • Resolved problems, improved operations and provided exceptional service.
  • Passionate about learning and committed to continual improvement.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Worked well in a team setting, providing support and guidance.
  • Strengthened communication skills through regular interactions with others.
  • Identified issues, analyzed information and provided solutions to problems.
  • Demonstrated respect, friendliness and willingness to help wherever needed.

A/R Representative III

North American Partners in Anesthesia
11.2021 - 01.2022
  • Coordinates, monitors, and manages the follow-up on unpaid claims
  • Ensures follow-up and reimbursement appeals of unpaid and inappropriately paid claims
  • Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims
  • Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
  • Ability to communicate and collaborate effectively with other internal as well as external resources to achieve desired results and resolve issues
  • Review and work all daily correspondence
  • Appeals denied claims via mail, telephone, or websites
  • Perform audits on accounts when needed to review for accuracy
  • Update accounts with information obtained through correspondence and telephone
  • When necessary, contacts patients, referring providers or a hospital to obtain better insurance information, authorization, or updated patient demographics to assist with collections
  • Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes
  • Accurately documents all follow up on the account to ensure there is an accurate record of the steps taken to collect on an account
  • Pitches in to help the completion of the daily AR Representative 2 workload to support AR team productivity and outcome measures
  • Meets the current productivity standard which include both quantity and quality metrics
  • Maintains a working knowledge and understanding of CPT and ICD-10 codes
  • Keeps current with healthcare practices and laws and regulations related to claims collections
  • Performs other job-related duties within the job scope as requested by Management.

Collections Admin II

Mednax
01.2016 - 12.2017
  • Communicates with providers regarding verification of patient and insurance demographic information
  • Investigates and responds to errors generated from electronic claim submissions
  • Assists in researching eligibility submissions problems/new client submissions
  • Interfaces with other departments, external providers or clients, as may be required to resolve errors
  • Initiates verbal and written correspondence to internal and external sources to verify patient and claim information
  • Verify patient information using links to hospitals and web based sites
  • Coordinates activities with other team members to insure timely distribution of work to outside locations
  • Remains knowledgeable and current on third party requirements, and regulatory guidelines at the federal, state, and local levels
  • Assist in evaluation of reports, decisions, and results of department in relation to established goals
  • Recommends new approaches, policies, and procedures to effect continual improvements in efficiency of the department and services performed
  • Takes ownership of special projects, researches data and follows through with detailed action plans
  • Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
  • Performs other related duties as required and assigned.

Refund Coordinator/Collection Specialist

Southeastern Retina Associates
08.2013 - 01.2016
  • Research patient and insurance credits
  • Research accounts and prepare documentation to insure appropriate party is refunded within deadline
  • Works credit and collection accounts from queue
  • Review accounts for final notice
  • Prepare documentation for accounts to be placed with outside collection agency
  • Balance daily batches and prepare deposit
  • Retain and secure daily work batches.

Accounts Receivable/Payment Entry Specialist

Southeastern Retina Associates
04.2004 - 07.2013
  • Post patient and insurance payments using manual and electronic methods timely
  • Upload remits into practice management system
  • Customer Service
  • Reconcile A/R with bank statement and practice management system
  • Prepare and reconcile daily deposit and transfer logs
  • Work closely with accounting department on end of month balancing and reporting
  • Meets all monthly and year end closing deadlines
  • Peer training/new equipment training
  • Electronic patient statement processing
  • Research and ensures timely processing of payments, allowable, etc
  • Identify trends and report them to proper management
  • Special projects as assigned.

Accounts Receivable/Billing Specialist

East TN OB-GYN
09.2002 - 03.2004
  • Post patient and insurance payments using manual and electronic methods timely
  • Work closely with accounting department on end of month balancing and reporting
  • Meets all monthly and year end closing deadlines
  • Insurance verification and claim follow up
  • Customer Service
  • Research and ensures timely processing of payments, allowable, etc
  • Identify trends and report them to proper management
  • Works credit and collection accounts from queue
  • Charge entry
  • Other duties as assigned.

Occupation Health Office Team Leader/Occupational Billing Specialist

HDI
01.2000 - 01.2002
  • Oversee daily activities and staff of Occupational Health Office
  • Assist physician with patient work up and perform variety of test including hearing, breath alcohol, drug testing, and DOT exams
  • Generate random drug test queues per company policy
  • Data entry/charge entry
  • Billing/ICD-9 coding and collections
  • Customer service
  • Post patient payments
  • Work closely with accounting department on end of month balancing and reporting
  • Meets all monthly and year end closing deadlines
  • Insurance verification
  • Other duties as assigned.

Education

Diploma -

Rutledge High School
05.1986

Skills

  • Insurance Verification
  • Account Reconciliation
  • Discrepancy Resolution
  • Collections processing
  • Payment posting
  • Denial Management
  • HIPAA Compliance
  • Month-end closing procedures
  • Claim submission

Other Experience

Available upon request

References

  • Ryan Corker, 865-219-3374
  • Wendy Wall, 865-755-0216
  • Kim McNamee, 865-318-5040
  • Kristen Perry, 865-310-5385

Timeline

Billing Specialist

Providence-HP
10.2022 - 03.2024

RCM Billing Specialist Ll

Envision Healthcare
01.2022 - 10.2022

A/R Representative III

North American Partners in Anesthesia
11.2021 - 01.2022

A/R Representative. II

North American Partners in Anesthesia
10.2019 - 01.2022

Collections Admin II

Mednax
01.2016 - 12.2017

Refund Coordinator/Collection Specialist

Southeastern Retina Associates
08.2013 - 01.2016

Accounts Receivable/Payment Entry Specialist

Southeastern Retina Associates
04.2004 - 07.2013

Accounts Receivable/Billing Specialist

East TN OB-GYN
09.2002 - 03.2004

Occupation Health Office Team Leader/Occupational Billing Specialist

HDI
01.2000 - 01.2002

Diploma -

Rutledge High School

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Kimberly Sands