Kimberly Sinnard
Blue Springs,MO
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
23
23
years of professional experience
Work History
Provider Disputes Representative
GEHA
Lee's Summit, MO
04.2023 - Current
- Increased customer satisfaction by addressing and resolving complaints in a timely manner.
- Handled customer complaints quickly and professionally to restore customer confidence and prevent loss of business.
- Enhanced company reputation by providing exceptional customer service and support.
- Developed and maintained positive customer relations and coordinated with team members to properly handle requests and questions.
- Exceeded performance targets through diligent work ethic and focus on results-driven tasks.
- Learned and followed all organizational policies and procedures to maintain safe and professional working environments.
Senior Medical Claims Adjustor
GEHA
Independence, MO
12.2014 - 04.2023
- Analyzed policy details along with supporting documents provided by healthcare providers to make informed decisions on claims approvals or denials.
- Resolved complex claims issues for expedited processing and resolution.
- Participated in cross-functional teams to address systemic issues within the organization, contributing insights from a medical claims perspective.
- Streamlined communication channels between departments, expediting information flow and improving overall productivity.
- Improved customer satisfaction with timely and accurate claim settlements.
- Conducted thorough investigations of medical claims to ensure proper payment or denial.
- Maintained strict compliance with HIPAA regulations, safeguarding patient privacy throughout the claim evaluation process.
- Collaborated with healthcare providers to obtain necessary documentation for claim support.
- Provided exceptional customer service to both internal and external stakeholders during the entire claim lifecycle process.
- Reduced claim processing time by streamlining medical claims adjudication processes.
- Implemented quality control measures to reduce errors and improve overall accuracy rate in claims processing.
- Identified patterns of fraudulent activities through meticulous analysis of medical claims data.
- Managed high volume caseloads, prioritizing urgent and sensitive cases for immediate attention.
- Managed large volume of medical claims on daily basis.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Researched and resolved complex medical claims issues to support timely processing.
- Monitored and updated claims status in claims processing system.
- Paid or denied medical claims based upon established claims processing criteria.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
Commercial Accounts Manager
GE Card Services
Merriam, KS
12.2000 - 08.2010
- Streamlined account management processes for improved efficiency and productivity.
- Collaborated with cross-functional teams to develop tailored solutions addressing client needs and expectations.
- Delivered timely and accurate reporting on account performance, facilitating informed decision-making among stakeholders.
- Maintained a high level of knowledge about industry trends and best practices, allowing for proactive client consultation and recommendations.
- Optimized internal processes and systems for managing commercial accounts, resulting in reduced manual effort and improved overall efficiency.
- Increased client satisfaction by effectively managing commercial account portfolios and providing exceptional customer service.
Education
Bachelor Of Applied Arts And Science - Organizational Management And Leadership
Friends University
Wichita, KSSkills
- Customer Support
- Goal-oriented mindset
- Customer Relations
- Data entry proficiency
- Client Services
- Staff Training
- Paperwork Processing
- Telephone reception
- Client Service
Timeline
Provider Disputes Representative
GEHA
04.2023 - Current
Senior Medical Claims Adjustor
GEHA
12.2014 - 04.2023
Commercial Accounts Manager
GE Card Services
12.2000 - 08.2010
Bachelor Of Applied Arts And Science - Organizational Management And Leadership
Friends University