Job Search Status
Open to workDesired start date: Immediately
Open To Work
Kimberly Tomaselli
Knoxville,Tennessee
Work Preference
Summary
I have 20 plus years experience in Medical Office Billing, Data Entry, Accounts Receivables, Denials and Appeals. Patient Collections. Obtaining Precertification’s Prior Authorization’s. Obtaining Eligibility and Benefits. Working Knowledge of all Ins Plans… Tenncare Medicaid, Medicaid TN. Traditional Medicare, Medicare MCO Advantage Plans HMO and PPO Policies, Third Party Payers, Precertifications, Prior Authorizations, Insurance Verification, Electronic Medical Records, Medical Terminology, Mail Distribution, Purchasing, Shipping and Receiving, Measured and fit patients with off the shelf back bracing, Measure for compression stockings, Taking Foam impressions for Custom Shoe Orthotics under Practitioner License and I am seeking multi-task employment in all of these categories.
Overview
20
20
Years of Experience
Work History
Reimbursement Specialist
Helen Ross McNabb
06.2018 - 07.2019
- Worked numerous projects, Data Entry, Correction of Data Entry, Verified Eligibility on patient accounts via reports and all Tenncare Medicaid Rejections.
- Duties
Accounts Receivables Prior Authorization Specialist In DME, MRI
Knoxville Orthopedic Clinic
08.2019 - Current
- DME – Posting $0.00 Payments when found for denied claims, Entering Charges when needed. Obtaining Prior Authorizations. My primary job is working Accounts Receivables and Prior-Authorizations in DME. I fill in when needed in MRI-CT Scans, and PT/OT AR when needed. I work all denials in Waystar EDI Clearinghouse, I work denials in my task daily, and denials.
- Primary Responsibilities
AR, Denials and Appeals Representative
Tennessee Sports Medicine Group
03.2017 - 12.2017
- Work AR and Denials Daily. File Appeals as necessary. Payment posting, Patient Collections.
AR, Denials and Appeals Representative
Generations ObGyn
08.2016 - 03.2017
- Worked patient past due accounts and Insurance Accounts. Worked all denials and filed appeals as necessary.
Denials and Appeals Specialist
TeamHealth Billing Center
06.2013 - 01.2016
- Filed appeals for numerous insurance companies including Medicare that had denied for different reasons and the AR department could no longer go forward with them, at that point they were sent our Appeals Department.
- Wrote appeal letters in detail in explanation of why I disagreed with their denial decision and attached proof of filing, medical records, etc. to prove services rendered and was filed timely
- Trained new hires on the IDX billing software along with company procedures one week per month. I also worked special projects when
- Direct Supervisor: Donna Paul
- Phone Cell: 865-300-8407
Billing and AR Supervisor
Home Health Care of Middle Tennessee
02.2008 - 05.2013
- Responsible for daily office operation
- Hired and trained 4 new hires as the billing and AR was moved from Nashville to Knoxville due to the company not collecting monies being billed for services being rendered to the home bound patients.
- Completed Weekly Billing for Private Duty and Monthly Billing for Skilled Nursing Visits
- Electronic Claims Filing
- Submitted all secondary claims for the Private Duty
- Submitted Corrective Claims when necessary
- Payment Posting and corrections on payment posting
- Worked all Private Duty AR for Commercial Insurance Plans, Medicare, Medicare MCO Advantage Plans, Medicaid TN, and Medicaid MCO Plans
- Manager: Amy MacLaughlin, RN Administrator
- Phone: 615-519-8407
Education
Certificate - Billing, Medical Terminology
Rice College
Knoxville, TN09.1990
Skills
- Microsoft applications expertise
- Terminology in healthcare
- Accounts receivable expertise
- Verification and authorization processes
- Purchasing and inventory management
- Posting payments accurately
- Care and scheduling for patients
- Management of medical records
- Broad experience in medical settings
- Service-oriented customer relations
- Call center support
Timeline
Accounts Receivables Prior Authorization Specialist In DME, MRI
Knoxville Orthopedic Clinic
08.2019 - Current
Reimbursement Specialist
Helen Ross McNabb
06.2018 - 07.2019
AR, Denials and Appeals Representative
Tennessee Sports Medicine Group
03.2017 - 12.2017
AR, Denials and Appeals Representative
Generations ObGyn
08.2016 - 03.2017
Denials and Appeals Specialist
TeamHealth Billing Center
06.2013 - 01.2016
Billing and AR Supervisor
Home Health Care of Middle Tennessee
02.2008 - 05.2013
Certificate - Billing, Medical Terminology
Rice College
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