Kimberly Treadway
Salt Lake City,UT
Summary
Knowledgeable Certified Professional Coder with comprehensive expertise in medical coding and compliance. Proven track record in ensuring accurate coding practices, contributing to efficient and effective healthcare operations. Demonstrated proficiency in ICD-10-CM and CPT coding, along with strong analytical and problem-solving abilities.
Overview
35
35
years of professional experience
Work History
BILLING SPECIALIST
BRIGHTON RECOVERY CENTER
08.2023 - 11.2023
- Submitted electronic claims
- Resolution of unpaid and denied claims
- Verification of benefits for potential clients
- Processed client payments
- Posted insurance payment
Utilization Management Coordinator
U of U Hospitals and Clinics H.O.M.E Program
01.2003 - 02.2023
- Processed Prior Authorization requests from inside and outside vendors, input referrals and attached documentation
- Review claims from Health Plans, to determine if they should be approved or denied, based off plan policy
- Worked with Utilization RNs to receive clinical information for in-patient mental health admits and manage authorizations
- Worked with Credentialing and Contracting to on board new hires/transfers in a timely manner
- Performed benefit inquiries for ABA Therapy
- Requirements for services for ABA Therapy
- Submitted prior authorizations for ABA Therapy
- Notified both provider and client and to help the client understand their benefits
- Submitted claims
- Worked denials
Certified Professional Coder
U of U Hospitals and Clinics H.O.M.E Program
02.2003 - 01.2021
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures for around 1,500 patients and 15 providers billing for mental health and medical services
- Interacted with physicians and other healthcare staff to ask questions for clarification on any vague statements to maximize level of service
- Assign procedure and diagnostic codes reviews for accuracy and then submit to billing
- Scheduled patients and cleared providers schedule for same day cancellations
- Applied official coding rules from American Medical Association and the W.H.O to assign CPT codes and ICD-10 codes
- Resolve bills for patients both within the University and from outside providers
- Worked with Utilization Management, processing authorization requests, reviewing claims to pay or deny
- Worked with credentialing and contracting to get new hire/transfers paperwork submitted in a timely manner
- Utilized active listening, interpersonal and telephone etiquette skills when communicating with others
- Scheduled patients
- Participated in both H.O.M.E patient activities and the UNI (now HMHI) employee engagement committee
- Participated in various volunteer opportunities
Pain Management Program Scheduler
UNIVERSITY OF UTAH HOSPITALS AND CLINICS
01.2003 - 02.2003
- Scheduled patients for follow up appointments as well as in clinic procedures for the University of Utah Pain Management Clinic
- Maintained and updated appointment calendars
Inpatient Staffing Coordinator
KAISER PERMANENTE
01.1989 - 11.2000
- Company Overview: The Permanente Medical Group
- Staffed Inpatient Hospital & Outpatient Clinics with RN's, LVN's, Unit Clerks, CNA's abiding by Union contracts
- The Permanente Medical Group
Education
Certified Professional Medical Coder
Private Teacher
Salt Lake City, UT05.2004
Associate of Arts - Merchandise Marketing
Fashion Institute of Design And Merchandising
San Francisco, CA01.1989
Skills
- Knowledge of Revenue Billing Cycle
- Experience with Medicaid
- Utilization Management
- Certified Professional Coder
- Problem Resolution
- knowledge in Mental Health
- Patient Advocacy
- Up to date with Federal and State Guidelines
- Epic
- Prior authorizations
- Microsoft Suite
- Credentialing & Contracting Providers
- Volunteer work
Timeline
BILLING SPECIALIST
BRIGHTON RECOVERY CENTER
08.2023 - 11.2023
Certified Professional Coder
U of U Hospitals and Clinics H.O.M.E Program
02.2003 - 01.2021
Utilization Management Coordinator
U of U Hospitals and Clinics H.O.M.E Program
01.2003 - 02.2023
Pain Management Program Scheduler
UNIVERSITY OF UTAH HOSPITALS AND CLINICS
01.2003 - 02.2003
Inpatient Staffing Coordinator
KAISER PERMANENTE
01.1989 - 11.2000
Associate of Arts - Merchandise Marketing
Fashion Institute of Design And Merchandising
Certified Professional Medical Coder
Private Teacher
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