KIMBERLY WIKE
PORT ORCHARD
Summary
Certified Electronic Medical Records Specialist/Billing and Coding graduate with solid background in patient access. Facilitated seamless patient admissions, ensuring accurate data entry and efficient processing. Demonstrated proficiency in managing patient inquiries with accuracy and abiding HIPPA laws.
Overview
8
8
years of professional experience
Work History
Care Management Support Coordinator
Mindlance-Ambetter
Remote
04.2025 - Current
- Organize and prioritize incoming request for peer to peer reviews, ensuring all necessary clinical and patient information is gathered and documented. Coordinate and schedule meetings between the insurance plan medical reviewer and the ordering provider. Manage multiple case files simultaneously. Maintain up to date rules and criteria of the peer to peer process. Also assist with other administrative task, such as requesting medical records. Communicate professionally with providers, clients and colleagues.
Patient Access Representative
Randstad-Kaiser Permanente
11.2024 - 03.2025
- Responsible for handling a large volume of calls for medical appointments and procedures
- Pharmacy, lab, prior authorization and referral knowledge
- EPIC EMR knowledge
- Adapt quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
Patient Access Representative
Community Health Plan of WA
10.2022 - 07.2024
- Responsible for first call resolution by responding accurately, being courteous towards member and provider inquiries regarding claims and benefit interpretation and more
- Accurately documenting all calls in a timely manner
- Knowledge of Medicare Part C and Medicare
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
Patient Access Representative
Cambia Health Solutions
07.2021 - 09.2022
- Responsible for first call resolution by responding accurately, being courteous towards member and provider inquiries regarding claims and benefit interpretation, prior authorizations, referrals and more
- Knowledge of Medicare Part C
- Achieved high levels of accuracy in patient data entry, minimizing errors and enhancing record reliability.
- Awarded for 100% SQM World Class certified for Medicare
- EMR knowledge
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
CALL CENTER AGENT
Peninsula Community Health Services
02.2018 - 06.2021
- Responsible for scheduling a large volume of medical, dental and mental health appointments for a large group
- Knowledge of pharmacy and lab processes
- EMR knowledge
Education
CERTIFIED ELECTRONIC MEDICAL RECORDS SPECIALIST -
US Career Institute
Remote, CO06.2024
Successful Completion of Study - Professional Billing And Coding
US Career Institute
Remote, CO06.2021
Skills
- Healthcare administration
- Compliance adherence
- Medical record retrieval
- EPIC charting
- Insurance documentation
- Clinical coordination
- Benefits interpretation
- Effective communication
Timeline
Care Management Support Coordinator
Mindlance-Ambetter
04.2025 - Current
Patient Access Representative
Randstad-Kaiser Permanente
11.2024 - 03.2025
Patient Access Representative
Community Health Plan of WA
10.2022 - 07.2024
Patient Access Representative
Cambia Health Solutions
07.2021 - 09.2022
CALL CENTER AGENT
Peninsula Community Health Services
02.2018 - 06.2021
CERTIFIED ELECTRONIC MEDICAL RECORDS SPECIALIST -
US Career Institute
Successful Completion of Study - Professional Billing And Coding
US Career Institute