Kimla O. Charles
Manager /Revenue Cycle Collector Biller
Florida,USA
Summary
Accomplished professional with over 20 years of experience in healthcare and administration. Proven track record in collecting outstanding balances from Medicare, Medicaid, workers' compensation, and commercial insurance, with meticulous data entry and issue escalation to supervisors. Expertise in reviewing explanations of benefits (EOBs) to ensure accurate claim reimbursements and identifying payer trends. Skilled in Microsoft Office Suite, financial management, training, and project planning.
Overview
26
26
years of professional experience
Work History
Revenue Cycle Lead Collector Specialist/ Biller
Monte Nido & Affiliates
06.2021 - Current
- Insurance claims follow-up, claim payment discrepancies, and inconsistencies of payment.
- Review authorizations and single case agreements (SCAs).
- Follow up on all regulations and guidelines by state programs, and HMO/PPO billing requirements per contract.
- Follow up on the missing payment, and investigate and appeal the denial claims.
- Bill insurance claims for primary, secondary, and tertiary payers.
- Ensure patient information is accurate and complete for billing.
- Request missing patient information, prepare, and submit billing data and medical claims to insurance companies or patients.
Floater /Collection
Broward Specialty Surgical Center
01.2017 - 06.2021
- Created and maintained medical records, ensuring accurate patient registration and insurance verification.
- Identified coding and billing discrepancies from EOBs for timely re-submission of claims.
- Resolved unpaid claims by analyzing reports from Advantx and contacting insurance companies.
- Prepared accounts for re-billing and secondary insurance filing, including necessary documentation.
- Addressed patient and insurance inquiries to provide clear information and support.
Collection Specialist
HCA Healthcare
01.2014 - 01.2017
- Ensured payment promptly by performing the surveillance of all accounts.
- For re-submission of claims, identified coding or billing delinquencies from EOBs, resolved claims that are not paid by generating the appropriate reports from Advantx and contact insurance companies.
- Developed the accounts for rebilling and for filing secondary insurance; sends them to carrier with necessary documents, as needed.
- Updated current documentation in patient files, while assigning the bad debt accounts to Collection Agency as approved by BOM.
- Managed the reconciliation of accounts that are turned over to collections.
(Team Lead)/EPIC Subject Matter Expert
Piedmont Healthcare
01.2006 - 02.2014
- Generated daily pre-registration budget for scheduled patients to ensure efficient resource allocation.
- Oversaw work and training of 20 team members, enhancing overall performance.
- Utilized ONTRAC and EPIC tools to meet quality and productivity standards.
- Acted as liaison between patients and administration to resolve issues effectively.
- Executed special projects including audit preparation, statistical reporting, and patient accounting assistance.
- Recruited as PRN; selected for full-time employment in 2007.
- Achieved credentialing in Epic ADT and HOD application.
Patient Access Representative
Atlanta Medical Center
01.2002 - 01.2007
Patient Access Rep/Patient Financial Counselor
DeKalb Medical Center
01.2000 - 01.2002
Education
Credits towards Doctor of Philosophy - Human Services (Healthcare Administration)
Capella University
MinneapolisMinneapolis
Master of Business Administration - Technology Management
American InterContinental University
GAGA
Bachelor of Information Technology -
American Inter Continental University
GAGA
CFC Certified Financial Counselor -
Skills
- Medical accounts
- Patient account balances
- outbound calls
- Medicaid
- Medical bills
- Insurance companies
- Customer service
- Payment arrangements
Timeline
Revenue Cycle Lead Collector Specialist/ Biller
Monte Nido & Affiliates
06.2021 - Current
Floater /Collection
Broward Specialty Surgical Center
01.2017 - 06.2021
Collection Specialist
HCA Healthcare
01.2014 - 01.2017
(Team Lead)/EPIC Subject Matter Expert
Piedmont Healthcare
01.2006 - 02.2014
Patient Access Representative
Atlanta Medical Center
01.2002 - 01.2007
Patient Access Rep/Patient Financial Counselor
DeKalb Medical Center
01.2000 - 01.2002
Credits towards Doctor of Philosophy - Human Services (Healthcare Administration)
Capella University
Master of Business Administration - Technology Management
American InterContinental University
Bachelor of Information Technology -
American Inter Continental University
CFC Certified Financial Counselor -
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