Kiriosha Marks
Humble,TX
Summary
Results-driven Insurance Verification Specialist with extensive experience at Millennium Physicians Group, achieving a 98% accuracy rate in insurance validation. Proficient in EMR systems and HIPAA compliance, I excel in claims processing and foster effective communication with patients and providers, ensuring seamless operations and enhanced workflow efficiency.
Overview
20
20
years of professional experience
Work History
Insurance Verification/Referral Specialist
Millennium Physicians Group
Kingwood, TX
11.2023 - 05.2025
- Maintained a 98% accuracy rate in validating insurance coverage details, contributing to efficient referral processing.
- Analyzed patient records to facilitate referrals in accordance with medical necessity and insurance requirements.
- Obtained necessary pre-authorization for medical services by coordinating with insurance companies.
- Ensured compliance with HIPAA regulations to protect sensitive health data.
Insurance Verification Specialist
Preventice Services
Houston, TX
10.2021 - 10.2023
- Verified patient insurance coverage, ensuring accuracy and productivity.
- Communicated effectively with patients, medical personnel, and insurance providers.
- Multitasked across various medical software programs to enhance workflow efficiency.
- Maintained strict confidentiality of patient healthcare information in compliance with regulations.
Verification/Recovery Specialist
BENEFIT RECOVERY
Houston, TX
02.2017 - 10.2021
- Assume responsibility for the verification of patient insurance coverage; posting of accurate data into the healthcare verification databases; and review of explanation of benefits and correspondence.
- Take charge of writing appeals and reviewing medical records; creating claims in client systems; following up on claims; encoding payments; and conducting uncollectible accounts write-off.
- Maintain effective communication with various insurance companies.
- Successfully prevented Health Insurance Portability and Accountability Act (HIPAA) violations by maintaining the confidentiality and security of patient and procedural data in compliance with regulatory requirements.
- Played a vital role in boosting the productivity of the organization by identifying and resolving discrepancies.
Administrative Assistant
MS. LITHA'S CHILDCARE CENTER
La Porte, TX
08.2008 - 02.2017
Health Information Management Intern
THE PARK AT SUGAR CREEK MEDICAL CENTER
10.2016 - 12.2016
- Organized patients' registration for office visits.
- Utilized various databases in documenting patient demographics and insurance information.
- Ensured strict compliance with HIPAA regulations and privacy standards confidentiality agreements.
- Cultivated productive business relationships with internal and external clients.
- Drove on-time completion of tasks and assignments through prioritization, multitasking, and effective time management.
Health Information Management Specialist
UT SOUTHWESTERN MEDICAL CENTER
Dallas, TX
10.2005 - 08.2008
- Carried out gathering and organization of patients' charts for proper processing.
- Adhered to HIPAA regulations in securing sensitive health information and situations.
- Provided first-rate customer service by promptly processing customers' medical record requests, as well as by ensuring accurate and high-quality patients products.
Education
BACHELOR'S DEGREE - HEALTHCARE MANAGEMENT
The College of Health Care Professions
Houston, TX10.2018
ASSOCIATE'S DEGREE - HEALTH INFORMATION MANAGEMENT
The College of Health Care Professions
Houston, TX12.2016
Skills
- EMR systems and medical records
- HIPAA compliance
- Medical terminology expertise
- Claims processing and insurance verification
- Microsoft Office proficiency
- Epic software experience
- Medical office operations
Assessments
- Attention to Detail, Familiar, 02/01/20
- Medical Billing, Proficient, 08/01/20
- Filing & Organization, Expert, 09/01/18
- Scheduling, Highly Proficient, 09/01/18
- Work Style: Reliability, Proficient, 03/01/19
- Data Entry: Accuracy, Expert, 07/01/19
- Verbal Communication, Highly Proficient, 09/01/20
- Electronic Health Records: Best Practices, Completed, 09/01/20
Personal Information
Authorized To Work: US
References
References available upon request.
Timeline
Insurance Verification/Referral Specialist
Millennium Physicians Group
11.2023 - 05.2025
Insurance Verification Specialist
Preventice Services
10.2021 - 10.2023
Verification/Recovery Specialist
BENEFIT RECOVERY
02.2017 - 10.2021
Health Information Management Intern
THE PARK AT SUGAR CREEK MEDICAL CENTER
10.2016 - 12.2016
Administrative Assistant
MS. LITHA'S CHILDCARE CENTER
08.2008 - 02.2017
Health Information Management Specialist
UT SOUTHWESTERN MEDICAL CENTER
10.2005 - 08.2008
BACHELOR'S DEGREE - HEALTHCARE MANAGEMENT
The College of Health Care Professions
ASSOCIATE'S DEGREE - HEALTH INFORMATION MANAGEMENT
The College of Health Care Professions
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