Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Kristal Holcomb

Springfield,IL

Summary

Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

12
12
years of professional experience

Work History

Retirement Benefits Representative

State of Illinois
Springfield , Illinois
09.2023 - Current
  • Provided customer service to employees regarding their benefits packages, including answering questions and resolving issues.
  • Assisted in the development of employee benefits plan documents and summaries.
  • Managed employee changes related to benefits such as terminations, leaves of absence, and transfers.
  • Developed presentations on benefit topics for staff meetings and trainings.
  • Coordinated open enrollment communications, materials, and events.
  • Participated in surveys conducted by external organizations regarding benefit offerings compared with industry standards and best practices.
  • Provided guidance on complex issues involving special circumstances such as disability leave or long-term care coverage.
  • Created training materials and provided instruction on how employees can access their online accounts.
  • Coordinated benefits processing, including enrollments, terminations and claims.
  • Managed and maintained employee benefits programs including health insurance, retirement plans, and wellness programs.
  • Resolved employee issues related to benefits, serving as a liaison between employees and insurance providers.

Medical Insurance Associate

Siu School Of Medicine
Springfield , IL
05.2023 - 08.2023
  • Assisted customers with their insurance coverage needs, including providing quotes and answering questions.
  • Processed new applications for insurance coverage, ensuring accuracy of information provided by the customer.
  • Resolved customer complaints in a timely manner, escalating as necessary to management for resolution.
  • Filed and submitted insurance claims.
  • Double-checked and reviewed documentation for denied and accepted insurance claims.
  • Assisted claimants, providers and clients with problems or questions regarding claims.
  • Processed claims for payment or forwarded to appropriate personnel for further investigation
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Collaborated with fellow team members to manage large volume of claims.
  • Organized information by using spreadsheets, databases or word processing applications.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Prepared and reviewed insurance-claim forms and related documents for completeness.
  • Coordinated and planned investigations of claims to confirm compensability and coverage.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.
  • Handled billing related activities focused on medical specialties.

Patient Account Representative

Hshs Medical Group
Springfield , IL
05.2019 - 04.2023
  • Provided customer service to patients regarding billing inquiries and account information.
  • Identified areas for improvement in work processes, providing constructive feedback to colleagues.
  • Coordinated with other departments to ensure smooth workflow between teams.
  • Mentored new employees on company policies and procedures, as well as job duties.
  • Contributed ideas for process improvements which resulted in increased efficiency across departments.
  • Assisted in resolving patient complaints related to account balances, insurance coverage, and payment plans.
  • Conducted follow-up calls with patients to ensure that accounts were up to date and properly documented.
  • Researched discrepancies in patient accounts to determine appropriate resolution.
  • Verified accuracy of medical coding for services rendered by healthcare providers.
  • Performed monthly reconciliations of patient accounts to ensure accuracy of financial data.
  • Generated reports using proprietary software programs to analyze trends in patient accounts receivable balances.
  • Initiated collection activities on delinquent accounts while adhering to HIPAA guidelines and regulations.
  • Maintained detailed notes on all patient interactions for future reference purposes.
  • Ensured compliance with company policies concerning the privacy of confidential health information.
  • Resolved any issues arising from incorrect or incomplete documentation relating to a particular claim.
  • Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
  • Submitted appeals on behalf of patients when appropriate based on findings from research conducted into denied claims.
  • Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
  • Reconciled payments received against outstanding invoices ensuring proper posting of credits and debits.
  • Communicated frequently with healthcare providers regarding payment status updates on their claims submitted.
  • Collaborated with relevant parties to resolve billing issues, insurance claims and patient payments.
  • Reviewed flagged items daily and resolved issues.
  • Applied organizational policies and complied with regulations for patient privacy.
  • Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
  • Wrote appeal letters to insurance companies for denial of claims.
  • Accepted and processed customer payments and applied toward account balances.
  • Received payments and posted amounts to customer accounts.
  • Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.

Customer Advocate/Claims Adjuster

Blue Cross Blue Shield of Illinois
Springfield , Illinois
03.2016 - 03.2019
  • Provided customer support through phone, email and chat channels.
  • Researched customer inquiries to ensure accurate resolution of their issues.
  • Escalated complex customer cases as necessary to appropriate teams and departments.
  • Developed strong relationships with customers by providing timely responses and solutions.
  • Recorded detailed notes in customer accounts for future reference and follow-up.
  • Maintained a high level of professionalism while communicating with customers via all channels.
  • Identified trends in customer service inquiries and reported them to management team.
  • Collaborated with colleagues across multiple departments to resolve customer issues quickly and efficiently.
  • Monitored incoming calls, emails, chats and other communication channels for customer inquiries.
  • Provided training sessions for new employees joining the Customer Advocate team.
  • Ensured compliance with applicable laws and regulations related to the handling of personal information.
  • Performed quality assurance checks on completed cases prior to closure.
  • Performed extensive research on all inquiries and concerns to achieve complete client satisfaction.
  • Researched problems with benefits, accounts, and services with speed and accuracy.
  • Reached out to providers to help develop comprehensive solutions.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Supported sales team members to drive growth and development.

Patient Care Technician

Northwestern Hospital
Chicago , Illinois
04.2012 - 01.2016
  • Provided direct patient care and assistance to healthcare team members.
  • Assisted in preparing patients for examinations and treatments, including vital signs monitoring.
  • Performed EKGs, phlebotomy, and other laboratory tests as directed by physician or RN.
  • Ensured that all medical equipment was properly maintained and sterilized.
  • Maintained accurate records of patient care, condition, progress, and concerns.
  • Observed changes in patient's conditions and reported any abnormalities to the RN on duty.
  • Explained treatment procedures to patients and their families.
  • Assisted with patient transfers from bed to wheelchair or strher as needed.
  • Provided emotional support for patients and families during difficult times.
  • Collected specimens such as urine samples for testing purposes according to established protocols.
  • Answered call lights promptly and responded appropriately to requests from patients, families, staff members.
  • Educated patients on basic health-related topics such as nutrition, hygiene habits.
  • Reported any observed changes in behavior or physical condition to the nursing staff immediately.
  • Organized supplies in order to maintain adequate stock levels throughout shift.
  • Conducted safety rounds regularly to ensure safe environment for patients.
  • Participated in quality improvement activities within the department.
  • Helped create a safe environment by following infection control policies.
  • Responded quickly in emergency situations by providing appropriate first aid measures.
  • Collaborated with interdisciplinary teams to provide comprehensive care services.
  • Instructed new employees on proper techniques of performing daily tasks.
  • Obtained patient vital signs and reported results to staff nurse or physician to identify changes from prior measurements.
  • Responded to bell or light signal calls to assist patients with needs.
  • Performed variety of delegated basic patient care services to support nursing functions and activities of daily living.
  • Documented patient intake and dietary requirements and aided with feeding and monitoring.
  • Assisted with patient admissions, discharges and transfers.
  • Recorded patient conditions and vital signs before and after medical operations.
  • Delivered outstanding patient care based on physical, psychological, educational and related criteria.
  • Promoted patient satisfaction by assisting with bathing, dressing and exercising.
  • Identified and reported observations and clinical symptoms to appropriate healthcare professionals, driving timely intervention.
  • Transported patients to other areas of hospital in wheelchairs and gurneys for tests, treatments and therapies.
  • Collected biological specimens and packaged for laboratory transport to complete diagnostic tests.
  • Performed minor housekeeping tasks to keep patient areas clean and sanitized.
  • Restocked unit frequently with necessary medical supplies.
  • Supported healthy patient skin with bedside baths, wound care and integrity checks.
  • Looked for physical, emotional, and symptomatic changes in patient condition and obtained necessary care for medical concerns.
  • Kept instruments and equipment clean and sanitized.
  • Notified senior staff of patient emergencies to optimize outcomes.
  • Prepared patient chart for admission and compiled appropriate paperwork.
  • Maintained inventory levels of stock items, supplies and equipment to foster smooth and cost-effective unit operations.
  • Communicated with patients to determine feelings, need for assistance or social and emotional support.
  • Documented information in patient charts and communicated status updates to interdisciplinary care team.
  • Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
  • Answered patient call signals and signal lights to determine patients' needs.
  • Provided physical support to assist patients with bathing, dressing and toileting.
  • Turned and repositioned bedridden patients to prevent bedsores.
  • Measured and recorded food and liquid intake and output, reporting changes to medical or nursing staff.
  • Assisted nurses with wound care for pressure ulcers, bed sores and surgical site wounds.
  • Kept medical supply room and patient rooms stocked with necessary supplies, equipment and instruments.
  • Planned and served meals and snacks to patients according to prescribed diets.
  • Assisted with lifting patients to move on or off beds, examination tables and surgical tables.
  • Safeguarded patient privacy with strict adherence to HIPAA protocols.
  • Supplied, collected and emptied patient bedpans on frequent basis.
  • Collected specimens from patients for laboratory testing purposes.
  • Administered medications and educated patients and families on correct at-home administration.
  • Transported specimens, laboratory items or pharmacy items, verifying proper documentation and delivery to authorized personnel.
  • Reminded patients to take prescribed medications or nutritional supplements.
  • Shaved and draped patients to prepare for surgery, treatment or examination.
  • Exercised comatose and paralyzed patients to reduce delirium and improve physical function.

Education

Some College (No Degree) - Certified Nursing Assistant

City Colleges of Chicago - Wilbur Wright College
Chicago, IL

Skills

  • Benefits Administration
  • Policy Interpretation
  • Compliance knowledge
  • Microsoft Office
  • Employee Relations
  • Proficient in Microsoft products
  • Benefits Explanation
  • Benefits interpretation
  • Employee benefits practices
  • Special projects
  • Strategic Planning
  • Business Administration
  • Goal-Oriented
  • Complex Problem-Solving
  • Negotiation
  • Training and mentoring
  • Staff Development
  • New Hire Training

References

References available upon request.

Timeline

Retirement Benefits Representative

State of Illinois
09.2023 - Current

Medical Insurance Associate

Siu School Of Medicine
05.2023 - 08.2023

Patient Account Representative

Hshs Medical Group
05.2019 - 04.2023

Customer Advocate/Claims Adjuster

Blue Cross Blue Shield of Illinois
03.2016 - 03.2019

Patient Care Technician

Northwestern Hospital
04.2012 - 01.2016

Some College (No Degree) - Certified Nursing Assistant

City Colleges of Chicago - Wilbur Wright College

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Kristal Holcomb