Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

Kristen Dalton

Emmett,ID

Summary

Organized and dedicated with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm. With a background as an Administrative Assistant, Customer Service Representative and an Insurance Specialist I offer keen attention to detail and strong decision-making skills to manage multiple, concurrent tasks. Self motivated work ethic to perform effectively in independent or team environments. Responsible, punctual and productive professional.

Overview

23
23
years of professional experience

Work History

Administrative/Insurance Verification Specialist

Horizon Home Health & Hospice
05.2023 - 01.2025
  • Answered phone calls and messages, and managed approximately 75-100 calls per day. Dealt directly with Primary Care physicians, Medical Directors, medical facility, team members and patient scheduling appointments, and handling patient inquiries.
  • Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Updated patient records with accurate, current insurance policy information.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
  • Assisted patients with understanding personalized insurance coverage and benefits.
  • Developed strong relationships with insurance representatives, facilitating smooth communication channels for resolving inquiries or disputes.
  • Coordinated with care teams across various departments to ensure seamless integration of verified coverage information into overall treatment planning.
  • Trained new staff on current, correct insurance verification procedures.
  • Collaborated with healthcare providers to ensure that insurance coverage met needs of patient treatments.
  • Improved claim submission times by streamlining verification and authorization process.
  • Ensured accuracy in patient insurance information by meticulously verifying details, leading to reduction in claim denials.
  • Performed various administrative tasks by filing, copying and faxing documents.
  • Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
  • Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.


Customer Service Representative

Pass Photography-CSR/Project Assistant - Remote
09.2021 - 05.2023
  • Managed approximately 45-80 emails daily in high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts between photographer, clients and labs
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Responded to customer requests for products, services, and company information.
  • Assisted customers in navigating company website and placing online orders, improving overall user experience.
  • Improved resolution time with effective problem-solving for customer complaints.
  • Fostered positive customer service culture within team which led to higher customer satisfaction rates.

Manager/Customer Service Representative

Raw Iron Gym
10.2019 - 02.2022
  • Managed high-volume calls & daily operations, ensuring efficient handling of member inquiries and concerns.
  • Resolved escalated member issues promptly, maintaining professionalism under pressure situations.
  • Developed strong relationships with members and key clients, leading to increased loyalty and repeat business.
  • Delivered exceptional customer service to every member by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
  • Educated all members about billing, payment processing and support policies and procedures.
  • Managed and operated all the daily cleaning of the 6500 sq ft. facility.
  • Handled all insurance billing/monthly billing cycles for members
  • Worked 24/7

Susbtitute

Emmett Independent School District
09.2010 - 09.2020
  • Kept students on-task with proactive behavior modification and positive reinforcement strategies.
  • Managed classroom behavior effectively, ensuring a safe and respectful atmosphere for all students.
  • Improved student comprehension by tailoring teaching methods to individual learning styles.
  • Followed classroom plans left by class teacher to continue student education and reinforce core concepts.
  • Repeatedly requested as substitute teacher by teachers based on excellent past referrals and trusted performance.

Secretary

First Baptist Church
07.2014 - 06.2017
  • Handled sensitive information discreetly, maintaining confidentiality when managing personnel files or financial data.
  • Answered multi-line phone system and enthusiastically greeted callers.
  • Typed minutes, weekly bulletins, worked closely with the pastors in our area and region in serving the needs of the community and church outreach
  • Decorated & organized for weddings, funerals and holiday parties held at the church
  • Prepared all the Quarterly and Annually reports

Administrative Assistant

Lutheran Community Services
07.2007 - 09.2008
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting patients & visitors
  • Maintained confidentiality of sensitive information by adhering to strict HIPPA policies and implementing secure filing systems.
  • Delivered excellent customer service through prompt responses to patient inquiries, addressing concerns effectively, and building strong relationships.
  • Maintained inventory of office supplies and placed orders.
  • Ensured accurate record-keeping with diligent data entry and database management for vital company information.
  • Promoted a positive work environment through effective communication skills and fostering professional relationships among colleagues.

Billing Administrator

Boise Heart Clinic
10.2005 - 05.2006
  • Answered all high levels of patient calls
  • Established clear communication channels between the billing department and AP/AR teams to ensure seamless collaboration on account management issues.
  • Handled all billing/statements, invoices and insurance
  • Data entry of patient demographics, obituaries and trust declarations & collections
  • Took care of all the business minutes for physicians and updated protocols and procedures

Administrative Assistant/Billing Department Manager

STARS Rehabilitation(Saint Als') & Pain Center
10.2001 - 10.2003
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors & patients. High volume patient calls.
  • Promoted a positive work environment through effective communication skills and fostering professional relationships among colleagues.
  • Maintained confidentiality of sensitive information by adhering to strict privacy policies of HIPPA and implementing secure filing systems.
  • Improved staff morale by organizing recognition programs, acknowledging outstanding contributions and fostering positive work culture.
  • Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
  • Built and maintained excellent patient relationships through timely response to inquiries and going above and beyond to accommodate unusual requests.
  • Opened and properly distributed incoming mail to promote quicker response to patient inquiries.
  • Volunteered to help with special projects of varying degrees of complexity.
  • Handled escalated patient inquiries related to invoicing discrepancies by conducting thorough investigations and implementing appropriate resolutions.
  • Managed a team of billing specialists, ensuring timely and accurate invoicing for patients.
  • Maintained open communication lines between the billing department and other internal teams, fostering a collaborative work environment.
  • Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
  • Worked with patients to develop payment plans and bring accounts current.
  • Organized and updated databases, records and other information resources.
  • Optimized organizational systems for payment collections, AR, deposits, and recordkeeping.
  • Ensured accurate record-keeping with diligent data entry and database management for vital company information.

Education

General Studies/Business

Centennial High School
Meridian, ID
05-1993

Skills

  • Attention to detail
  • Patient confidentiality
  • HIPAA compliance
  • Insurance coverage verification
  • Data entry proficiency
  • Eligibility determination
  • Data entry and review
  • Communication and interpersonal skills
  • Coverage and authorizations
  • Coordination and scheduling
  • Insurance billing
  • Electronic medical records
  • Patient contact
  • Prior authorization processing
  • Customer relationship management
  • Medical terminology
  • Patient communication
  • Customer service
  • Documentation and correspondence
  • Accuracy and precision

Additional Information

  • Gaps in employment due to being a stay-at-home mom and COVID-19




Timeline

Administrative/Insurance Verification Specialist

Horizon Home Health & Hospice
05.2023 - 01.2025

Customer Service Representative

Pass Photography-CSR/Project Assistant - Remote
09.2021 - 05.2023

Manager/Customer Service Representative

Raw Iron Gym
10.2019 - 02.2022

Secretary

First Baptist Church
07.2014 - 06.2017

Susbtitute

Emmett Independent School District
09.2010 - 09.2020

Administrative Assistant

Lutheran Community Services
07.2007 - 09.2008

Billing Administrator

Boise Heart Clinic
10.2005 - 05.2006

Administrative Assistant/Billing Department Manager

STARS Rehabilitation(Saint Als') & Pain Center
10.2001 - 10.2003

General Studies/Business

Centennial High School

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Kristen Dalton