Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Kristen Hall

Mohave Valley,AZ

Summary

Multi-skilled Billing Specialist with background in managing several different positions within a pediatric office. Strengths include deep understanding of coding procedures uniquely to each insurance, proficiency in medical record management, and ability to handle various workloads efficiently. Previous roles involved proactively resolving claims denials, maintaining medical records and obtaining prior authorizations and referrals for continued patient care.

Overview

10
10
years of professional experience
1
1
Certification

Work History

Pediatric Billing and Coding

Children's Medical Center
Bullhead City, AZ
07.2016 - Current
  • Current with CPT and ICD-10 coding principles, government regulations, protocols, and third-party billing requirements while adhering to HIPAA regulations for safeguarding confidential patient information.
  • Analyzed medical records to identify and include diagnosis codes, procedures, services, and supplies in support of existing diagnoses.
  • Ensured accurate documentation by working closely with the provider on any discrepancies.
  • Performed daily audits on all insurance claims created for accuracy and completeness, upon submitting claims electronically and by mail for primary, secondary, and tertiary claims.
  • Following up and working denials or discrepancies for prompt payment.
  • Monitored aging accounts receivable report daily to identify unpaid balances due by insurances and patients.
  • Ensured timely filing of all claims within established guidelines.
  • Provided customer service support to patients and insurances regarding billing inquiries.
  • Developed an understanding of how various insurance plans process claims and their requirements for reimbursement purposes.
  • Collected, processed, posted and managed various claims payments from insurance companies.
  • Processed recoupment of insurance funds.
  • Served as the main point of contact for inquiries related to upcoming meetings with insurance representatives.
  • Supported external audits by providing coded data and documentation as requested.
  • Transmitted information, medical records, or documents to patients or other practices through email, mailings, or facsimile machine.
  • Created and organized electronic charts to manage patient records, utilizing scanning, copying, and filing for efficient documentation.
  • Purged inactive files and destroyed obsolete files following procedures.
  • Obtained and coordinated pre-authorizations, pre-certifications, and referrals required for treatment and specialties.
  • Answered phones, scheduled appointments, verified insurance benefits, and managed patient flow while greeting patients in a professional manner.
  • Managed state inventory levels of vaccines by documenting administered vaccines and performing timely ordering.
  • Ensured proper storage, handling, and disposal of vaccines by maintaining quality assurance certifications during vaccine shipment receipt.
  • Prepared vaccines for administration following established safety protocols.
  • Maintained current documentation of applicable laws pertaining to immunization requirements and regulation changes.
  • Assisted physician in delivering patient care through the acquisition of vital signs, recording patient histories, and generating examination notes.
  • Performed all duties efficiently and effectively, utilizing the EMR system eClinicalWorks.

Medical Biller

Physicians Management Solutions Inc.
06.2014 - 03.2016
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Collected, posted, and managed account payments from insurance companies and patients.
  • Prepared bank deposits of collected revenue from insurance companies and patients.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Completed and submitted appeals for denials using provider portals and phone communication.
  • Performed follow-up activities on unpaid claims with insurance companies by phone or written correspondence.
  • Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
  • Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
  • Organized paperwork and documents for practices, including filing systems and document scanning.
  • Successful use of Centricity EMR.

Education

Certificate of Proficiency - Medical Assisting Insurance Coding

Mohave Community College
Bullhead City, AZ
05.2014

Skills

  • HIPAA Compliance
  • Qualified Pediatric Coder
  • Medical Billing
  • Claims Creation and Processing
  • Payment Posting
  • Insurance Verification
  • Medical Records Management
  • Generating Prior Authorizations and Referrals
  • ASIIS
  • Front Desk Operations
  • Organization and Time Management
  • Strong communication abilities
  • Proficiency in eClinicalWorks

Certification

  • Immunization: You Call the Shots - Vaccine Storage and Handling

Timeline

Pediatric Billing and Coding

Children's Medical Center
07.2016 - Current

Medical Biller

Physicians Management Solutions Inc.
06.2014 - 03.2016

Certificate of Proficiency - Medical Assisting Insurance Coding

Mohave Community College

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Kristen Hall