Summary
Overview
Work History
Education
Skills
Career Highlights
Timeline
KRYSTAL KING

KRYSTAL KING

Porterville,CA

Summary

Seasoned Medical Claims Processor and Health Information Technician with six years of experience. My expertise in claims processing, as well as my ability to interpret medical records and data, has allowed me to effectively process claims and ensure compliance with industry standards. Having gained a comprehensive understanding of the healthcare revenue cycle, I am now eager to pivot my skills and experience toward a career in healthcare revenue cycle management. My proven ability to streamline processes, identify inefficiencies, and drive revenue growth makes me a valuable asset to any organization seeking to optimize its revenue cycle performance

Overview

18
18
years of professional experience

Work History

Claims Processor

United Health Group
01.2022 - 04.2023
  • Provides support by reviewing, researching, investigating, and processing claims
  • Authorize payment and enter into our companies database
  • Research & review processed claims for necessary adjustments or corrections
  • Collaborate within our claims department and industry anti-fraud organizations to resolve claims
  • Follow up on potentially fraudulent claims initiated by claims representatives.

Health Information Technician/Release of Information Spec

Adventist HealthCare
04.2019 - 12.2021
  • Sorted, scanned and indexed documents, developed workflows and processed workflow reports to keep clinical records maintained in accordance with guidelines
  • Participated in committees to discuss electronic health records and methods to improve overall workflows
  • Collaborated closely with physicians and nursing staff to improve quality of patient records documentation.

Customer Services Rep

Mindlance- Cigna
10.2017 - 06.2018
  • Help clients, customers and health care providers understand determination of payments and claims related to medical and dental procedures and office and hospital visit costs
  • Take ownership of their issues and do your best to resolve them over the phone the first time, every time
  • Educate customers on disease management programs and make recommendations on the right healthy living programs for their needs.

Records Technician

Valley Presbyterian Hospital
08.2009 - 09.2010
  • HIPAA privacy rules and Release of Information procedures and uses keen judgment in releasing PHI to all requestors
  • Coordinates the electronic transfer of PHI to insurance companies through designated secure portals as needed to assure payment
  • Judges the legitimacy of each request and determines whether information can be released
  • Checks for properly executed authorization to release medical information.

HIM Specialist

Sierra View District Hospital
06.2005 - 10.2006
  • Accurately enters all requests into the Release of Information stations
  • Provides support by reviewing, researching, investigating, and processing claims
  • Authorize payment and enter our company database.

Education

Associate's Degree - Health Information Technology

DeVry University
10.2022

RHIT Eligible

Skills

  • HIPAA Regulations
  • Revenue Cycle
  • Insurance Claims
  • Reporting
  • Process Improvement
  • Clinical Documentation
  • Critical Thinking
  • Auditing
  • Analytics
  • Accuracy
  • Performance Improvement

Career Highlights

 Collaborate within our claims department and industry anti-fraud organizations to resolve claims. By collaborating with our claims department and industry antifraud organizations to resolve claims, I was able to reduce fraudulent claims by 20% within a year.

Timeline

Claims Processor - United Health Group
01.2022 - 04.2023
Health Information Technician/Release of Information Spec - Adventist HealthCare
04.2019 - 12.2021
Customer Services Rep - Mindlance- Cigna
10.2017 - 06.2018
Records Technician - Valley Presbyterian Hospital
08.2009 - 09.2010
HIM Specialist - Sierra View District Hospital
06.2005 - 10.2006
DeVry University - Associate's Degree, Health Information Technology
RHIT Eligible - ,

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KRYSTAL KING