Krystal McCarthy
Louisville,KY
Summary
Seeking a dynamic opportunity within a professional environment, which could help further fine-tune my skillsets while adding to the overall success and productivity of a reputable organization.
Overview
19
19
years of professional experience
Work History
Personnel (Human Resource Specialist II)7
Kentucky State Reformatory
Lagrange , KY
08.2021 - Current
- Recruit new staff members and assist them during the hiring process
- Work in collaboration with our training department to get the new hires in for orientation and set up for academy
- Conduct interviews, urinalysis drug screens, coordinate background checks, and ensure all new hire paperwork is complete
- Assist with job fairs and maintain GoHireText QR code messages
- Maintain detailed records of personnel files like sick leave, comp time, and annual leave
- Assist Deputy Warden of Security with tracking new hire training and academy status
- Maintain and update correctional officer register including posting the register and tracking all new applicants
- Work with Personnel Cabinet to make sure all new hire paperwork is in and processed, and that the new hire is added to the personnel action’s spreadsheet
- Put together new hire orientation packets for all staff and assist with open enrollment
- Track new employees to make sure they receive their pay increase for completing their six-month probation.
Offender Information Specialist I (Programs Department)
Kentucky State Reformatory
03.2019 - 08.2021
- Performs sentence calculations that determine parole eligibility and release of inmates and maintains accurate offender inmate records in a state adult prison
- Enters data regarding terms of imprisonment into the Kentucky Offender Management System (KOMS), which includes sentence credits/debits, court orders, and ensuring any good time loss entered is accurate
- Serves as a liaison for institutional staff concerning inmate time calculations, release dates, and open records requests
- Provides requested information regarding inmates within our care to DOC staff attorneys, court officials, administrative staff, parole board, and inmate attorneys as needed
- Maintains accurate and updated inmate files within KOMS, which includes parole eligibility information and release dates
- Verifies and processes court orders for both Circuit and District Courts and verifies and serves detainers
- Discharges inmates by parole, conditional release, court order or shock probation according to statutory/judicial direction
- Answers telephone inquiries relevant to an inmate's projected release date and parole eligibility.
Correctional Officer
Kentucky State Reformatory
04.2018 - 03.2019
- Maintains control of the institution to provide safety and security of the inmates, staff, and general public by enforcing rules, regulations, policies, and procedures
- Supervises inmate activities in housing units, dining areas, recreation, and work areas
- Assists other officers and administrative or medical staff with inmate needs, including medical, visitation, personal property, and recreational activities
- Inspects and patrols the grounds and dorms for contraband, unauthorized personnel, and for other security risks
- Completes required reports and daily logs
- Conducts inmate counts, security rounds, and searches.
Surgical Charge Capture
Kentucky One Health
07.2017 - 07.2018
- Performed all daily charge reconciliation tasks to ensure timely and accurate charge capture
- Made sure all surgical supplies used were billed out correctly and within the required timeframe
- Managed workflow in an efficient manor to meet required productivity targets
- Responsible for accurate charge capture, charge codes and maintaining the implant log
- Ensured surgical case manual charges were accounted for and tracked all bill holds, then released them to the insurance companies for timely and proper payment.
Revenue Charge Specialist
Conifer Health (Jewish Hospital)
02.2015 - 07.2017
- Responsible for ensuring that all billing charges were captured in an appropriate manner
- Identified, analyzed, and reconciled billing errors or omissions
- Reviewed patient account records and third-party payer issues
- Performed a variety of tasks to include medical coding, correcting incorrect claim codes, and adding modifiers to claims in order to ensure proper billing
- Received and reviewed charge documents from hospitals
- Ensured charge information provided was correct, balanced, and accurate before keying the charge summary into the system
- Billed and entered charges in a timely manner in a high-volume setting
- Have broad knowledge of medical terminology, coding skills, specialty medical practices, and can decipher and explain EOBs to patients who called with questions.
Utilization Management
Seven Counties Services, Inc.
02.2014 - 02.2015
- Under moderate supervision, performed initial and recurrent authorizations to ensure timely reimbursement by payers for care, treatment, and services provided by SCS
- Verified client’s mental health, intellectual disability, and/or substance abuse benefits and obtained initial authorization and subsequent authorizations, as determined by client’s health insurance plan
- Accurately identified behavioral health payer per a client’s medical plan
- Implemented tracking system to obtain recertification of services, as needed, for psychiatrists, psychologists, licensed clinical social workers, and licensed professional counselors
- Verified information about client’s financial status or insurance coverage and completed insurance forms
- Answered inquiries regarding insurance coverage from clients, doctor’s offices, or third-party payers, and followed up with insurance companies to make sure benefits were accurately processed
- Explained to clients and their families the charges, services, and bill payment policies applicable to them
- Performed various administrative functions including, but not limited to, recording client identification data and physician diagnosis, investigating charges, correcting, and updating data, and preparing claims to bill
- Resolved billing problems and/or received insurance updates.
Human Resource Assistant
Recover Care
10.2012 - 01.2014
- Provide all facets of administrative support to Human Resources Department, including, but not limited to, document preparation, scanning, filing, and organization of records
- Run background checks electronically on potential and current employees, including DOT compliant information, Workers’ Compensation claims
- Extremely accurate data entry skills - enter employee data into HRIS system
- Run end of month reports for current employees for expiring licenses and MVR's
- Maintain proficiency in MSOffice and other software used within the organization
- Must be extremely detailed oriented and conduct follow ups with all executive and management staff as needed
- Maintain confidentiality in accordance with all state and federal regulatory standards with personnel files and employees
- Work with all managers and staff to ensure all company standards are followed consistently and accurately in all locations.
Human Resource Administrative Assistant
Amazon
01.2011 - 10.2012
- Provided all facets of administrative support to Human Resources Department, including, but not limited to, document preparation, scanning, filing, completing urinalyses, preparing, and reviewing new hire benefit packets with incoming staff, scheduling online CBL trainings for all staff, and organizing records
- Ran background checks electronically on potential and current employees, including DOT compliant information and Workers’ Compensation claims
- Accurately entered employee data information into HRIS system
- Ran the end-of-month reports for current employees with expiring licenses and MVR's
- Conducted follow up meetings with all executive and management staff as needed
- Maintained confidentiality in accordance with all state and federal regulatory standards with personnel files and employees
- Worked with all managers and staff to ensure that all company standards were followed consistently and accurately in all locations.
Executive Assistant
RL LLC
Louisville, KY
03.2009 - 01.2011
- Duties included overseeing all aspects of general office coordination and maintaining office calendar to coordinate workflow and meetings
- Maintained confidentiality in all aspects of client, staff, and agency information
- Interacted with clients, vendors, and visitors
- Answered telephones and transferred to appropriate staff member
- Opened, sorted, and distributed incoming correspondences, including faxes and emails
- Signed for and distributed UPS/FedEx or similarly delivered packages
- Prepared responses to correspondences containing routine inquiries
- Performed general clerical duties to include, but not limited to, bookkeeping, copying, faxing, mailing, and filing
- Provided administrative support associated with all components of the Organization Development Department, which included training, creating replacement charts, profiles, binders, and scheduled all meetings with executives
- Monitored and tracked monthly budget, analyzed discrepancies, and prepared variance reports
- Maintained all department files, including confidential files, in an organized manner
- When appropriate, responded on behalf of the team members.
Reimbursement Specialist
RX Crossroads
Louisville, KY
09.2008 - 03.2009
- Duties included calling insurance companies to get information on the patient’s plan to verify if the medication they were prescribed was covered by their insurance plan
- Provided reimbursement information to providers and patients, including private insurance companies, Medicare, and Medicaid
- Enrolled patients in drug reimbursement and patient assistance programs in an accurate and timely manner
- Acted as a partner with pharmaceutical and sales representatives
- Supported offices and patients in moving cases to paid therapy as needed within program policies and procedures
- Coordinated drug shipments and patient training between patients, physician offices, and specialty pharmacies
- Maintained all patient’s confidentiality.
Enrollment and Billing Rep III
Anthem Blue Cross Blue Shield
Louisville, KY
08.2006 - 08.2008
- Duties included converting membership applications from retired systems to new system
- Prepared paperwork for other associates and kept track of each individual group that had been loaded
- Ran daily reports for associates on production
- Responsible for individual enrollment, billing activities, and maintaining assigned accounts
- Responded to incoming calls and initiated outgoing calls, provided customer service to plan members and employer groups by answering eligibility and billing questions, resolved issues, and educated callers
- Verified enrollment status, made changes to records, researched, and resolved enrollment system rejections, and addressed various enrollment questions or concerns received by phone or mail.
DM Clerk
Anthem Document Management
Louisville, KY
09.2005 - 07.2006
- Duties included prepping medical and dental claims for imaging
- Kept track of daily production and quality of claims
- Helped plan and organize activities for associates to improve morale
- Corrected claims which were processed incorrectly from other departments and processed claims that were a priority for other business units
- Assisted in the Return to Provider claims issues
- Sent letters to external customers if there was missing or invalid information on claims
- As the back-up team lead for Operations Expert, distributed and picked up work in the absence of manager and Operations Expert
- Assisted in answering questions for newly trained associates and trained new associates in the Return to Provider process.
DM Clerk
Kelly Services
Louisville, KY
02.2005 - 09.2005
- Duties included prepping medical and dental claims for imaging
- Kept track of daily production and quality of claims
- Helped plan and organize activities for associates to improve morale.
Education
Medical Office Tech -
Daymar College
01.2006
Jefferson Co. High School
Skills
- Referral Coordination
- Assessment procedures
- Goal Setting
- Training and mentoring
- Relationship Building
- Time Tracking and Payroll Administration
- Adaptability and Flexibility
- Analytical Skills
- Time Management
- Personnel Recruitment
- Project Management
- Recruitment Management
- HRIS applications proficient
- Eligibility Determinations
- Administrative assistance
- Transfer Coordination
- Employee Orientation
- Temporary and Seasonal Employees
References
References can and will be provide upon request.
Timeline
Personnel (Human Resource Specialist II)7
Kentucky State Reformatory
08.2021 - Current
Offender Information Specialist I (Programs Department)
Kentucky State Reformatory
03.2019 - 08.2021
Correctional Officer
Kentucky State Reformatory
04.2018 - 03.2019
Surgical Charge Capture
Kentucky One Health
07.2017 - 07.2018
Revenue Charge Specialist
Conifer Health (Jewish Hospital)
02.2015 - 07.2017
Utilization Management
Seven Counties Services, Inc.
02.2014 - 02.2015
Human Resource Assistant
Recover Care
10.2012 - 01.2014
Human Resource Administrative Assistant
Amazon
01.2011 - 10.2012
Executive Assistant
RL LLC
03.2009 - 01.2011
Reimbursement Specialist
RX Crossroads
09.2008 - 03.2009
Enrollment and Billing Rep III
Anthem Blue Cross Blue Shield
08.2006 - 08.2008
DM Clerk
Anthem Document Management
09.2005 - 07.2006
DM Clerk
Kelly Services
02.2005 - 09.2005
Medical Office Tech -
Daymar College
Jefferson Co. High School
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