KYLA HODGE
South Holland,IL
Summary
Motivated Patient Account Representative offering 14 + years of healthcare and customer service experience. Highly effective time management, conflict resolution and communication skills. Dedicated professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
20
20
years of professional experience
Work History
Patient Account Specialist/Litigation Associate
ATI Physical Therapy
Bolingbrook, IL
12.2022 - Current
- Analyzed accounts to ensure proper follow up on accounts receivables including inbound/outbound calls, written correspondence (emails, fax), understand and research denied claims, submitted appeals
- Posted payments and processed refunds.
- Electronically and manually submitted bills according to compliance guidelines.
- Utilized computer programs to create invoices, letters, liens and other documents.
- Contacted attorneys to discuss past-due accounts and negotiation of balances.
- Worked with attorneys, work compensation, medical, auto, and personal injury insurance carriers to resolve issues with billing, claims and payments.
- Utilized Microsoft Outlook, Excel, Word and other software to complete daily tasks and maintain work log.
- Escalated trends and issues to Senior Account Specialist with proper research and supporting documentation.
- Documented clear, and concise account notes using standard formats
- Prevented impending loss and increased profitability by enforcing scheduled collection attempts consistently achieving targeted recovery rate.
Fulfillment Associate
Amazon
08.2022 - 12.2022
- Cross-trained new associates on picking and filling orders for warehouse products.
- Oversaw warehouse staff and maintained efficiency in fast-paced environment.
- Reported and analyzed inventory data to help management strategically improve pricing and marketing strategies.
- Received and reviewed new orders, located requested merchandise and promptly initiated processing.
- Coordinated efficient shipping and receiving for 15 -20 trucks each day while implementing continuous improvement strategies to optimize team performance.
Provider Advocate Specialist
Health Care Service Corporation
07.2018 - 10.2021
- Provided primary customer support to internal and external customers.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
- Review of previously processed medical claims to determine accuracy of processing and to develop plan of action.
- Followed up with providers and departments on unresolved issues.
- Modeled exceptional customer service skills and implemented appropriate diagnostic procedures to assure provider issues were completely resolved.
- Reviewed outstanding requests with projects consisting of over 1,000 claims and redirected workloads to complete projects on time.
- Acted as commercial and medicare claim subject matter expert, answering internal and external questions and inquiries.
- Processing of Medicare, Medicaid, Commercial, and Workman's Comp claims
- Proficient use of Microsoft Excel, Outlook, OneNote, Powerpoint, and Word
Claims Examiner
Health Care Service Corporation
08.2017 - Current
- Processing complex paper and electronically submitted claims that require further investigation
- Determine proper coding: HCPCS, ICD 10, CPT, and Rev Codes
- Resolve pending claims and process adjustments
- Review and analyze Medicare claims for final processing
- Verify benefits, eligibility, and review medical records for approvals and denials
- Research medical guidelines based on Cost Containment and established new processes
- Increased departmental productivity
Office Manager/Medical Assistant
Great Lakes Pulmonary and Sleep Associates
06.2014 - 08.2017
- Overseer for daily office operations/clerical procedures & managed various office projects
- Maintained records for PQRS submission to CMS (Medicare)
- Analyze submission of EMR via EPIC software and rectify inconsistencies
- Verified medical benefits & eligibility, schedule appointments, and register over 50 patients per day
- Assist coordinating patient's care
- Managed Staff of 5-8 employees
- Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties.
- Investigated and resolved customer inquiries and complaints quickly.
- Collected customer feedback and made process changes to exceed customer satisfaction goals.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Welcomed, greeted and assisted customers on their appointments
- Trained staff on operating procedures and company services.
- Quickly and accurately answered customer questions, suggested effective solutions and resolved issues to increase customer satisfaction.
Office Manager/Medical Assistant
VRAJ
05.2011 - 06.2014
- Overseer for daily office operations/clerical procedures & managed various office projects
- Distributed sample pharmaceuticals as prescribed
- Efficiently entering and processing orders via EMR systems
- Assist over 30 patients per day with registration and scheduling
- Compile and prepare medical charts daily
- Manage office of 3-4 employees
- Performed monthly inventory checks for supplies, including office and clinical
- Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties.
Security Officer
Allied Barton Security
09.2007 - 05.2011
- Processed payroll for secured sites
- Managed mobility activity for employees and/or visitors (over 30 per day)
- Ensured proper security for all sites
- Updated and submitted data entry logs daily
- Provided security footage when applicable
Medical Records Director
Pavilion of Forest Park
03.2004 - 05.2007
- Managed confidentiality and storage of over 250 patients health information
- Management of assigned weekend staff, when needed
- Prepared monthly calendars for patient care planning
- Communicated with patients, staff, internal departments, and external clients for various requests
- Managed & facilitated various projects assigned by Administrator
Education
Real Estate License -
Keller Williams Real Estate School
Orland Park, IL04.2022
General Studies/Prerequisites -
South Suburban College
South Holland, Illinois05.2011
Certified Medical Assistant -
Everest College
Merrillville, Indiana2011
High School Diploma -
Paul Robeson High School
Chicago, IL05.2003
Skills
- Adaptable
- Multitasking skills
- Excellent customer service skills
- Creative problem solver
- Efficient and reliable team player
- Detail oriented
- Accelerated Learner
- MS Office/Word, Excel, Outlook Proficient
- Strong Client Relations
- Medical Accounts Receivable, ICD-10 and CPT coding
- Project management experience
- Knowledge of legal/litigated process and documentation (Lien, LOP, Subpoena, Pro Rata)
Timeline
Patient Account Specialist/Litigation Associate
ATI Physical Therapy
12.2022 - Current
Fulfillment Associate
Amazon
08.2022 - 12.2022
Provider Advocate Specialist
Health Care Service Corporation
07.2018 - 10.2021
Claims Examiner
Health Care Service Corporation
08.2017 - Current
Office Manager/Medical Assistant
Great Lakes Pulmonary and Sleep Associates
06.2014 - 08.2017
Office Manager/Medical Assistant
VRAJ
05.2011 - 06.2014
Security Officer
Allied Barton Security
09.2007 - 05.2011
Medical Records Director
Pavilion of Forest Park
03.2004 - 05.2007
Real Estate License -
Keller Williams Real Estate School
General Studies/Prerequisites -
South Suburban College
Certified Medical Assistant -
Everest College
High School Diploma -
Paul Robeson High School