Kymmya Rowe
San Antonio
Summary
Dedicated healthcare professional with 10+ years of experience in the medical field, specializing in authorization management, medical billing, and patient account services. Proven track record of navigating complex insurance processes, securing timely pre-authorizations, and ensuring accurate billing to optimize revenue cycle efficiency. Skilled in collaborating with providers, payers, and patients to resolve authorization or billing discrepancies while maintaining compliance with HIPAA and insurance regulations. Recognized for strong organizational skills, attention to detail, and the ability to thrive in fast-paced environments. Passionate about supporting both patients and healthcare teams by ensuring seamless access to care and accurate financial processing.
Overview
8
8
years of professional experience
Work History
Contact Center Agent
OSF HealthCare
Peoria
06.2024 - Current
- Provided exceptional customer service via phone, email, and chat, handling inquiries, complaints, and support requests with professionalism and empathy
- Accurately documented customer interactions, transactions, and feedback in CRM systems, ensuring data integrity and efficient follow-up
- Resolved issues effectively by troubleshooting problems, offering solutions, and escalating complex cases to appropriate departments
- Met and exceeded performance metrics including call handling time, first-call resolution, customer satisfaction (CSAT), and quality assurance scores
- Maintained up-to-date knowledge of products, services, promotions, and policies to provide accurate and helpful information
- Adapted communication style to suit diverse customers while maintaining a calm and positive attitude under pressure
- Participated in regular training sessions to improve service skills and stay aligned with company standards and updates
- Collaborated with team members and supervisors to improve workflows and enhance customer experience
Nursing Operation Support
OSF HealthCare
Peoria
10.2022 - 06.2024
- The Nursing Operations Support (NOS) Representative acts as a resource on multiple units for Mission Partners, patients, visitors, and family members for general questions, information, and way-finding needs and provides unit support.
- Provides guidance to individuals related to other OSF facilities/service areas, coordinates and may assist with patient transport needs, provides local area direction, and advises of area accommodations or amenities.
- Utilizes various software to provide assistance and complete assigned tasks.
Authorization Specialist
Quality Response Medical Staffing
San Antonio
08.2022 - 08.2023
- Verify insurance coverage for patients before medical services are provided.
- Obtain pre-authorizations and pre-certifications from insurance companies for procedures, medications, surgeries, or referrals.
- Review medical records and provider notes to ensure all required documentation is included.
- Communicate with insurance companies by phone, fax, or online portals to get approvals.
- Track authorization requests and follow up on pending cases.
- Update patient records in the system with authorization numbers and details.
- Collaborate with providers and staff (doctors, nurses, billing) to resolve any insurance or authorization issues.
- Notify patients if services are denied or need additional documentation.
- Ensure compliance with insurance policies, HIPAA regulations, and healthcare laws.
- Assist with appeals or denials when authorizations are not approved.
Observer
Medical Staffing Agency
San Antonio
05.2020 - 08.2022
- Monitored vital signs of patients during rounds and reported any changes to physicians immediately.
- Evaluated nursing staff performance in delivering quality patient care services.
- Maintained confidentiality of sensitive information related to patients' health status at all times.
- Conducted research into new treatments or therapies for various medical conditions.
- Provided assistance to nurses and other healthcare professionals with patient care activities.
- Reviewed charts and records prior to physician evaluations to ensure accuracy of information.
- Assisted physicians with documentation of patient progress.
- Maintained compliance with HIPAA protocols to safeguard patient privacy.
- Built strong and trusting rapport with clients and loved ones.
Camp Advocate Assistant
Friendship House
San Antonio
01.2018 - 04.2020
- Supervised and engaged children in age-appropriate recreational, educational, and creative activities in a safe and supportive camp environment.
- Planned and led daily activities such as arts and crafts, sports, nature walks, team games, and themed events.
- Promoted a positive, inclusive, and respectful atmosphere, encouraging teamwork, confidence, and friendships among campers.
- Ensured the safety and well-being of all children by enforcing camp rules, monitoring behavior, and responding to emergencies or injuries.
- Communicated effectively with campers, parents, and fellow staff to ensure smooth daily operations and address concerns promptly.
- Served as a mentor and role model, demonstrating patience, enthusiasm, and strong leadership at all times.
- Assisted with setup, cleanup, and maintenance of activity areas and camp facilities.
- Adapted plans and support to meet individual needs, including children with behavioral or emotional challenges.
Education
High school diploma -
Peoria High School
Peoria, IllinoisSome College (No Degree) - Business Administration
ICC
Peoria, IllinoisSkills
- Sales negotiation
- Data entry
- Customer service
- CRM software
- Performance tracking
- Team collaboration
- Client relationship management
- Pre-authorization processing
- Insurance verification
- Medical record review
- Sales coordination
- Prior authorization processing
- Medical terminology expertise
- Medical coding
- Payment processing
- Account reconciliation
- Vital sign monitoring
- Healthcare documentation
- Data entry accuracy
- HIPAA compliance
- Performance metrics analysis
Personal Information
Willing To Relocate: Anywhere
Timeline
Contact Center Agent
OSF HealthCare
06.2024 - Current
Nursing Operation Support
OSF HealthCare
10.2022 - 06.2024
Authorization Specialist
Quality Response Medical Staffing
08.2022 - 08.2023
Observer
Medical Staffing Agency
05.2020 - 08.2022
Camp Advocate Assistant
Friendship House
01.2018 - 04.2020
High school diploma -
Peoria High School
Some College (No Degree) - Business Administration
ICC