Tamesia Kennedy
Savannah,GA
Summary
"Compassionate and dedicated healthcare professional with over 6 years of experience in providing high-quality patient care. Skilled in conducting assessments, developing treatment plans, and implementing medical procedures. Proficient in electronic health records systems and ensuring compliance with regulatory standards. Strong interpersonal and communication skills, with a proven ability to work effectively in a fast-paced environment. Seeking a rewarding opportunity to utilize my medical expertise and make a positive impact on patient outcomes."
Overview
10
10
years of professional experience
Work History
Patient Service Representative
Knowtion Health-Remote
10.2022 - 02.2024
- Obtains and inputs complete and accurate patient, guarantor and insurance information which includes verification of existing information regarding personal and employer information
- Ensures all necessary forms are completed for each patient, all signatures are obtained and each patient receives an armband at the time of registration
- Performs insurance verifications on insurance that is entered into a patients account
- Acknowledges all external and internal calls as soon as possible and operates the telephone system in an efficient, courteous manner to process telephone communications for patients, physicians, personnel and the general public
- Collects, posts payments and sets up financial arrangements with patients at the time of service, referring patients to financial counselor as needed
- Verifies medical necessity and ensure physician orders include correct information
- Accurately documents discharge information for all patients in a timely and efficient manner
- Completes audits to ensure accuracy of insurance information
- Processes daily census and create necessary spooled reports.
Insurance Specialist
Conifer-Savannah, GA
Savannah, GA
07.2018 - 09.2022
- Obtains pre-authorization approvals for outpatient procedures from the Surgery, Day Medicine, Radiology, Nuclear Medicine, Genetics, Sleep lab and Heart Station departments
- Preregisters, obtains prior authorization, price estimates, PCP referrals, upfront collections and referred accounts prior to date of service
- Obtains prior authorizations and insurance verification for all clinics, Medicare patients, out-of-state Medicaid, SDC and for specialty drugs
- Obtains the appropriate prior authorizations for surgical and outpatient procedures and the necessary CPT/ICD-10 diagnosis codes when appropriate
- Obtains price estimates, upfront collections and referred accounts prior to date of service
- Completes outbound calls to families regarding insurance coverage and benefits, high deductibles, co-pays, denials
- Conducts appropriate follow-ups and verifications on all assigned accounts including documenting in the patients account detailed insurance information prior to services being rendered
- Ensures that pre-certifications, pre-notifications, prior authorizations or referrals are received for each account with a financial class of insurance and/or Medicaid
- Appropriately refers all high dollar or self-pay accounts to Financial Counselor
- Serves as a liaison between the clinical staff and insurance payers
- Collects deductible, co-pay and all other applicable payments
- Performs other duties as assigned.
Payment Posting Specialist
BroadPath-Savannah, GA
Savannah, GA
05.2015 - 06.2018
- Ensures all batches balance daily
- Balances applicable primary payment information for electronic submission to secondary payer weekly
- Completes posted batch daily cover sheets accurately
- Posts all manual batches
- Ensures all batches balance
- Completes daily balance log correctly
- Reviews and responds appropriately to correspondence according to established time parameters
- Documents all action taken
- Ensures correspondence is scanned to the account
- Promptly reviews outstanding Credit Accounts receivable in addition to all submitted charge adjustment and other refund request forms
- Accurately posts all approved requests for charge adjustment and refunds
- Produces required, related reports and documents accounts properly
- Evaluates paid claims to ensure accurate payment; Identifies and assigns underpaid claims; Maintains variance report files
- Posts all payments and denials.
Customer Service Representative
DISH-Guyton, GA
Guyton, GA
05.2014 - 05.2015
- Handle escalated calls, resolving more complex customer issues in a one and done manner
- An average of 50-90 calls are expected daily
- Answer incoming phone calls from Policyholders, Agents and Third-parties
- Processing and identifying the type of assistance the customer needs
- Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
- Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
- Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
- Meet the performance goals established for the position in the areas of: first call resolution, call quality, efficiency, provider satisfaction, and attendance.
Education
Associate's degree - Insurance billing & coding
Herzing University
Atlanta, GA04.2022
High school diploma -
Effingham High School
Springfield, GA05.2014
Skills
- Insurance Verification
- Medical Billing
- HIPAA
- Accounts Receivable
- Epic (4 years)
- Appeals (4 years)
- Microsoft Word (6 years)
- Microsoft Excel (6 years)
- Microsoft Outlook (6 years)
- Inbound calls (6 years)
- Outbound calling (6 years)
- Customer service (9 years)
- Medical Records
- EMR Systems
- Hospital Experience
- Windows PC (5 years)
- Accounting (3 years)
- CPT Coding
- ICD-10
- Medical Coding
- ICD-9
- Medical records
Timeline
Patient Service Representative
Knowtion Health-Remote
10.2022 - 02.2024
Insurance Specialist
Conifer-Savannah, GA
07.2018 - 09.2022
Payment Posting Specialist
BroadPath-Savannah, GA
05.2015 - 06.2018
Customer Service Representative
DISH-Guyton, GA
05.2014 - 05.2015
Associate's degree - Insurance billing & coding
Herzing University
High school diploma -
Effingham High School