Insurance Medical
Resume:
Kimberly A DePugh
PO Box ***
Jonestown, PA ***38
********@***.***
Objective I am a highly qualified and well organized individual. I am able to work well under
high levels of pressure. I also enjoy working with others and am always ready for
a challenge.
Experience Financial Account Technician
Department of Veterans Affairs NE CPAC – Lebanon, PA
May 2012 –
Had responsibility for the collection functions of the Revenue program third party
insurance reimbursements and other account receivables.
Performed aggressive follow up analysis on outstanding third party receivables
and other accounts receivables to determine best course of action to effect
maximum recovery.
Initiated or performed all follow up action based on a variant number of criteria
(age, type and amount of receivables); and analyzed, planned, initiated,
coordinated and implemented actions required to maximize collections of
receivables.
Received and responded to a variety of communications generated by third party
payers, and has signatory authority for collection letters and subsequent follow up
correspondence.
Audited, analyzed and reviewed information regarding the established third party
receivables to discuss the status of the account when inquiry is made on follow
up.
Contacted and pursued insurance companies and other third party payers to
expedite collections; and determined when referral to Regional Counsel or other
departments is appropriate for further progression of the collections.
Analyzed claims to ensure expected payments are consistent and in accordance
with the specific policy and or regulatory rules.
Identified and followed up on ways to expedite collections through contacts in the
public and/or private sector.
Maintained and updated computerized records of debts to document collection
efforts and to prepare statistical reports for management.
Coordinated collections efforts by utilizing an automated accounts receivable
program, edited and uploaded an automated system to ensure the information is
accurate; and maintained account receivable files by ensuring appropriate
documentation to support subsequent auditing activities (i.e., audit trails)
Medical Reimbursement Technician
Department of Veterans Affairs – NE CPAC, Lebanon, PA
February 2012 – May 2012
Verified patients’ insurance coverage for inpatient and outpatient services,
entering updated information and maintained the database, including verifying
benefits, policy numbers, pre certification requirements, insurance company
contact information and effective dates of coverage.
Documented pre admission requirements and identified patients’ requiring second
opinions, assisting with the pre certification process, generating monthly reports
and reviewing and explaining insurance coverage with patients.
Performed all reimbursable billing activities, including consideration of
professional and facility services, sharing agreements, Tri care, Champ VA,
Medicare and pharmacy billing, ensuring that all billable cases are identified and
bills are generated, coordinating completion of forms with patients, providers and
administrative staff and obtaining information required for tort cases, workman’s
compensation, Office of Workers Compensation Programs (OWCP) and personal
injury cases.
Patient Account Associate
Milton S Hershey Medical Center – Lebanon, PA
November 2003 – December 2011
Patient account billing, follow up with patient accounts in work list. Requesting of
patient medical records, review of professional claims, phone contact with auto
insurance companies, compositions of auto exhaust letters, processing of trauma
and non trauma claims with both hospital and physician facilities, preparation of
medical records and release letters. Special projects: work reports off of e
premis, pc print and intra viewer, Distributing and processing of mail for all
departments.
Claims Processor/Assistant
Princeton Insurance Company, Camp Hill, PA
December 1999 – October 2003
Processing of medical and loss time claims, personal phone contact with
insured/claimant. Contact with attorneys and witnesses to workman’s
compensation injuries/incidents. Issuing of URO’s, denials, statement of wage
forms and letters, processing of occupational injury forms and hospital letters and
medical report forms. Processing of incoming payments, posting of recovery
checks, stop payments and voids. Coding of claims sent out to re pricing
companies. Distributing and processing of mail to departments.
Typist/Claims Processor
Nationwide Insurance Company, Harrisburg, PA
June 1996 – December 1999
Typing of farm policies, form letters, processing of claims, sorting and distributing
mail, filing. Operation of copier, fax machine, typewriter and computer
Education Certification in Dental Assisting
Harrisburg Area Community College, Harrisburg, PA
May 1992
Graduated from Middletown Area High School, Middletown, PA 1990
Computer Skills
Microsoft Word 6.0, Excel, Outlook Express, Windows 95,98, 2000 and XP, Citrix,
AS 400, Microsoft Word 12, Eclipsys, SMS, Group Wise and Power Chart, Vista,
Vista web and Huron programs
Training Programs
HMC Annual Safety Training
Outpatient Payment Prospective Overview
Cultural Competency for PFS and IA Staff
Rebill Competency
Transaction Master Consolidation and Fee Changes
Adult and child CPR Training Heart saver with AED and choking
Service Excellence for Staff
Generations in the Workplace
Release of Information
Coordination of Benefits 3
Coordination of Benefits II
Received Certification of Training from North East Consolidated Patient Account
Center (CPAC)
*Basic Accounts Management Course
*Basic Billing Course
*Basic Eligibility Course
References Danny L Bass Sr – Department of Veterans Affairs
717-***-**** – *****.****@**.*** Joshua Freeman – Department of Veterans Affairs
717-***-**** – ******.*******@**.*** George Olsen – Princeton Insurance
503-***-**** Indicates Professional References
Robyn Hartman – Department of Veterans Affairs (
717-***-**** – *****.*******@**.***
Troy Horst – Department of Veterans Affairs – ****.*****@**.***
Contact this candidate