Customer Service Medical Assistant
Resume:
Kimberly A. Sponseller
Stow, OH 44224
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EDUCATION
Northcoast Medical Training Academy "Accredited by ACCSC"
Program: Medical Assistant
Graduated: December 18, 2009
Knowledge of: (151) Injections (182) Blood Draws
Nationally Registered Certified Medical Assistant
Nationally Registered Certified Phlebotomy Technician
CPR-Certified
Baldwin-Wallace College
Bachelor of Arts 1987
Major: Business Administration
Minor: Biology
CAREER EXPERIENCE
Summit Pain Specialists Updated Practice address change with all
4/2010-7/2010 payors
(90 day position) Credentialed new physician
Organized Managed Care Contracts
Answered Patient Services Calls,
Appointment Scheduling
Summa Healthcare Consultant
2006
Assisted with Medicare Part D filing and
HF Medical Management, Inc. traditional Medicare filing
Akron, Oh.
Operations Specialist (Part time Responsible for monthly financial
position) reporting including:
December 1997 to December 2002 Capitation and check distribution
Revenue
Member months
Bed days
Stop loss
IBNR
Primary care financial reports
Responsible for accounts receivable and
accounts payable
Payroll reporting
All entry and maintenance of Quick Books
HF Medical Management, Inc. HF Medical Management, Inc. partnered
Akron, Oh. with Kaiser Permanente to create a
Director, Operations network of independent private
September 1995 to September 1997 practitioners to service Kaiser
Permanente members in Stark and Summit
counties. HF Medical Management, Inc.
shared financial responsibility for
members who chose primary care
physicians in private practice and was
responsible for utilization management
for those members.
Assisted in all aspects of setting up a
company branch exclusively created for
the implementation of the Kaiser
Permanente contract
Directly responsible for creation of
operations department including:
Network Medicare and commercial
membership reconciliation
Monthly primary care physician financial
profiles
Development of fee schedules for network
providers
Financial reconciliation including
capitation, claims and revenue for
network providers
Kimberly A. Sponseller
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Aetna Health Plans of Ohio, Inc. Monitored progress and performance of
Beachwood, Oh. all Medicare product operational
Administrator, Senior Choice Operations functions
Responsible for all aspects of plan
September 1994 to September 1995 payment, provider reimbursement, billing
reconciliation and collections
Acted as liaison to Minneapolis service
center and physician hospital
organizations
Developed, staffed and managed member
service and enrollment departments
Aetna Health Plans of Ohio, Inc. Recruited and serviced ancillary
Beachwood, Oh. providers for all of Northeast Ohio,
Network Management Coordinator, regional representative for national
September 1992 to September 1994 ancillary contracts
Established and maintained local
provider database and consulted with the
corporate office for national database
Created innovative methods for
contracting unique providers
Established customer specific networks
State Chemical Manufacturing Co. Monitored progress and performance of
Cleveland, Oh. everyday operations for the customer and
Customer/Marketing Service Supervisor marketing service departments
July 1987 to July 1992 Handled front-line legal issues and
wrote claim settlements
Developed training materials for
consistent and effective work flows
Developed an information pool to promote
expertise in customer/sales force
interaction
Developed customer service department
from the ground-up
Fully staffed and trained customer
service department
Implemented interdepartmental
educational sessions
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