KIMBERLY DOUGLAS

**** **** **** **** #***

Collierville, TN 38017

210-***-****

ac2nnl@r.postjobfree.com

Dependable, multi-tasked, individual with the ability to operate at a maximum efficiency in a fast paced environment.

QUALIFICATIONS

History of effective problem solving and increasing productivity. Background includes a diversity of strengths in a medical setting in areas including:

Medical Terminology

General knowledge ICD9 and CPT-Coding

Research and problem-solving

Oral and written communication skills

Medical Transcription

Working knowledge of all facets of insurance requirements

Ability to organize and prioritize work

Other skills and abilities include:

Using on-line Network and PC Systems with software including Microsoft Word, Excel, IDX, Outlook, Cerner, FileNet, Avaya; HERO; Delair; RightFax; PASS

WORK HISTORY

KINETIC CONCEPTS INC Jun 2015 to Nov 2016

5800 Farinon Dr. Bldg IV

San Antonio TX 78249

Supervisor Cynthia Miller

Office 210-***-****

ac2nnl@r.postjobfree.com

HEALTHCARE INTAKE SPECIALIST

Qualified orders for placement based on payers requirements. Acts as the liaison between the customer, KCI, and third party payer to ensure the order meets regulatory and payer requirements. Obtain and analyze required documentation for shipping of product and billing of claims.

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SOUTH TEXAS VETERANS ADMINISTRATION Jan 2015-Jun 2015

8410 Data Point Dr

San Antonio TX 78229

Supervisor Sharon Benitez

Office 210-949-8900x65475

ac2nnl@r.postjobfree.com

MSA (MEDICAL SUPPORT ASSISTANT)

Responsible for scheduling appointments, including interpreting and verifying provider orders in accordance with VHA national scheduling guidelines. Assignments included scheduling, canceling, re-scheduling patient’s appointments and/or consults; entering no show information; assisted with monitoring the electronic wait list; facilitated and assisted with patient travel activities; verified and updated demographics and insurance information; gave

advisory and technical assistant to all applicable customers regarding eligibility and enrollment services, programs and activities; accurately interprets eligibility requirements in order to make eligibility determination to ensure that veterans and beneficiaries meet legal/contractual requirements for medical care; processed all emergency and non-emergency transfers to other VA facilities and non-VA hospitals and facilities; communicated pertinent information to patients, co-workers and clinical staff members; provided clerical support to include but not limited to preparing/mailing letters, placing phone calls, printing labels/armbands, maintaining/updating rosters and phone lists, and running various reports; performed accurate eligibility assessments, co-pays and preauthorization requirements for specific coverage.

UNIVERSITY HEALTH SYSTEM Jan 2009- Nov 2016

4502 Medical Drive

San Antonio TX 78229

Supervisor Cindy Marek

Office 210-***-****

Central Lab Facility Clerk

Receive and process samples that are submitted to laboratory for analysis. Performs duties required for computer order entry of tests requests. Retrieves patient test results from the lab computer and provides to clinicians verbal test results on which medical action will be based. Handles inquiries pertaining to specimen collection requirements and other lab test information. Serves as a receptionist to patients and visitors.

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KINETIC CONCEPTS, INC May 2009-Jan 2015

5800 Farinon Dr. Bldg IV

San Antonio TX 78249

B18.35/E19.08

Martha Gonzalez-ph210-406-5166

Healthcare Intake Specialist-Full time

Act as a contact person for the field personnel, medical professionals, patients, and claims carriers to facilitate the organization of paperwork required for processing DME claims. Verify member insurance benefits/eligibility online and through auto-mated phone system; Communicates with facilities and clinics to request referrals and medical documentation as needed for DME requests, including contacting insurance providers to initiate authorizations; Review insurance information entered by order entry dept for accuracy; Remains informed of new insurance guidelines and procedures for medical review; Collect and review incoming medical documentation by verifying ICD9 codes and insurance requirements noting acceptance in system. Accurately and completely documents communications and transactions between the

facilities, internal, and external customers. Escalates issues and situations within practice management; Responds to phone calls, emails and faxes from

internal and external customers; Manages transition process by working with discharge planners and case managers to ensure initial paperwork is properly complete and ensure timely release of delivery of DME products. Tracks orders

until payer and internal requirements are met for billing by monitoring bill pending reports to ensure collection of documents in a timely manner by following up with physician offices, home health agencies, wound clinics, hospitals, and patients. Assist in the resolution of accounts beyond authorization date; Coordinate and communicate with customers and service staff regarding asset, delivery, and pick up.

KINETIC CONCEPTS, INC. Sept. 2005-May 2009

1801 North Shelby Oaks Dr.

Memphis TN 38134

B15.00/E18.35

Eva Vasquez-ph210-406-4849

Coordinator of Patient Administration (COPA)-Full time

Point of contact for the field, acute facilities, clinics, and home health agencies to meet client needs. Monitored unbilled document issues report and collected missing information for billing. Assisted in the resolution of DME orders beyond authorization date; monitored pending report daily and maintained Bizflow system application to ensure complete documentation was obtained. Assisted internal departments with retrieval of documents, resulting in certification and recertification of DME products and therapies. Ensured timely processing of required paperwork to prevent delays in delivery, billing and recovering of DME products; Assisted in identifying patients transitioning between care settings (e.g. Acute to Home); Coordinated DME products for delivery; Ensured seamless transition of product placement.

EDUCATION

Everest Institute-2008 to 2009

Medical Billing and Coding-Diploma

6550 First Park Ten Blvd

San Antonio TX 78213

GPA 3.9

Northwest Mississippi Community College-1991 to1994

Associate of Applied Science Degree in Medical Office Technology

US Highway 51

Senatobia MS 38668

Medical Office Technology-Associate Degree

GPA 2.5

ACTIVITIES

Kinetic Concepts, Inc. Habitat for Humanity Sept-Oct 2008

Attended San Antonio Medical Managers Seminars (SAMM)

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