Kim Buchholz

***** * ********* **

El Mirage, Az 85335

602-***-****

acyy7j@r.postjobfree.com

Career Summary

I am professional, motivated, dedicated, with healthcare insurance and business administration experience. I have leadership skills, organizational management, and have utilized strategic planning to prioritize the workload. My knowledge and work history has given me practical experience as well as allowed me the ability to focus on interpersonal skills leading to team collaboration which synergistically empowers productivity.

Programs/system utilized with Work History

Word, Excel, Sales Force, Market Prominence, Share Point, Cloud, EHR- EMR, Centricity, Next Gen, Passport, I-Terminal (computerized payment systems), Citrix, Avaya, Care One, CCS systems, Multiple phone-lines, Electronic Fax systems. FEMA flood system,

POS.

Work Experience

MEMBER BENEFITS ADVISOR AGIA

08/14-03/15 Scottsdale, Az

Assisted with policy, benefit information, general claim filing information regarding supplemental plans: AD&D, Term-life, Disability

Created new member benefit accounts as a result of marketing and product offer solicitation

Initiated escalation to prioritize the customer’s request

Utilized on-line banking system

Advised of rates for premiums to groups such as: GSC, AOPA, LIT,NRA

SALES COORDINATION/CLERICAL ADMIN/PFS BANNER HEALTH-Staffing 07/13-06/14 Mesa, Az

Accessed patient/client account to initialize the processing of Medicare applications within informational guidelines for BCBS Advantage

Filing, completed fulfillment requests

Processing electronic payments, Physician’s order tasking, scheduling appointments while accessing appropriate EMR systems

CARE COORDINATION/CLINICAL MEDICAL ADMIN. UNITED HEALTH GRP 03/06-10/06//04/09-5/12 Phoenix, Az

Worked with business affiliates to complete accurate documentation of records and updating patient information for notification purposes Commercial division

Utilized Care Management systems and tools for processing notifications

Learned HIPPA laws, and received fraud training in compliance with corporate guidelines

Approved DME, HHC: products/services for Medicare Advantage (Medicare Complete/Secure Horizons division)

Triage calls to appropriate care management function as well as accessed notification wizard to verify ICD-9 and CPT coding when applicable for notification

ADMIN. ASSISTANT/ FRONT OFFICE ADMIN DESERT STATE APPRAISING

04/05-11/05 Peoria, Az

Maintained A/R and billing for over 13 business affiliates

Created electronic accounts using computer systems, as well as creating and maintaining hard copy files

Managed phone systems, customer accounts, scheduling, office supplies, inventory and filing

Achieved a high level of accuracy in processing of documents and correspondence while maintaining a high production volume in a fast paced, demanding work environment

TEACHING ASSISTANT CATHEDRAL CHRISTIAN ACADEMY

03/04-04/05 Glendale, Az

Responsible for maintaining order in the classroom setting

Set up play stations, and oversaw students in social interaction with one another

Assisted with documenting growth and progress of each individual student

BENEFIT VERIFICATION SPECIALIST PRINCIPAL FINANCIAL GROUP 05/02-02/04 Phoenix, Az

Accessed personal and confidential information pertinent to updating systems

Verified benefits for various insurance policies to policy holders or medical affiliates

Assisted with the submission of claims, predeterminations, and appeal process

RETENTION/CUSTOMER SERVICE DISCOVER CARD

10/01-05/02 Phoenix, Az

Consulted with clients, while retaining and setting up customer accounts

Daily duties consisted of assessing strategies to offer optimum customer assistance and service in diverse situations

Negotiated rate reductions where applicable

Implemented sales and product promotion

Routed misdirected calls to the correct department to fulfill the customer's needs

Education: AIBT-Medical Assistant Administration; Service Training for Retention at Discover Card included Credits through Rio Salado College

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