KIM MUEHLHAUSEN

Medical Billing & Reimbursement Claims Processing Health Care Administration

New Lenox, IL 60451 815-***-**** adodz5@r.postjobfree.com Analytical, detail-oriented professional with a progressive career in claims processing operations and adjudication. Proficient coder and biller equipped with in-depth knowledge of medical billing, reporting, coding, and data entry skills. Knowledgeable at resolving claims, preparing patient charts for registration, collecting and verifying data to complete documentation, and reviewing health records to identify proper relationships between procedure and diagnosis codes. Agile leader with irrefutable accountability, leveraging communication, collaboration, and interpersonal skills to optimize daily operations and goals. CORE COMPETENCIES

Medical Coding Quality Assurance Inventory Control Medical Reimbursement Medical Billing & AR Healthcare Customer Service Appointment Scheduling Meticulous Data Entry Anatomy & Medical Terminology Written Communication Information System Payments Management Research Skills Policy Implementation Continuous Process Improvement Stellar Patient Service Needs Analysis Leadership & Collaboration Problem Solving SKILLS PROFILE

Demonstrate proficient understanding of CPT, ICD-9-CM, and HCPCS coding systems

Streamline a full range of organizational data management and coordination of finance reporting and project duties

Apply coding guidelines and key performance indicators in diagnostic codes to ensure accurate and timely billing

Demonstrate superior knowledge and thorough understanding of government and commercial insurance regulations

Correct coding and billing services, diagnoses, treatments, and healthcare claims for hospitals and physician facilities

Knowledgeable in medical terminology; leverage excellent verbal and written communication skills

Committed to enhancing healthcare business operations, providing patient services, and finding solutions to issues PROFESSIONAL EXPERIENCE

Secondary Claims Processor 05/2017 – 05/2021

Scheck and Siress, a Hanger company Oakbrook Terrace, IL

Met and exceeded daily/monthly account quotas by 97% by efficiently processing new claims and verifying data and documentation before submitting for approval or review.

Applied knowledge of insurance rate standards to calculate premiums, adjustments, and new reserve requirements.

Processed all secondary claims and followed up to ensure they were processed correctly and communicated with policyholders to acquire missing information for claims processing.

Accomplished multiple tasks, such as verifying eligibility, computing accounts receivables, defining coding methods based on physician’s notation, billing out claims to insurance companies, and ensuring strict regulatory compliance.

Exemplified strong organizational skills and flexibility in processing confidential information in a fast-paced environment. Claims Processor 04/2013 – 05/2016

Coram Machesney Park, IL

Achieved accounts quotas at 95% by adjudicating healthcare claims in line with departmental policies and procedures.

Employed administrative guidelines on scheduling, processing, or filing insurance verification, and follow-up on medical claims while providing medical claims decisions based on established processing criteria.

Investigated and resolved claim issues by coordinating with appropriate departments while addressing inquiries. Claims Processor 03/2010 – 09/2012

McKesson Wheeling, IL

Managed, updated, and organized files/records while delivering exceptional guest relations through welcoming visitors warmly, offering immediate assistance, and providing quality support for other claims activities as needed.

Exhibited strong technical expertise by researching denied claims and processed appropriate appeals for resubmission.

Performed consistent data entry to ensure proper disposition of multiple claims that cannot be entered into systems. EARLY CAREER

Claims Processor; University Physicians Healthcare – Tucson, AZ 11/2005 – 11/2009 Customer Service Representative; Allied Benefit Systems – Chicago, IL 02/2003 – 05/2004 Customer Service Representative; Coursource – Matteson, IL 12/1999 – 02/2003 EDUCATION

Associates in Business Management

Robert Morris College; Orland Park, IL

Accomplishments:

Three-time recipient of Dean’s List award

3.75GPA. – 4 GPA

Diploma

Lincoln-Way Central High School; New Lenox, IL

TECHNICAL SKILLS

Adobe Microsoft Office Suite (Word, Excel, PowerPoint) Facebook Twitter Instagram

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