Kimberlee S. Wilson

**** ******** ***.

Kettering, OH 45429

937-***-****

adwak3@r.postjobfree.com

SUMMARY

Experienced and versatile professional with over 20 years of experience in the medical field. Proficient in medical terminology and practices in the following specialties: Surgical, PACU Trauma, Orthopedics and prosthetics. Advanced proficiency in various computer applications such as Microsoft Office, including Word, Excel, PowerPoint, and Access. Highly experienced in CPRS, VISTA, HURON, and CITRIX.

CAREER ACCOMPLISHMENTS

•Help Implement new algorithm in updating preregistration process to maximize healthcare reimbursement.

•Reduce time and costs and increase efficiency by introducing new initiative to Eligibility Department

•Member of Redesign Team for Travel Pay Reimbursement

•Help create a New IT System for location verification and appointment check in

•Help create Electronic Consults Program for Beneficiary Travel Program

•Recognition for excellence in customer service

PROFESSIONAL EXPERIENCE

October 2016 - Present Department of Veterans Affairs Madison, WI

(GS-7, Step 9 Facility Revenue Technician

40 hours per week

$58,889 per year

•Review data and conduct various analyses concerning first party and third-party claims for Non-VA Care-Fee Basis and Choice program this involves processing all claims, tracking and maintaining accurate program specific data for maximum reimbursement for the VA Medical Center in Dayton, Ohio.

•Process claims for VA clinical encounters according to Federal Regulations, Eligibility and VA Laws: Research medical reports, diagnostic tests codes and documents to collect, compile and/or track, data and program information regarding services working with VA software such as VISTA, CITRIX and Huron systems in support of revenue programs within VA Medical Center.

•Manage various reports involving several entities of the Revenue cycle along with identifying errors and inefficiencies

•Prepare, execute and/or track revenue program specific information through Consolidated Patient Accounts (CPAC) SharePoint

•Organize and retrieve computerized data, generating reports of data, reviewing data for inconsistencies and refer to appropriate areas.

•Responsible for the coordinating and reviewing medical documents concerning the billing process involving worker's compensation or tort cases.

•Review Prosthetics and Reasons-Not-Billables (RNB’s) reports

•Responsible for administrative functions along with providing assistance and information to Veterans and staff concerning Medical Care Cost Fund Program responding to customer service inquiries/complaints regarding accounts receivable via, in-person, by mail, email or phone

•Manage and answer phones calls on multi- phone lines for the department

•Manage records through various VA programs

•Review, evaluate and monitor reports for Facility Revenue Manager to ensure accuracy and identify errors

•Work alongside Facility leadership to help improve program effectiveness for Revenue Operations

•to maximize reimbursement

•Train CPAC staff on processing claims and other revenue cycle activities through VA systems

•Update patient records including health insurance

•Knowledge of Federal regulations involving sensitive diagnosis, process release of information required documents

•Communicate VA Laws and regulations to Lay audiences including private sectors

•Assists with congressional and or/patient inquiry letters as requested by the Office of the Director including the Facility Patient Advocate

•Communicate and Educate to Services Care Line Leadership and their staff along with other government agencies on the Federal Regulations requirements for the revenue operations, HIPPA, eligibility and health care reimbursement.

10/2002- 07/2016 Department of Veterans Affairs (VA) Dayton, Ohio

(GS -0301 5/6) Program Support Assistant/TraveI Clerk

40 hours per week

$38,412 per year

•Served as an Eligibility expert and Lead Spokesperson for the VA Beneficiary Travel Program (BT)

•Led and oversee BT Department in absence of Supervisor.

•Review and process over 300 travel claims daily, this involves interacting with consumers, extensive research and reviewing data/documents to determine eligibility, ensuring eligibility requirements are met, accuracy and expediency for travel reimbursement of expenses incurred

•Conduct monthly analyses of the beneficiary travel budget along with coordinating with Fiscal Department gathering and maintaining statistical data, request monthly and yearly funds, open and close control point accounts, generate financial reports

•Oversee various contracted transportation companies and perform functions for VA BT programs this includes reviewing statements, billing, processing ambulance payments for services provided

•Train individuals, new and existing employees as well as students on VA software systems such as Beneficiary Travel and Veterans Health Information Systems (VISTA) individually and in groups

•Communicate with all levels of personnel both clinical and administrative, veterans and family members, local and out of state agencies, social workers, service representatives concerning rules and regulations individuals with various backgrounds and socioeconomic statuses

•Communicate effectively with multiple departments. Veterans and family members to execute and schedule transportation requests for Veterans medical appointments throughout the Medical Center, Community Outpatient clinics and other healthcare facilities, in-person, electronically or by phone

•Process enrollment applications for VA health care, determine eligibility according to federal regulations; routinely conduct interview sessions, review required documents, communicate, educate and assist Veterans, family members, staff and other healthcare facilities with the VA enrollment process and conduct financial means test

•Review and respond to consults in Computerized Patient Record System (CPRS) and manage health information

•Collect and compile insurance data for third party accounts

•Handles multifaceted clerical tasks such as data entry, filing and records management.

•Manage a multi-line phone system

•Helped market various programs to reach target goal

•Lead/facilitated meetings and groups to improve services for BT program this process included conducting analyses and presentations that identify problem areas and develop strategies to improve customer service: edit documents and managed work flows, worked alongside leadership.

•Created, analyzed, edited and reviewed documents needed for the BT Eligibility Department using Microsoft Word, PowerPoint and Excel

•Served as an Outreach Enrollment Specialist help increase the amount of new enrollee to Medical Center and help bring awareness of VA services within the community

•Provide exceptional customer service in a high-volume area

•Compose correspondence letters concerning BT eligibility concerns and inquiry statuses

10/1997-5/2002 Carriage by the Lake Nursing Facility Bellbrook, Ohio

Medical Unit Clerk

•In-process and out- process patients to nursing care unit

•Review physician orders, patient charts and assist with customer requests

•Review patient's charts and insurance information. verifying pre-cert process and eligibility, contact and bill third party agents.

•Schedule transportation for patients to and from unit

•Communicate with patients, family members, staff and other health care facilities concerning patient care needs.

RELEVANT SKILLS

Extensive knowledge of Revenue Cycle VA Programs

Effective Customer Service Trained in Purchase Card/IFCAP

Analytical

Knowledge of Medical Terminology

Effective time management

Effective Leadership skills

Expert in Microsoft Office Software

Trainer/Facilitator

Expert in written and oral communication

EDUCATION

Tecumseh High School (1976) New Carlisle, OH

Served in the United States Army from 08/1976 to 02/1983

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