Verification Specialist Data Entry

Kimberly Kinney

adwnwv@r.postjobfree.com 614-***-**** Columbus, Ohio 43213

Summary

Self-motivated and detail-oriented healthcare professional with 25+ years of experience in the healthcare industry.

Associate degree – National College (12) Health Information Technology Areas of Expertise

• Claims Adjudication Collection/Billing

• Data Entry/Payment Posting Contract Management

• Account Reconciliation Compliance/ HIPPA Regulations Specialist

• Enrollment/Authorization Provider Insurance Verification Specialist Trinity Healthcare 2019-Current Government Billing & amp; Follow-up

• Knowledge, understanding, and demonstration of the Trinity Health Mission, Vision, and Values in behaviors practices and decisions.

• Perform daily billing and follow-up for Tricare and Champ VA Insurance and Ohio Medicare Insurance, documenting claims billed paid and settled. My current position is to identify and escalate issues affecting accurate billing, and follow-up activities. Adheres to “initiative-taking practice”, which includes contacting payer directly for payment due on accounts. Investigation of all billing discrepancies, obtain demographic info

(UCR and DRGs), clinical adaptation of ICD-10 related to CPT codes, client’s financial and insurance information. Research claim rejections, takes corrective action and refers claims to appropriate colleagues to ensure timely resolution. Insurance Benefits Specialist Accredo/Express Scripts – Columbus, Ohio 09/2018 – 07/2019

• Aided plan participants explaining benefits information to ensure educated selections.

• Communicated effectively via Email, phone and face-to-face with plan participants to resolve issues pertaining to health and delivery of pharmaceutical benefits.

• Advised patients on options available for financial assistance as needed. Reviewed grants and aided patients in modifying their payment status.

• Provider Data Specialist United Healthcare – Columbus, Ohio 10/2015 – 05 2018

• Leveraged database information and worked to input current licenses, specialties, location to compile and update the current data information previously gathered from various sources in improve accuracy conveyed to patients receiving provider directory resources.

Employer Group Reconciliation Specialist Aetna Inc. – New Albany, Ohio 02/1997 – 11/2009 I have 25+ years in the Insurance Claims Processing. My work is my passion.

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