Executive Assistant Customer Service
Resume:
K I M B E R KG L Y G I L S T R A P
C O N T A C T
*************@*****.***
Colorado Springs, CO 80918
(Relocating to the Joplin, MO area)
1987
High School Diploma
Joplin (MO) High School
E D U C A T I O N
S K I L L S
Attention to Detail
Excellent Customer Service
Effective Communication
Critical Thinking
Leadership
Multitasking
Well Organized
Flexibility
CPT/HCPCS
ICD-9/10
HHCFA-1500 & UB-04
Contracting and Negotiations
Nurse/Utilization Review
Training & Auditing
Medical Terminology
Dental, Vision, FSA/HSA, Flex, Rx
ERISA, HIPAA, ACA
S P E C I F I C S K I L L S
P R O F I L E S U MMARY
WORK E X P E R I E N C E
Colorado Springs School District 11 2019 - 2025
Colorado Springs, CO
Executive Assistant to Deputy Superintendent
2014 - 2019
1991 - 2000
Benefit Management, Inc.
Joplin, MO
Sr. Claims Examiner/Account Manager
Most recently, my professional experience has been in the Colorado Springs K-12 public school system, as an Executive Assistant to the Deputy Superintendent, Chief Resource Officer, Chief Operations Officer and CFO, since 2020 In this position, one of my primary responsibilities was to serve as the district's acting steward of the Mill Levy Override Oversight Committee and their budget of nearly $80M.
Verify eligibility and coverage for proper adjudication of paper/electronic claims payment determinations, while maintaining member/provider records;
Apply negotiated rates and discounts of maximum industry allowable to ensure compliance with eligibility, contract, and timely filing requirements;
Provide exceptional customer service to members, providers, business owners/managers, insurance companies, attorneys, etc., as the primary point of contact;
Efficient correspondence for requests of additional information and documentation of support and necessity, as well as responses to claims/benefits appeals;
Stoploss and catastrophic claims facilitation;
Develop, create, maintain self-funded employer group plan documents and required notices of coverage and claims determinations to members and providers; and
Compile and provide data, trends, Utilization and cost management reports to clients.
Experienced healthcare insurance professional with over 20 years of expertise in third-party administration (TPA) for self-funded employer groups. Recognized for being dependable, detail-oriented, and deadline- driven, with a strong commitment to accuracy and efficiency. Skilled in managing complex benefits administration, ensuring regulatory compliance, and delivering top-notch customer service to clients and members alike. Known for building lasting client relationships, streamlining operations, and consistently exceeding service expectations in a fast- paced, evolving environment, with compassion and integrity. Freeman Health System
Joplin, MO
Accounts Receivable Specialist II
Billing and claims management, ensuring accurate and timely claims submission to Medicare, Medicaid, commercial insurances, etc., utilizing appropriate CPT/HCPCS and ICD-10 codes & modifiers;
Post payments, discounts, and UCR to correct accounts, reconcile discrepancies, set payment arrangements and collection activities for self-pay balances; research denied/rejected claims for correction or appeals processing;
Reporting and analysis;
Compliance : HIPAA, standard industry regulations and requirements;
Maintaining consistent records of billing activities and interactions with patients, insurance companies, and any other contacts regarding payment and claims status; and
Collaborate with other health system departments for coding, medical records, registration, and all other factors in ensuring smooth and efficient accounts receivables processes and successful month-end closing.
2000 - 2009
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