Revenue Cycle Medical Billing

Kimberly Rooks

Tomball, TX ***** 281-***-**** *****************@*****.***

Professional Summary

Results-driven healthcare operations and medical billing leader with 15+ years of experience optimizing revenue cycle management, payer compliance, and team performance. Expertise in contract administration, coding, and denial management, with a proven record of reducing billing errors by 20%, increasing revenue recovery by 15%, and improving staff retention by 10%. Adept at implementing system enhancements (Dynamics 365, Xifin) and developing cross-functional strategies that strengthen compliance, streamline workflows, and maximize reimbursement.

Core Competencies

Revenue Cycle & Billing Operations Leadership

Payer Relations & Denial Management

Compliance & Regulatory Training (HIPAA, CMS, State/Federal)

Medical Coding: CPT, ICD-10, HCPCS

System Implementations: Dynamics 365, Xifin, CRM Platforms

Staff Training, Development & Retention

Financial & Operational Reporting

Process Optimization & Audit Readiness

Professional Experience

Boston Scientific – Preventice Solutions

Contract Administration Implementation & Operations 2017 – Present

Drive national payer compliance by implementing Dynamics 365 programs supporting contractual and clinical coverage obligations.

Collaborate with Finance, IT, and RCM teams to optimize Xifin billing software, enhancing claim accuracy and reducing denials.

Develop and maintain payer coverage guides to ensure adherence to complex regional and federal billing requirements.

Conduct policy reviews to ensure accurate data entry, proper coding, and reimbursement alignment.

Home Health Store of Tomball

Customer Service Supervisor 2015 – 2016

Managed patient, physician, and insurer interactions for a DME provider; improved authorization turnaround times.

Streamlined pre-authorization and documentation processes, ensuring compliance and reducing delays.

Built a collaborative service culture, strengthening team efficiency and patient satisfaction.

Holdsworth Pelton

Billing Division Manager 2008 – 2015

Directed billing division for 85+ clients, overseeing compliance, reporting, and financial accuracy.

Launched and trained staff on new billing platform, improving claim turnaround and reporting efficiency.

Delivered compliance training on federal/state billing requirements; reduced errors and audit risk.

Enhanced client relationships by leading policy education sessions and improving transparency.

Medco

Senior Team Lead 2007 – 2008

Led collections and denial management for large-scale DME supply operations.

Reduced claim denials and improved reimbursement through proactive payer engagement.

Supported Billing Manager in staff training and department performance improvements.

Holdsworth Pelton

Operations Manager 2002 – 2007

Directed day-to-day operations, including scheduling, training, and inventory management.

Created employee recognition and retention programs, reducing turnover and boosting morale.

Holdsworth Pelton

Account Representative 1997 – 1999

Managed client onboarding, account maintenance, and service delivery.

Identified and closed business development opportunities.

Connecticut Multispecialty Group

Medical Billing Specialist 1999 – 2002

Processed hospital and office claims, ensuring accuracy and timeliness.

Resolved physician billing inquiries and verified patient insurance eligibility.

Education & Certifications

Certified Ambulance Coding, National Academy of Ambulance Coding (2012)

Billing & Coding Certification

Coursework in Accounting, Mohegan Community College

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