Customer Service Revenue Cycle

Kimberly Bronson

217-***-**** *********.*******@*****.***

Billing Specialist

Revenue Cycle Management/Leadership/ Process Improvements

Professional Profile

Accomplished professional and dynamic leader with hands-on experience building and leading successful medical billing operations in full-time and contract roles. Thrives in remote environments with the ability to navigate ever-changing insurance plan guidelines, help businesses grow, and continuously drive profitability.

Recognized for Subject Matter Expertise in Medical Billing, Medicare, Medicaid (state specific), Third-Party Insurance Plans, Claims Submission, Payment Posting, Charge Review, Revenue Cycle Management, Behavioral Health, ABA Therapy and more.

Adept at cultivating partnerships and building trusted relationships, including communications with mental health professionals and service providers.

Areas of Expertise

Claims Submissions – Claim Denial Research – Patient Communication – Payment Posting – Process Optimization Charge Capture – Charge Review – Accounts Receivable – Revenue Cycle Management – Collaborative Teamwork Behavioral/Mental Health – Psychology Offices, ABA Therapy – Prior Authorizations – Medicare – Medicaid – Third-Party Insurance Leadership – Technology Implementation – Policy Development – Compliance – Team Building. Software knowledge-Availity, Prompt EMR, Simple Practice, Waystar, Rethink, and Brightree, AdvancedMD.

Professional Experience – Independent Contractor

Revenue cycle Management-Medical Billing Specialist

Deliver high-quality back-office support for mental health professionals and small businesses. Complete eligibility checks and daily verifications, collect co-pays and deductibles, post payments, and utilize Availity (RCM software) to submit claims.

Notable Contributions:

Medical Recovery Consultant (2022 – Present): Complete third-party and secondary insurance billing in the behavioral health setting.

Input and varication of accuracy of patient demographics

Verified Insurance. Coverage and collected Copay, Co-insurance and Deductible.

Expert with Medicare, Secondary. BCBS, CIGNA, AETNA, United health Care, Optum, Humana, State level Medicaid.

Daily Claim submission- currently submitting 500 claims per month.

Time working denials. Corrections are completed right away for payment.

a steady flow of income. Bill on the same date of service provided.

AbiliLife (2018 – 2021): Completed billing for Parkinson’s client services.

Input and varication of accuracy of patient demographics

Verified Insurance. Coverage and collected Copay, Co-insurance and Deductible.

Expert with Medicare, Secondary. BCBS, CIGNA, AETNA, United health Care, Optum, Humana, State level Medicaid.

East Bay Therapy Services (2017 – 2020): Handled therapy service billing and implemented social media strategies for upcoming DPT classes.

Kimberly Bronson *********.*******@*****.*** Page 2

Pharmacy Billing Director - PSGWV 2023 to Present

Direct an 8-person Billing team in daily operations by effectively setting goals and communicating new information. Responsible for new Long-Term Care (LTC) admits, hospice admits, claims adjudication, prior authorizations, composite billing, MedTrak maintenance, welcome packets, and Best Available Evidence (BAEs) submitted to insurance. Manage monthly facility, hospice, and private pay billing. Oversee daily deposits, cash posting, and collections. Monitor pricing and margins for third-party insurance. Communicate with insurance companies and adjust processes based on plan changes.

Notable Contributions:

Established the Billing team and policies for this medium-sized pharmacy; turned around operations to make a profit and played an instrumental role in doubling revenue.

Secured contracts for Express Scripts, United Health Care, Envision, and WV Medicaid

Set up a new software system to operate and meet billing requirements.

Recognized for expertise in billing claims outside of the EHR system during potential claim processor outages, leading to no stops in business operations.

Pharmacy Billing Manager 2014 to 2024

Managed a 17-person team to ensure accurate billing across plans and contracts. Supported Medicare Part D plans, Medicaid, third-party plans, and specialty drugs. Tracked and monitored medication pricing compliance, therapeutic interchanges, and clinical edits. Supplied information to Medicaid and third-party plans for prior authorizations. Oversaw and monitored monthly QA summaries, consultant pharmacist monthly summaries, and P&T meetings for compliance.

Notable Contributions:

Spearheaded efforts to grow the pharmacy billing department, including developing policies, securing prior authorizations for nursing home patients, and coordinating Medicare Part D payments.

Identified, tracked, and monitored high-cost medications excluded from the daily rate based on signed contracts with managed care plans.

oHelped the Managed Care team by providing excluded medications and additional needed support.

Established Cover My Meds (CMM) boxes within facilities and designed the process for the pharmacy to send prior authorizations to facility CMM boxes.

Gained experience working with Ohio, Maryland, Pennsylvania, Virginia, and Indiana Medicaid and Managed Medicaid programs.

Education

BACHELOR’S Degree in Bu sin es s

Unive rsity of Phoe nix

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