Kimberly Martinson
Allentown
Summary
I am a completely dedicated professional and have excellent billing and insurance skills, which were gained while working within many Healthcare environments. I am a compassionate individual with excellent organizational and communication skills, with a strong desire to contribute a high degree of proficiency at work. An effective communicator and coordinator, capable of working independently, directing and motivating others, or contributing to the common goals of a team. Experience in project management and development. Attentive to detail, accurate, and thorough, with a strong work ethic. Personable and articulate: able to establish a positive rapport with individuals of all ages and backgrounds. A quick, independent learner, with analytical aptitude, and excellent memory.
Overview
9
9
years of professional experience
Work History
Authorization Specialist
Springtide Child Development
09.2021 - Current
- Requested, tracked, and obtained 200+ authorizations from different payors within allotted timeframes.
- Contacted insurance carriers to verify eligibility for over 200 patients.
- Worked with multiple insurance companies to find correct billing and authorization requirements that led to smooth billing and payment.
- Organized meetings weekly with clinicians to enhance and create new processes to organize workloads.
- Helped build projects to focus on specific issues and come to resolutions to prevent.
- Worked closely with billing and invoicing for all patients.
- Worked with individual case managers within payors to create contracted rates and fee schedules.
Follow up/Billing analyst
WFH Resolution/QHR
04.2021 - 09.2021
- Works directly with vendor or payer to ensure reasons for delayed or denied claims are addressed in a comprehensive manner.
- Review and obtain authorizations for necessary accounts and work with insurance companies for retro authorization policies.
- Uses payor portals to access claim information and patient eligibility.
- Proficient in Excel, EPIC, MEDITECH, Change Healthcare, OPTUM, Outlook, and many payor portals.
- Works with state Medicaid, Medicare, and commercial insurances.
- Performs extensive follow-up to third parties, resolving issues that are adversely impacting claims payment.
Insurance Follow Up Representative
Lehigh Valley Health Network
Allentown
05.2017 - 04.2021
- Ensures timely and accurate adjudication of insurance claims.
- Ensures efficient processing of denials and appeals.
- Meets cash collection goals by reviewing, analyzing, completing, and submitting appropriate documentation based on payer requirements.
- Serves as a communication link to various departments and external payers by developing positive relationships with managed care organizations and outside agencies, and clinical areas within the organization.
- Performs liaison services to both internal and external customers providing assistance in claims resolution.
- Monitors the status of denials, appeals, and claim errors by using work queues and conducting routine, periodic follow up on previously researched claims items.
- Monitors, reviews, and suggests revisions or updates to existing forms, documents, and processes required to secure timely payment.
- Participate and attend meetings, training seminars and in-services to develop job knowledge.
- Uses Excel as a standard method for internal and external reporting.
Registration Specialist
Lehigh Valley Health Network
Easton
- Utilizing knowledge of medical terminology to better accommodate the patients and assist with updating and verify patient demographics.
- Worked specifically with PT, OT, and ST for pediatric and adult rehab offices.
- Obtain authorizations for continuous therapy sessions and initial evaluations.
- Obtain and review authorizations for patients by payor portals and calling insurances.
- Contacting insurance companies to verify medical coverage and pre-certification.
- Collects co pays, visit charges, and informs patients of financial responsibilities.
- Able to adapt to protocol changes, demonstrate teamwork and flexibility in assignments.
- Providing exceptional customer service and communication with patients and coworkers through telephone and email correspondence.
Skills
- Project coordination
- Proficiency in Microsoft software
- Documentation and reporting
- Recordkeeping and data input
- Process improvement
- Effective communication
- Conflict resolution
- Policy interpretation
- Time management
References
References upon request
Timeline
Authorization Specialist
Springtide Child Development
09.2021 - Current
Follow up/Billing analyst
WFH Resolution/QHR
04.2021 - 09.2021
Insurance Follow Up Representative
Lehigh Valley Health Network
05.2017 - 04.2021
Registration Specialist
Lehigh Valley Health Network