Kimberly Sims Email & Phone Number

Remote

Provides education on benefit clarification, eligibility requirements, and billing status.Works with team to identify resolution for potential trends that impact health plan members.Tracks and documents service interaction according to guidelines.

Detroit, Michigan, United States

Physician Referral AdvocateTrained new employees with operational physician referral procedures.Liaison for physician referral services supporting the Metropolitan Detroit areas. Promoted patient participation for various community sponsored programs, classes, or initiatives.Answered questions regarding community based services to empower patient awareness.Assessed appropriate emergent calls to direct for nurse triage services.SchedulingTrained new employees with operational scheduling procedures.Answered incoming calls to schedule outpatient diagnostic tests.Initiated outbound calls to schedule pediatric diagnostic tests.Captured and verified patient demographic and medical history to update for accuracy.Consistently responded to inquiries to refer callers to the appropriate departments or physician office.Negotiated and resolved complex scheduling challenges to meet the needs of the patient.Insurance VerificationProvided financial counseling services to assist patients in payment options.Following HIPPA guidelines, obtained necessary information to accurately generate charges for hospital services rendered. Verified and analyzed insurance benefit coverage to initiate insurance authorizations and referrals as needed.Reviewed patient accounts to ensure accuracy and completeness of claims billing for maximum reimbursement.Identified problem accounts requiring further work.

Detroit, Michigan, United States

Used Cerner EMR to schedule/re-schedule clinic and/ or diagnostic appointments.Determined appropriate clinic for the appointment based on symptoms described and urgency of the appointment requested. Maintained and updated appointment schedules based on the availability of service modalities.Determined existence of previous patient registrations; obtained, verified and updated insurance, financial, statistical and demographic information with the patient or physician staff.Provided exceptional customer service to patients, and clinical staff. Maintained current competencies and mandatory training. Served as a positive role model and an integral member of the call center team.Communicated effectively and positively with the entire health care team.

Detroit, Michigan, United States

Processed incoming patients by performing routine vitals in a timely manner.Performed various clinical procedures for adult and pediatric care.Executed administrative skills in outpatient medical office setting.Scheduled diagnostic tests and surgeries ordered by physicians.Maintained office supplies and equipment within OSHA guidelines.Triaged clinic calls for patient medical care and or treatment.Trained new employees for clinic and clerical duties.

Detroit, Michigan, United States

Responsible for greeting and directing patients, ensuring accurate and timely registration of all patients, collecting payments, and scheduling appointments. Registered all incoming patients (inpatient and outpatient). Obtained required paperwork and essential information for processing patients.Verified insurance eligibility during registration process.Educated patients regarding compliance while obtaining signatures.

Detroit, Michigan, United States

Scheduled and coordinated daily tasks to ensure maximum efficiency and effectiveness within the office.Developed and implemented computer billing system, and patient account collection protocol.Created employee policy and training manual.Performed various administrative and managerial tasks such as payroll and monthly budget.Supervised and trained newly hired employees.Performed clinical Medical Assistant duties as needed.

Bachelor Of Science - Bs, Education

Activities and Societies: Charity solicitor for United Way/Black United Way

Associate Of Science - As, Education