Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

KIMBERLY DRUIN

CLARKSVILLE

Summary

Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills. Medical Billing and Coding Specialist with 40 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Polished professional manages multiple tasks, utilizes electronic medical record systems, and provides excellent customer service to patients and staff. Adheres to medical records policies and procedures to comply with HIPAA regulations. Track record of effectively troubleshooting issues and maintaining patient confidentiality. Disciplined individual skilled in collecting and verifying patient demographic and insurance information and preparing and maintaining medical records. Proficient in using medical terminology and classifying diagnostic procedures, treatments and medications. Dedicated to providing highest quality care to patients. Methodically provides administrative and clerical support to medical staff. Proven record of accurately organizing, filing and retrieving patient information. Experienced in coding medical records and entering data into patient databases. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

47
47
years of professional experience
1
1
Certification

Work History

CODER/AUDITOR BILLER PHONES

NORTON CLARK PHYSICIANS PRACTICE
07.2010 - Current
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments.
  • Communicated with insurance companies to research and resolved coding discrepancies.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Trained and mentored junior coders to support growth and development amd apply high-quality coding practices.
  • Input data into computer programs and filing systems.
  • Communicated effectively with staff, patients, and insurance companies by email and telephone.
  • Verified accuracy of patient information in medical records.
  • Used classification manuals to gain additional knowledge of disease and diagnoses processes.
  • Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.

MEDICAL BILLER/CLAIMS/APPEALS/CREDENTIALING

ORTHOPEDIC SURGEONS OF SOUTHERN INDIANA
03.2000 - 07.2010
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Verified insurance of patients to determine eligibility.
  • Collected payments and applied to patient accounts.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
  • Filed and updated patient information and medical records.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Liaised between patients, insurance companies, and billing office.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Posted payments and collections on regular basis.

MEDICAL BILLER/Claims Representative

ORTHOPEDIC SURGEONS OF DUPAGE
08.1999 - 03.2000
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
  • Verified patient insurance coverage and benefits for medical claims.
  • Managed large volume of medical claims on daily basis.
  • Researched and resolved complex medical claims issues to support timely processing.
  • Paid or denied medical claims based upon established claims processing criteria.
  • Evaluated medical claims for accuracy and completeness and researched missing data.
  • Monitored and updated claims status in claims processing system.
  • Identified and resolved discrepancies between patient information and claims data.
  • Followed up on denied claims to verify timely patient payment and resolution.
  • Responded to correspondence from insurance companies.
  • Processed insurance payments and maintained accurate documentation of payments.
  • Generated reports on medical claims processing activities and results.
  • Generated, posted and attached information to claim files.
  • Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Prepared insurance claim forms or related documents and reviewed for completeness.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.

MEDICAL BILLER CLAIMS

ORTHOPEDIC SURGEONS OF SOUTHERN INDIANA
09.1998 - 08.1999
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Verified insurance of patients to determine eligibility.
  • Collected payments and applied to patient accounts.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
  • Filed and updated patient information and medical records.
  • Responded to customer concerns and questions on daily basis.
  • Handled account payments and provided information regarding outstanding balances.
  • Collaborated with customers to resolve disputes.
  • Used data entry skills to accurately document and input statements.

SURGERY SCHEDULING

KYANA EAR NOSE & THROAT
03.1998 - 09.1998
  • Arranged pre-operative and post-operative appointments for surgical patients.
  • Resolved scheduling conflicts to maintain high-quality patient services.
  • Expertly managed planning, scheduling, and coordination of outpatient procedures.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff.
  • Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
  • Verified insurance coverage and obtained pre-authorizations.
  • Educated patients about surgeries and provided treatment plan documentation.
  • Coordinated with facilities to set up surgeries for [Number] [Surgeon type].
  • Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
  • Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
  • Coordinated referrals through insurance and other medical specialists and documented details in patient charts.

BILLING DATA ENTRY FRONT DESK PHONES

JOSEPH H BEAVEN, MD
03.1987 - 03.1998
  • Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
  • Maintained organized and clean front office area to create professional and welcoming environment for visitors and employees.
  • Scheduled, coordinated and confirmed appointments and meetings.
  • Collected room deposits, fees, and payments.
  • Answered multi-line phone system and transferred callers to appropriate department or staff member.
  • Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.
  • Completed data entry and filing to keep records updated for easy retrieval.
  • Completed all tasks in compliance with company policies and procedures.
  • Maintained confidentiality of sensitive data to protect customer and business information.
  • Trained new team members on company procedures, customer service and issue resolution.
  • Sorted and delivered mail and packages upon arrival to correct staff members and departments.
  • Confirmed appointments, communicated with clients, and updated client records.
  • Organized, maintained and updated information in computer databases.
  • Operated multi-line telephone system to answer and direct high volume of calls.
  • Handled assignments independently with good judgement and critical thinking skills.

MEDICAL BILLING DATA ENTRY SUPERVISOR

FINCASTLE MEDICAL GROUP
08.1981 - 03.1987
  • Provided daily supervision, feedback and oversight to direct reports.
  • Audited production reports, tracking data entry and processing errors.
  • Participated in weekly conference calls with management to discuss department updates and strategies.
  • Developed and implemented department policies and Standard Operating Procedures (SOP).
  • Maintained data entry team access log-ins and granted system permissions to approved employees.
  • Delegated tasks to administrative support staff to organize and improve office efficiency.

Front Office Coordinator

CHARLES BYRD, MD
08.1980 - 07.1981
  • Screened and transferred incoming calls, took down messages, and transmitted information and documents to internal personnel.
  • Collect patient and client documents and information upon referral.
  • Created and updated records and files to maintain document compliance.
  • Aided colleagues, managers, and customers through regular communication and assistance.
  • Created and updated physical records and digital files to maintain current, accurate, and compliant documentation.
  • Welcomed patrons and immediately offered assistance by asking open-ended questions.
  • Maintained files and records by implementing effective filing systems that boosted efficiency and organization.
  • Oversaw appointment scheduling and itinerary coordination for both clients and personnel.

ER CLERK SWITCHBOARD OPERATOR PT REGISTRATION

CLARK MEMORIAL HOSPITAL
11.1979 - 07.1980
  • Answered calls on [Number] ring and engaged customers with friendly, professional demeanor.
  • Documented messages and forwarded to correct individual.
  • Connected callers with appropriate professional, department, or business.
  • Created and maintained company phone directory with current extensions and staff information.
  • Directed incoming calls to internal personnel and departments, routing to best-qualified department.
  • Announced important information and emergency notifications over PA system.
  • Operated switchboard and routed incoming calls to appropriate departments.

PAYROLL CLERK SECRETARY

AAFES OHIO VALLEY EXCHANGE REGION
04.1977 - 11.1979
  • Verified timekeeping records and handled any discrepancies with employees.
  • Processed new hire paperwork and documents.
  • Maintained payroll information by calculating, collecting, and entering data.
  • Updated employee files with new details such as changes in address or salary levels.
  • Issued paychecks on designated pay dates to avoid employee dissatisfaction.
  • Performed data entry tasks and maintained accurate records of employee payroll information.
  • Processed timecards and payroll data for team of employees.
  • Completed payroll accurately and timely to meet employee expectations.

Education

High School Diploma -

NEW WASHINGTON SENIOR HIGH
NEW WASHINGTON, IN 47162
05.1977

Skills

  • Proficiency in Allscripts, ECW
  • Insurance Claims Analysis
  • Physicians Coding
  • Certified Professional Coder
  • Medical Billing Processing
  • EMR Systems
  • Orthopedics & Cardiology Coding
  • Data Verification
  • Record Assessment
  • HIPAA Compliance
  • Insurance Billing
  • Inpatient Coding
  • Demographics Information
  • ICD-10 Coding
  • Paperwork Processing
  • Customer Service
  • Insurance Verification
  • Billing Procedures
  • Attention to Detail
  • Clerical Functions
  • Medical Terminology
  • Data Entry
  • Insurance Coding (ICD-9 and CPT)
  • Patient Data Compilation
  • Electronic Health Record Applications
  • Workers' Compensation Forms
  • ICD-9 Coding
  • Patient Information Verification
  • Doctor Communication

Certification

  • CPC - Certified Professional Coder, Certified December 2014
  • Orthopedics Billing and Coding 1999 thru present (2023)
  • Cardiology Coding 2014 thru present 2023
  • Certified Medical Coding Auditor, Norton Clark Physicians Practice, Certified May 2019 -
  • Credentailing - Physicians Mar 2000 thru 2013

Timeline

CODER/AUDITOR BILLER PHONES

NORTON CLARK PHYSICIANS PRACTICE
07.2010 - Current

MEDICAL BILLER/CLAIMS/APPEALS/CREDENTIALING

ORTHOPEDIC SURGEONS OF SOUTHERN INDIANA
03.2000 - 07.2010

MEDICAL BILLER/Claims Representative

ORTHOPEDIC SURGEONS OF DUPAGE
08.1999 - 03.2000

MEDICAL BILLER CLAIMS

ORTHOPEDIC SURGEONS OF SOUTHERN INDIANA
09.1998 - 08.1999

SURGERY SCHEDULING

KYANA EAR NOSE & THROAT
03.1998 - 09.1998

BILLING DATA ENTRY FRONT DESK PHONES

JOSEPH H BEAVEN, MD
03.1987 - 03.1998

MEDICAL BILLING DATA ENTRY SUPERVISOR

FINCASTLE MEDICAL GROUP
08.1981 - 03.1987

Front Office Coordinator

CHARLES BYRD, MD
08.1980 - 07.1981

ER CLERK SWITCHBOARD OPERATOR PT REGISTRATION

CLARK MEMORIAL HOSPITAL
11.1979 - 07.1980

PAYROLL CLERK SECRETARY

AAFES OHIO VALLEY EXCHANGE REGION
04.1977 - 11.1979

High School Diploma -

NEW WASHINGTON SENIOR HIGH

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