Kiara Age
McDonough
Summary
Detail-oriented Medical Billing and Coding Professional with over 10 years of experience in hospital billing and revenue integrity analysis. Skilled at fostering internal and external relationships, adept at problem-solving to resolve billing and coding issues, and proficient in managing multiple projects under tight deadlines. Experienced in medical billing process, payment posting, ICD 10, HCPCS, CPT coding, insurance verification, prior authorization, HIPAA compliance, follow-up/AR, electronic health records, office management, insurance claim processing, medical terminology, HIM coding, and medical office procedures. Successfully built relationships with healthcare professionals and partner agencies, conducted thorough research and data analysis to enhance operational efficiency. Proficient in MS Office Suite (Word, Excel, PowerPoint, Outlook), Epic, Craneware, Waystar, Availity, and Tableau. Possess strong interpersonal skills, excellent written and verbal communication abilities, exceptional organizational skills, and the flexibility to prioritize tasks effectively. Open to relocation opportunities worldwide.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Revenue Cycle Rep II
Piedmont Hospital
01.2023 - Current
- Submit appeals for denied claims
- Correct and resubmit denied claims
- Resolve AR follow-up issues daily
- Run claim run and file box via waystar
- Always available to pivot to higher priority assignments and projects
- Remote
Revenue Integrity Analyst
R1 RCM
08.2021 - Current
- Analyze data from billing systems, claims systems, and other sources
- Compare payments to contract and fee schedules
- Identify and resolve payment issues
- Determine the root cause of payment denials
- Collaborated with various departments to minimize denials.
- Prepare reports for management
- Educate departments on best practices for reviewing and reconciling charges
- Remote
- Managed data analysis for accurate charge capture and improved overall financial health of the organization.
- Served as liaison between clinical departments and finance teams, fostering effective communication and collaboration towards shared goals.
- Enhanced revenue integrity by identifying billing errors and implementing corrective measures.
- Monitored accounts receivable performance metrics regularly, taking action when necessary to improve collection rates or resolve outstanding issues promptly.
- Improved coding accuracy by conducting regular reviews, providing feedback, and offering targeted education to staff members.
- Streamlined revenue cycle processes by conducting thorough audits and implementing efficient workflows.
- Strengthened regulatory compliance through consistent monitoring of changes in industry standards and guidelines.
- Verified accuracy of accounts payable payments, resulting in reduction in payment errors and check reissues.
- Delivered comprehensive training programs to new hires as well as refresher courses for existing staff members, promoting a culture of revenue integrity awareness.
MEDICAL BILLING Manager (HYBRID)
Integrated Physical Medicine
01.2013 - 12.2022
- Ensure the accuracy and proficiency of coding and billing for two Chiropractors and a Pain Management Doctor.
- Supervise Front Desk Receptionist and Back Office Medical Assistant staff-members.
- Reduced issues related to payer denial and coding inquiries by 25% through follow through on reimbursement activities, also oversaw Prior Authorizations as well as Benefit Verifications Weekly.
- Provide technical assistance to staff in initiating billing procedures and ICD 10 coding Analyze all data for bill presentation based on technical and compliance requirements
- Statistically monitored revenue production in excess of $100K per QTR to ensure timely payment
- HYBRID
Office Manager/ Medical Biller
Trailways Mental Health
01.2017 - 12.2018
- Negotiated insurance contracts with insurance companies, tracked payments made by insurance agencies and patients, and hiring and training new employees in the billing department. FQHC trained.
Medical Biller
Precision Medical Billing
01.2010 - 12.2015
- Served as an apprentice Medical Biller under the direct supervision of a Certified Medical Biller. Gained knowledge of EOBs, collections, and CMS forms and appeals.
- Ensured the accuracy of administrative tasks such as emailing, answering phones, taking messages, and faxing documents.
Education
Technical school - Medical Billing & Coding
Everest College
Gardena, CA08.2013
H.S. DIPLOMA - undefined
Animo South Los Angeles High School
Los Angeles, CA12.2008
Skills
- Successfully developed and cultivated relationships with doctors, line staff, and partnering agencies
- Insurance verification
- Anatomy knowledge
- Medical billing
- PL/SQL
- ICD-10
- Proficiency in MS (Word, Excel, PowerPoint)
- Account reconciliation
- Medical collection
- Revenue cycle management
- ICD-9
- Epic
- Medical records
- Medical office experience
- Accounts receivable
- MySQL
- Accounting software
- General Ledger Accounting
- Accounting
- CPT coding
- Medical terminology
- Strong interpersonal, written and verbal communication, and organizational skills
- GAAP
- General Ledger Reconciliation
- QuickBooks
- ICD coding
- Medical Coding
- Oversee the daily process and resolution of medical billing, insurance processing of rejected claims
- Capable of in-depth research and data analysis with the purpose of improving and streamlining processes
- Analytics
- Outlook
- Medical billing expertise
- Accounts receivable management
- Analytical problem solving
- Managing records
- Collecting payments
- Writing reports
- Payment posting
- Insurance collaboration
- Healthcare finance
- Analyzing claims
- Revenue quotas
- Teamwork
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Multitasking Abilities
- Adaptability and flexibility
- Verbal and written communication
- Decision-making
- Financial and operational reporting
- Relationship building
- Team building
- Task prioritization
- Goal setting
- Project management
- Due diligence
- Professional demeanor
- Charge capture
- Advanced Excel
- Cash flow analysis
- Budget planning
- Key performance indicators
- GAAP standards
- SAS programming
Certification
- Medical Coding Certification
- Medical Billing Certification
Timeline
Revenue Cycle Rep II
Piedmont Hospital
01.2023 - Current
Revenue Integrity Analyst
R1 RCM
08.2021 - Current
Office Manager/ Medical Biller
Trailways Mental Health
01.2017 - 12.2018
MEDICAL BILLING Manager (HYBRID)
Integrated Physical Medicine
01.2013 - 12.2022
Medical Biller
Precision Medical Billing
01.2010 - 12.2015
Technical school - Medical Billing & Coding
Everest College
H.S. DIPLOMA - undefined
Animo South Los Angeles High School
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