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Kenya M Smith
2453 Rio Linda Blvd #18
Sacramento, CA 95815
Education: Grambling State University, Mass Communications
Objective: Passionate Member & Provider Service Representative with 10+ years of experience in the Healthcare Insurance industry, seeking a position with an Industry leader that will allow me to provide exceptional service seamlessly.
Medical Coding & Billing
Clear Communication Skills
Word, Excel, PowerPoint
Serve as Liaison between Insurance company and healthcare providers to ensure required referrals have been processed correctly.
Obtains insurance authorization for medical procedures, tracks physician referrals and provides pertinent details to billing staff.
Coordinates the credentialing procedure by compiling and processing applications in compliance with federal and state program and regional requirements.
Acts as a liaison between providers and the health plan. Educates providers concerning network participation and other plan policies and procedures.
Verifies details of insurance with Private and Government carriers and offers information to patients before medical services are provided.
Enters alphanumeric information into computer system. Stores, retrieves and updates files. Completes information analysis for procedures and reports.
Extracts key data from patient records and enters a summary of this information into electronic files. Reviews scanned records to verify information has been correctly transferred and saved.
Audits medical records to ensure patient information, treatments and diagnoses are accurately classified using ICD-9/ICD-10, Current Procedural Terminology (CPT) and/or Healthcare Common Procedure Coding System (HCPCS).
Initiation of medical charts, completion of insurance forms and death and birth certificates, transcription of dictated medical records, and retrieval of medical charts.
Sorts and prepares medical records for conversion to electronic format. Scans records, verifies they are imaged correctly and accurately indexes images.
Communicate with patients and providers via telephone, email or regular mail; managing database records; drafting status reports on patient / provider issues.
Arranges patient and physician schedules for medical and surgical procedures. Reserves rooms and schedules support staff.
Triwest Health Care Provider, Member Services Rancho Cordova, CA 10/2015 to Present
Health Net FS
VSP Global Companies
Med Docs Receiver
Provider Services Specialist
Provider Data Analyst
Rancho Cordova, CA
West Sacramento, CA
04/2015 to 10/2015
09/2014 to 03/2015
04-2013 to 07/2014
01/2013 to 04/2013
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11/2009 to 12/2012
Retention Account Manager
08/2006 to 11/2009
Day Trader, Banking Services
01/2005 to 08/2006
Insurance Services Trainer
Elk Grove , CA
06/ 2003 to 12/2004
11/2002 to 06/2003