Kathleen M. Ailts
University of Kentucky Medical Center
Lexington,KY
1
Certification
23
years of professional experience
I have 34 years of experience in healthcare, from registration to coding, billing and collections, finance and faculty affairs, and management, in both the hospital and office setting. I have extensive knowledge in radiation oncology. I am a valuable asset to any medical office.
Work History
Clinical Administrator I
3 Years 5 Months- Tracked cost centers to ensure balanced fund usage and created monthly reconciliation reports to support financial oversight.
- Facilitated physician recruitment by posting positions, creating and submitting offer letters, and ensuring compliance with documentation protocols.
- Heavily involved in physician recruitment, including posting positions, creating offer letters, and submitting signed offer letters and other documents to the appropriate areas.
- Reviewed and approved expense reports using Concur and PEW systems.
- Served as primary contact for overseeing OCR review processes.
- Utilize data to support quality improvement.
- Identify potential gains or losses and suggest potential revenue opportunities.
- Continue to assist our department, including the Morehead clinic and Lexington Clinic Richmond, with coding, compliance, insurance authorization, Epic/Aria interface testing, and error WQs in Epic.
- Working with IT on various metrics to better understand how the data is gathered and identify when data is missed or incorrectly identified.
- Manage UKG for all administrative employees as well as APPs and STEPS employees.
- Manage SAP payroll for B1 and M1 areas within our department.
- Identified potential revenue opportunities and suggested strategies to maximize financial performance.
- Supported the DA in policy development, budget oversight, process improvement, and productivity management.
Support Services Manager, Department of Radiation Medicine
10 Years- Code all radiation therapy for both UK campus and Morehead clinic, using CPT, HCPCS, and ICD-10 codes. Export charges daily, and ensure that charges exported correctly. Monitor various work queues in Epic. Assist KMSF and CDMS with any questions regarding the coding.
- Contributed to patient satisfaction metrics and achieved Ambulatory Services goals.
- Collaborated with Compliance to ensure accurate interpretation of guidelines.
- Work closely with Compliance to ensure we are interpreting guidance correctly.
- Participate in department financial meetings.
- Key player in Aria upgrade and build, Epic build and interface with Aria, Epic and Aria Superuser.
- Work with every member of the department, from the front desk to therapists, and all faculty, to ensure patient and employee needs are met.
- Oversaw timekeeping processes in Kronos to ensure accurate payroll.
- Have had 2 to 7 direct reports at various times.
Billing Specialist
1 Year 3 Months- Ensure accuracy of claims for Cardiology and CT Surgery. Verified supporting documentation and corrected coding errors. Follow-up on all Humana claims for all Cardiology and CT Surgery clinics in Lexington and London. This included Humana Medicare Advantage claims. Field patient calls regarding their bills, including collecting and posting payments.
- Utilized Allscripts Payerpath to ensure successful export of all cardiology and CT surgery claims to all payers, addressed failed claims through resubmission or deletion of invalid claims, and trained new employees on system usage.
- Conducted training sessions for St. Joseph clinics on insurance selection and billing processes for Medicare patients, enhancing understanding of insurance requirements.
Senior Billing Specialist/Payment Analyst
7 Years 10 Months- Entered physician and facility charges, submitted claims, and coded all E&M services to ensure accurate billing.
- Posting all patient and insurance payments. Obtaining prior authorization for endoscopic and radiologic procedures. Obtaining insurance benefits for procedures in different settings. Providing physicians with billing reports as requested. Performing daily, monthly, and yearly closing.
- Facilitated efficient office workflow by providing assistance with phone inquiries, patient check-ins, and record filing.
- Oversaw billing processes and prior authorization activities to ensure compliance and efficiency.
Skills
ICD-10-CM
CPT
and HCPCS coding
Specializing in Radiation Oncology
Auditing charts for compliance
Healthcare administration
Quality assurance
Operations oversight
Clinical leadership
Clinical workflow optimization
Human resources administration
Talent acquisition
Certification
Certifications include CPC and ROCC (Radiation Oncology Certified Coder)
Timeline
Clinical Administrator I
University of Kentucky Medical Center
03.2023 - CurrentRead More
Support Services Manager, Department of Radiation Medicine
University of Kentucky Medical Center
03.2013 - 03.2023Read More
Billing Specialist
St. Joseph Physicians Foundation
12.2011 - 03.2013Read More
Senior Billing Specialist/Payment Analyst
Gastroenterology Specialists of Lexington
02.2004 - 12.2011Read More