Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Kimberly Downey

LaGrange

Summary

Dynamic Medical Billing and Coding Department Manager and Practice Manager with a proven track record in medical billing and accounts receivable management. Spearheaded a team expansion from 2 to 10, boosting claims processing from 50 to 1500 weekly. Expert in staff training and compliance regulations, driving operational efficiency and revenue growth.

Overview

13
13
years of professional experience
1
1
Certification

Work History

Medicaid Reclamation Department Manager

Rawlings Corporation
LaGrange
08.2022 - 07.2025
  • Created the medical billing, coding and AR Department for the Medicaid Reclamation line of business.
  • Increased department size from 2 employees to 10.
  • Implemented new company wide billing software.
  • Increased billing volume from 50-100 claims weekly to 1500 claims weekly.
  • Created Billing team with team lead, created AR team with team lead, also created admin/support team.
  • Created and maintained all monthly reporting for internal purposes along with client facing reporting.
  • Created all internal training documents to support all team members.

Director of Billing and Accounts Receivable

Assure Labs
Greenville
09.2021 - 08.2022
  • Created internal practice billing and AR Department. from clearinghouse selection to credentialing all insurance payers, brought in all the AR from the previous billing company.
  • Responsible for all hiring and training of department staff.
  • Maintained all current daily billing, continued billing previous unbilled testing.
  • Managed all client bill accounts and sent out weekly statements.
  • Created monthly payment schedule and patient statement process.
  • Created process for medical records requests, along with submitting documents.
  • Created process for insurance denial, rejections and coding issues.
  • Maintain all ERA and manual payment postings.

Director of Billing and A/R Services

On-site Healthcare and Wellness
Simpsonville
04.2018 - 07.2021
  • Director of all Medical Billing and all Accounts Receivable.
  • Coordinates and directs the daily operations of the practice business affairs, including the development, implementation, and maintenance of department policies and procedures.
  • Director of all medical coding for all patient encounters.
  • Maintained and managed all aspects of this Medical Practice.
  • Worked with providers, Nurse Practitioner and ancillary staff.
  • I was responsible for all continuing education training for staff and internal audits for, medical staff medical encounters, for coding and medical necessity.
  • Manage hiring, disciplinary actions, investigations and firing.
  • Assure all federal and state guidelines are followed, OSHA, HIPPA, DHEC, FMLA, etc.
  • Hold and manage all weekly and monthly office meetings with all staff and department heads.
  • Billing and accounting such as billing reports, payroll, preparing budget reports and Insurance contracts.
  • Provide monthly reporting with recommendations/action plans on any issues.
  • Maintained all provider credentialing requirements, for state and federal plans.
  • Also maintained and updated their CAQH and PECOS accounts.

Business Office Manager

Simpsonville Rehab and Health
Simpsonville
08.2016 - 11.2018
  • Business Office Manager, in charge of staff, and all financial responsibilities for the Skilled Nursing Facility.

Office/Practice Manager

Advanced Vision of Louisville
Louisville
02.2014 - 08.2016
  • Increasing company revenue, through accounts receivable and correct collections of co pays from our patients at the front desk.
  • Revamping the therapy department, by implementing new policies and procedures to use their time and resources more efficiently.
  • Current Member of COVD.
  • Created a Vision Therapy Training Manual.
  • Certified Coder, CPC COC, CIC.
  • Training the pretest staff to obtain a complete medical history, chief complaints, HPI and ROS.
  • HIPPA Certified.
  • Designed and created our current website.
  • Excel and Quick books.

Office/Billing Manager

Sita Management
01.2013 - 12.2013
  • Managing the billing department for 8 Urgent care facilities.
  • Training the front desk staff for each facility, on the importance of correct patient demographics as well as verifying insurance coverage and co pay amounts.
  • Implementing policies and procedures to improve efficiency.
  • Implemented Correct and updated HIPAA regulations.

Education

Associate - medical Coding

ATA College
01.2010

Associate - Surgical Technologist

Blue Ridge Community College
01.1990

Skills

  • Medical billing
  • Insurance credentialing
  • Accounts receivable management
  • Compliance regulations
  • Staff training
  • Revenue cycle management

Certification

Medical Coding Certification, Certified Professional Coder

Timeline

Medicaid Reclamation Department Manager

Rawlings Corporation
08.2022 - 07.2025

Director of Billing and Accounts Receivable

Assure Labs
09.2021 - 08.2022

Director of Billing and A/R Services

On-site Healthcare and Wellness
04.2018 - 07.2021

Business Office Manager

Simpsonville Rehab and Health
08.2016 - 11.2018

Office/Practice Manager

Advanced Vision of Louisville
02.2014 - 08.2016

Office/Billing Manager

Sita Management
01.2013 - 12.2013

Associate - medical Coding

ATA College

Associate - Surgical Technologist

Blue Ridge Community College
Kimberly Downey