Kelcey Hargrove
Van Nuys
Summary
Accomplished administration professional with over 18 years in customer service, contract management, claims management, billing, and accounts receivable within healthcare. Utilizes strong analytical skills and critical thinking to resolve issues under pressure. Optimizes resources and manages multiple tasks efficiently to achieve corporate financial goals through effective revenue cycle management and procedural improvements.
Overview
21
21
years of professional experience
Work History
Patient Benefits Coordinator
Southern California Orthopedic Institute
Van Nuys
09.2025 - Current
- Streamlined coordination of patient insurance benefits and eligibility verifications for UCLA via Southern California Orthopedic Institute using EPIC EHR.
- Reviewed patient records to promptly assess eligibility for various benefits, ensuring accurate benefit coordination.
- Collaborated with medical staff to ensure precise documentation of patient benefit information.
- Developed efficient protocols for managing patient benefit coordination tasks.
- Educated patients on financial responsibilities and coverage options, enabling informed decision-making.
- Provided consultation on insurance coverage and options to enhance patient understanding.
- Resolved billing inquiries and supported patients with insurance claim challenges effectively.
- Identified and recommended improvements in processes for patient benefits management and referral authorization.
Contracts Manager & Accounts Receivable Manager
ANDERSON ORTHOPEDIC CLINIC
Arlington
04.2007 - 06.2025
- Secured $2 million increase in revenue for Anderson Orthopedic Clinic by negotiating commercial insurance contracts.
- Negotiated collection contracts to maximize outstanding receivables monetization.
- Supported revenue cycle management through oversight of third-party reimbursement and accounts receivable, ensuring compliance with regulations.
- Oversaw billing operations for primary and secondary insurances for 25 providers.
- Trained and managed 6 patient account specialists in claims processing and authorization procedures, boosting team efficiency.
- Processed 300 healthcare claims daily for 11 orthopedic surgeons and mid-level providers.
- Reviewed individual claims using extensive knowledge of major medical plans and healthcare networks.
- Acted as liaison between main office and Inova satellite office to ensure accurate claims processing.
Patient Accounts Representative
CRANIAL TECHNOLOGIES, INC.
Fairfax
02.2005 - 04.2007
- Processed appeals, successfully securing insurance approvals for cranial device.
- Advocated for patients by educating parents on the cranial device and their rights with the insurance company regarding payment.
- Conducted insurance verification checks to ensure patient coverage before appointments.
- Created medical files and coordinated insurance referrals, ensuring comprehensive patient readiness for appointments.
- Scheduled appointments for new patients and follow-up appointments.
- Processed claims for the experimental cranial correction device.
Education
Some College (No Degree) - Revenue Cycle Billing and Coding
Johns Hopkins University
Baltimore, MD12.2025
Certification - Medical Office Administration
Applied Career Training
Rosslyn, VA01.1998
High School Diploma -
Southern Vance High School
Henderson, NC01.1993
Some College (No Degree) - Physician Practice Management
AAPC
Salt Lake City, UTSkills
- Medical Billing & Coding
- Claims management
- Receivables management
- Case Management
- Regulatory compliance
- Contract management
- Medical Records Management
- Greenway Intergy EMR/HER
- Allscripts
- EPIC EHR Certified
- CBSI
- Workflow improvement
- Productivity Tools: MS Office
- Online Research
- Relationship Management
- Budget administration
- Online Research
References
Available upon Request
Timeline
Patient Benefits Coordinator
Southern California Orthopedic Institute
09.2025 - Current
Contracts Manager & Accounts Receivable Manager
ANDERSON ORTHOPEDIC CLINIC
04.2007 - 06.2025
Patient Accounts Representative
CRANIAL TECHNOLOGIES, INC.
02.2005 - 04.2007
Some College (No Degree) - Revenue Cycle Billing and Coding
Johns Hopkins University
Certification - Medical Office Administration
Applied Career Training
High School Diploma -
Southern Vance High School
Some College (No Degree) - Physician Practice Management
AAPC