Work history
Education
Skills
Languages
Affiliations
Additional Information
Timeline
Generic
Kimberly McGahan

Kimberly McGahan

Manchester

Work history

Tax Specialist / Paralegal

Ibarra's Income Tax
Weekends - Remote
01.2012 - Current
  • Prepared simple to complex tax returns for individuals and small businesses, adhering to IRS and state tax laws.
  • Conducted client interviews, reviewed financial records, and assisted in resolving tax-related inquiries.
  • Processed DACA applications, ITIN renewals, and immigration documentation including notary public services.
  • Ensured compliance with IRS requirements and AICPA Professional Code of Conduct.
  • Provided clients with tax advice and prepared filings to minimize tax liabilities.

Health Claims Assessor

International Medical Group (IMG)
08.2022 - 10.2024
  • Managed the comprehensive assessment and management of Group Protection claims for defined accounts.
  • Assessed and triaged claims, determining required medical evidence to substantiate decisions in line with company philosophies.
  • Cultivated strong relationships with Independent Financial Advisors (IFAs) and policyholders (employers), optimizing benefit management processes and portfolio support.
  • Liaised with clients, medical providers, and other stakeholders regarding initial and ongoing claims, coordinating medical care and treatment.
  • Investigated and flagged potentially fraudulent claims, ensuring compliance with internal processes and regulatory requirements.
  • Ensured all claims documentation was accurately allocated and maintained within the Case Management System.
    Provided feedback for the development of Standard Operating Procedures (SOPs).

Medical Billing & Coding

HBCS Medical Billing Inc
Weekends - Remote
08.2019 - 03.2023
  • Performed medical billing for healthcare providers, ensuring proper coding and claim submission on UB04 and CMS 1500 formats.
  • Conducted audits on claims, processed unpaid claims, and handled follow-up for payment discrepancies.
  • Assisted with pre-authorizations, reviewing EOBs (Explanation of Benefits) and processing secondary insurance claims.
  • Worked with patients and insurance companies to resolve billing issues, research denied claims, and maintain patient confidentiality.

Automotive Claims Adjuster

Progressive Car Insurance
California - Remote
10.2019 - 08.2022
  • Handled automotive claims involving assessing accident details, gathering evidence (photos, reports), and determining fault and liability.
  • Worked with repair garages, medical providers, and stakeholders to ensure efficient claim processing and resolution.
  • Evaluated the extent of vehicle damage or injuries, coordinating inspections, repairs, and settlement calculations.
  • Ensured settlements adhered to policy terms, legal requirements, and insurance coverage limits.
  • Collaborated with fraud investigation teams on suspected fraudulent claims.

Tax Specialist

Aca Tax Center
Huntington Beach, California
09.2011 - 08.2012
  • Prepared income tax returns for a wide range of clients, ensuring compliance with local, state, and federal requirements.
  • Assisted clients in understanding tax deductions, credits, and adjustments, helping to reduce overall tax obligations.
  • Ensured compliance with HMRC regulations by maintaining up-to-date knowledge of tax laws.

Account Manager / Mediator

Quality Support Services
Irvine, California
03.2008 - 09.2011
  • Managed accounts and facilitated dispute resolution between clients, credit companies, and lawfirms.
  • Negotiated settlements and ensured customer satisfaction while maintaining compliance with regulations.
  • Handled customer complaints and resolved concerns in a professional and empathetic manner

Education

High School Diploma -

Los Amigos High School
Fountain Valley, CA
09.2002 - 06.2006

Medical Insurance Specialist - undefined

American Career College
Anaheim, CA
01.2007 - 01.2009

Associate of Arts and science - undefined

Orange Coast College
Costa Mesa, CA
01.2009 - 04.2010

CA Life & Health Agent - Insurance

Upward Bound Training Solutions
USA
01.2012 -

Skills

  • Claims Assessment & Management: Group Protection, Automotive, Health Insurance, Taxation
  • Medical Billing & Coding: UB04, CMS 1500, EOBs, Pre-authorizations
  • Claims Investigation & Fraud Prevention: Identifying fraudulent claims, coordinating with investigation teams
  • Customer Service & Relationship Management: Building strong client and stakeholder relationships
  • Regulatory Compliance: HMO/PPO, Medicare, Medicaid, Insurance Claims, Data Protection (GDPR)
  • Technical Proficiency: Microsoft Office (Excel, Word, Outlook), Case Management Systems
  • Taxation Expertise: Federal Income Tax, State Tax Laws, IRS Code, AICPA Code of Conduct
  • Multilingual: Fluent in Spanish (C2 level)

Languages

Spanish
Proficient (C2)

Affiliations

  • Hiking
  • Art
  • Traveling

Additional Information

Experienced and results-driven professional with a diverse background in health claims assessment, automotive claims adjustment, medical billing, and tax preparation. Proficient in managing complex portfolios, determining liability, liaising with stakeholders, and ensuring compliance with regulatory requirements. Fluent in Spanish (C2 level), with a demonstrated ability to foster effective client relationships, enhance operational processes, and support cross-functional teams. Experienced in providing expert services remotely and with a deep understanding of medical insurance policies, claims processes, and tax regulations.

Timeline

Health Claims Assessor

International Medical Group (IMG)
08.2022 - 10.2024

Automotive Claims Adjuster

Progressive Car Insurance
10.2019 - 08.2022

Medical Billing & Coding

HBCS Medical Billing Inc
08.2019 - 03.2023

CA Life & Health Agent - Insurance

Upward Bound Training Solutions
01.2012 -

Tax Specialist / Paralegal

Ibarra's Income Tax
01.2012 - Current

Tax Specialist

Aca Tax Center
09.2011 - 08.2012

Associate of Arts and science - undefined

Orange Coast College
01.2009 - 04.2010

Account Manager / Mediator

Quality Support Services
03.2008 - 09.2011

Medical Insurance Specialist - undefined

American Career College
01.2007 - 01.2009

High School Diploma -

Los Amigos High School
09.2002 - 06.2006

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Kimberly McGahan