ALECIA NICHOLS
Menomonie,WI
Summary
Healthcare operations leader with a background in Medicare and employer-group enrollment, EDI 834 processing, and CMS compliance. Manages eligibility audits, resolves data discrepancies, and improves enrollment accuracy through clearer workflows and strong client, vendor, and internal support. Trusted SME and trainer across multiple healthcare platforms.
Overview
11
11
years of professional experience
Work History
CAREGIVER
Tainter Adult Family Home
Colfax, WI
01.2026 - 09.2026
- Delivered daily help with medication administration, mobility support, transportation, meal preparation, and recordkeeping to support resident comfort and well-being.
- Completed accurate care and medication documentation while following safety procedures and state compliance requirements.
- Provided companionship and emotional support during daily routines and activities.
SENIOR ENROLLMENT DATA MANAGER
United HealthCare
Menomonie, WI
11.2023 - 05.2025
- Managed enrollment and eligibility operations for multiple insurance plans, streamlining processes across healthcare and service platforms to improve overall service delivery.
- Acted as a subject matter expert (SME) for enrollment processes, providing training and consultative support to internal teams, clients, and vendors.
- Cultivated client and vendor relationships, ensuring accurate and timely enrollments through effective communication and support.
- Analyzed EDI test and production files to ensure compliance with client requirements, proper enrollment processes, and identified and resolved inconsistencies.
- Worked remotely to support team collaboration and project completion.
SENIOR ELECTRONIC ELIGIBILITY ANALYST
United HealthCare
Eau Claire, WI
02.2017 - 11.2023
- Piloted and maintained the implementation of the largest employer group enrollment for 400,000 members, ensuring seamless integration.
- Managed Medicare enrollment and employer group eligibility operations while ensuring CMS compliance.
- Audited enrollment files and member data to identify and resolve discrepancies between internal systems and client records.
- Acted as SME for complex employer group eligibility processes and training of new employees.
- Implemented process improvements that enhanced file accuracy and minimized processing time.
- Developed strategic recommendations and streamlined processes to enhance enrollment and data intake efficiency.
- Performed job responsibilities from a remote location, ensuring continuous productivity.
SENIOR ENROLLMENT REPRESENTATIVE
United HealthCare
Eau Claire, WI
11.2015 - 02.2017
- Managed UnitedHealthcare enrollment applications and eligibility updates for member accounts.
- Reviewed enrollment documents for accuracy, completeness, and compliance with plan requirements.
- Resolved member enrollment questions using clear, professional phone and email communication.
- Audited and managed member demographic data, ensuring accuracy to prevent disenrollment.
- Collaborated with team members in a hybrid environment, enhancing communication and coordination.
Education
ASSOCIATE DEGREE - HEALTH INFORMATION MANAGEMENT & TECHNOLOGY (HIMT)
CHIPPEWA VALLEY TECHNICAL COLLEGE (CVTC)
Eau Claire, WI05-2022
Skills
- Electronic Enrollment & Eligibility Medicare Operations CMS Compliance EDI 834 File Format Data Analysis & Auditing Microsoft Word, Excel, Outlook, PowerPoint, & Access Zoom Meetings Ultra Edit TSO Familiarity with ICD-10 Medical Terminology Knowledge of Fraud & Waste Management Educated of EMR Excellent Organization Able to Learn New Systems & Technology Ability to Multitask & Toggle Multiple Platforms Attention to Detail Dependable Team Oriented Time-management
Timeline
CAREGIVER
Tainter Adult Family Home
01.2026 - 09.2026
SENIOR ENROLLMENT DATA MANAGER
United HealthCare
11.2023 - 05.2025
SENIOR ELECTRONIC ELIGIBILITY ANALYST
United HealthCare
02.2017 - 11.2023
SENIOR ENROLLMENT REPRESENTATIVE
United HealthCare
11.2015 - 02.2017
ASSOCIATE DEGREE - HEALTH INFORMATION MANAGEMENT & TECHNOLOGY (HIMT)
CHIPPEWA VALLEY TECHNICAL COLLEGE (CVTC)