Karri Nickel
Edmond,United States
Summary
Claims Examiner with deep knowledge of Reserve National Insurance policies. Excellent skills compiling, coding, categorizing and auditing information to process claims. I have worked with these policies collectively over 20 years.
Overview
13
13
years of professional experience
Work History
Referral Support Specialist
Medical Mutual Of Ohio
09.2023 - 04.2024
- Learned and adapted quickly to new technology and software applications.
- Passionate about learning and committed to continual improvement.
- Self-motivated, with strong sense of personal responsibility.
Claims Processor
Medical Mutual of Ohio/Reserve National Insurance
12.2017 - 09.2023
- Able to read and make determinations for medical records
- Subject matter expert for policies
- Process claims including life insurance policies
- Assisted with many aspects of department and help train others
- Managed large volume of medical claims on daily basis
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
- Verified patient insurance coverage and benefits for medical claims.
- Researched and resolved complex medical claims issues to support timely processing.
- Processed and recorded new policies and claims.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient finances, records, and health statuses.
Patient Access Representative
Mercy Health Partners
07.2016 - 12.2017
- Assisted patients with checking in for appointments using EPIC
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Delivered support to medical staff in completion of patient paperwork.
- Verified patient insurance eligibility and entered patient information into system.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Provided excellent customer service to patients and medical staff.
- Greeted and assisted patients with check-in procedures.
REWARD Technician
The Center for Early Childhood Professional Development (CECPD) OU
11.2014 - 06.2016
- Received applications for program
- Updated and logged information
- Made logs of information
- Calls for follow up information
- Assisted with scanning technology
- And other tasks as needed.
Receptionist
Digestive Disease Specialists
10.2011 - 08.2014
- Checked in patients
- Did billing
- Assisted staff as needed.
- Maintained confidentiality of information regarding clients and company.
- Kept reception area clean and neat to give visitors positive first impression.
- Answered central telephone system and directed calls accordingly.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
Education
High School Diploma -
Francis Tuttle Technology Center - Portland
Oklahoma City, OK05.1985
High School Diploma -
Edmond Memorial High School
Edmond, OK05.1985
Skills
- Insurance Claims
- Thorough claims reviews
- HIPAA
- Critical Decision-Making
- Medical record review
- Insurance claims processing
- Medical Terminology
- Medical terms and procedure knowledge
Timeline
Referral Support Specialist
Medical Mutual Of Ohio
09.2023 - 04.2024
Claims Processor
Medical Mutual of Ohio/Reserve National Insurance
12.2017 - 09.2023
Patient Access Representative
Mercy Health Partners
07.2016 - 12.2017
REWARD Technician
The Center for Early Childhood Professional Development (CECPD) OU
11.2014 - 06.2016
Receptionist
Digestive Disease Specialists
10.2011 - 08.2014
High School Diploma -
Francis Tuttle Technology Center - Portland
High School Diploma -
Edmond Memorial High School
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