Monica Nichols
Carson City,NV
Summary
Highly experienced, multi-faceted professional with extensive experience in all aspects of Insurance Verification. A team player with a vast knowledge of medical terms and unique ability to work with all types of personalities effectively. Offering dynamic organizational skills and attention to detail, particularly adept with complex claims. Effective, well-defined interpersonal skills, along with a high level of integrity and commitment to patient confidentiality.
Overview
24
24
years of professional experience
Work History
Customer Retention Specialist
Trupanion
Seattle , WA
04.2019 - Current
- Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving and problems that resulted in high customer retention rates.
- Working remotely, consistently exceeded monthly goals
Insurance Verification Specialist
Carson Tahoe Regional Hospital
Carsen City, Nevada
04.2018 - 04.2020
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Communicated verification and authorization status updates with Radiology, Surgery and Infusion department to facilitate decision-making for patient admissions and insurance coverage.
- Adept at handling patient grievance Processes and Retro Authorizations
Patient Access Representative - Admitting ER
Renown Regional Medical Center
Reno, NV
07.2017 - 04.2018
- Analyzed loss of revenue due to lack of co-pay collections from inpatient stays by developing and implementing a process designed to standardize the collection process. Was able to achieve $15K increase of monthly in revenue.
- Co-developed an effective method of calculating and verifying bill accuracy to check for errors. The process became a standard procedure that prevented nearly $500K in losses.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
Insurance Verification - Admitting Clerk
Carson Valley Medical Center
Gardnerville, NV
02.2017 - 07.2017
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
Senior Customer Service Specialist
Liberty Utilities
South Lake Tahoe, CA
06.2011 - 06.2017
- Responsible for all Major Account billing.
- Resolved customer service issues using company processes and policies and provided updates to customers.
- Entered customer data into system and made work orders.
- Trained staff on operating procedures and company services.
Licensed Pharmacy Technician
Kaiser Permanente
Santa Rosa, CA
05.2000 - 10.2011
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Calculated dosage, filled prescriptions and prepared prescription labels with absolute accuracy.
- Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
- Collected co-payments or full payments from customers.
Education
Associate of Arts - Medical Office Assistance
Lake Tahoe Community College
South Lake Tahoe, CA10.2022
CPhT - Pharmacy Technology
Online Certified Pharmacy Technician
On-line04.2000
Skills
- High Level Security Clearance, Renown Medical Center
- Policy Investigations
- ICD-10/CPT Codes
- Medical Terminology
- Medicaid & Tricare
- Case Coordination
- Hippa Compliance Training
Timeline
Customer Retention Specialist
Trupanion
04.2019 - Current
Insurance Verification Specialist
Carson Tahoe Regional Hospital
04.2018 - 04.2020
Patient Access Representative - Admitting ER
Renown Regional Medical Center
07.2017 - 04.2018
Insurance Verification - Admitting Clerk
Carson Valley Medical Center
02.2017 - 07.2017
Senior Customer Service Specialist
Liberty Utilities
06.2011 - 06.2017
Licensed Pharmacy Technician
Kaiser Permanente
05.2000 - 10.2011
Associate of Arts - Medical Office Assistance
Lake Tahoe Community College
CPhT - Pharmacy Technology
Online Certified Pharmacy Technician
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