Nahashon G. Machoka
Lewisville
Summary
Dynamic professional with extensive experience in revenue cycle management, corporate compliance, and ethics, specializing in medical billing, coding, and collections. Proven ability to drive efficiency and accuracy while ensuring adherence to regulatory standards. Committed to contributing to organizational growth and development through innovative solutions and strategic initiatives. Eager to leverage expertise in a challenging role that fosters personal and professional advancement.
Overview
27
27
years of professional experience
Work History
Senior Patient Account Representative
GuideHouse (UAB-University of Alabama Hospital)
12.2020 - Current
- Training fellow team members
- Variety of reports from leadership
- Assisting team members, providing/finding solutions and account guidance
- Assisting Supervisor/Manager as needed with various projects
- Review and Resolve Blue Cross/Commercial Denials
- Submit Facility - nonclinical appeals
- Facilitate resolution by referring to the matter to the issue/content expert.
- Escalate the matter to a supervisor, request the appropriate information or take appropriate action so that the issue expert can effectively resolve the matter.
- Resubmit Corrected Claims and supporting documentation as needed for the patient experience.
- Communicate with other organizational departments to ensure proper handling of patient accounts.
- Communicates issues to management timely and performs other duties as assigned by direct supervisors.
- Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure
Senior Revenue Cycle Compliance and Ethics Consultant
Parkland Health and Hospital System
07.2017 - 10.2020
- The Primary Purpose is to assist the Director of Revenue Cycle Compliance with the design and implementation of an effective compliance monitoring program designed to prevent, detect, and respond appropriately to revenue Cycle compliance risks.
- Conduct routine monitoring to prevent, detect, and respond appropriately to revenue cycle compliance risks, consult with management, and provide corrective action recommendations.
- Conducts thorough research and provides prompt, courteous consultative services regarding revenue cycle compliance matters
- Assists with monitoring and responding to audits and inquiries from government agencies and contractors.
- Identifies ways to improve work.
- Stays abreast of the latest development of new or revisions and trends in revenue cycle compliance
- Collaborates with other personnel system-wide.
- Job Accountabilities
Collector III
Parkland Health and Human Services
09.2005 - 06.2017
- Responsible for the clean claims billing process. Conduct billing and collection for primary, secondary, and third-party payers. Perform medical records review for appeals and other requests associated with utilization management. Appeal and dispute unpaid claims within Health care policies and guidelines. Payment Posting and account reconciliation.
- Government Reimbursements
Default loans Servicing/Mortgage Collections
Bank of America
09.2009 - 04.2010
- Collect 60 to 90 days past due Mortgage payments.
- Review and advise Homeowners on different Loan Modifications
- Obtain all necessary documents for the loan Modification review.
- Review individual circumstances for non-payment/delinquencies.
- Advice/Offer suggestions in resolving delinquency and avoiding foreclosure.
Customer Service Representative – Accounts Receivable
Hospital Corporation of America
12.1998 - 04.2005
- Received incoming calls from patients on outstanding balances
- Resolve accounts receivable issues
- Reconcile collections, payments, balances, and settlement offers.
- Act as liaison between collections, Coding, and Medical Records staff on audits, coding issues
Education
Associate of Science -
Jersey City State College
Jersey City, NJSkills
- HIPAA compliance
- Claims processing
- Patient account management
- Insurance verification
- Denial management
- Payment plan negotiation
- Medical billing expertise
- Data analysis capabilities
- Financial counseling
Timeline
Senior Patient Account Representative
GuideHouse (UAB-University of Alabama Hospital)
12.2020 - Current
Senior Revenue Cycle Compliance and Ethics Consultant
Parkland Health and Hospital System
07.2017 - 10.2020
Default loans Servicing/Mortgage Collections
Bank of America
09.2009 - 04.2010
Collector III
Parkland Health and Human Services
09.2005 - 06.2017
Customer Service Representative – Accounts Receivable
Hospital Corporation of America
12.1998 - 04.2005
Associate of Science -
Jersey City State College
SUMMARY OF QUALIFICATIONS
- Extensive knowledge of billing and collections.
- Proficient in Microsoft Office software and EPIC Healthcare System
- Knowledge of medical terminology and ICD-9 and ICD -10, CPT, HCPCS coding
- Strong interpersonal and organizational skills
- Strong Auditing skills