Nedra Friday
Belleville,MI
Overview
11
11
years of professional experience
1
1
Certification
Work History
Revenue Cycle Representative
Corewell Health
09.2020 - 02.2025
- Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization for the service delivered.
- Identified root causes of claim denials through analysis, implementing corrective actions for improved results moving forward.
- Improved revenue cycle efficiency by streamlining processes and implementing best practices.
- Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
- Ensured accurate billing and coding practices, leading to a reduction in claim denials.
- Maintained up-to-date knowledge of payer policies, regulations, and guidelines, ensuring compliance throughout the revenue cycle process.
- Reduced outstanding accounts receivable balances by 30% through diligent follow-up and effective communication with payers.
- Balanced and reconciled accounts.
Appeals Specialist
Concentra Health Services
10.2018 - 09.2020
- Followed all company policies and procedures to deliver quality work.
- Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
- Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
- Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
- Reduced claim denial rates with thorough pre-appeal reviews, identifying potential issues before submission.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations.
- Consistently met or exceeded performance metrics, demonstrating a strong understanding of the claims review process and an unwavering commitment to achieving positive results for clients.
- Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
Home Health Aide
Visiting Angels
05.2016 - 10.2018
- Chart for patient record
- Continue physical therapy for post injury
- Schedule appointments and services needed
- Became go-to staff member for relaying complicated medical information to patients of diverse backgrounds
- Care for client during periods of family disruption and illness recovery
- Manage bedside care plans and assist clients in personal hygiene and ambulation
- Vital signs recorded and medication reminders
Health Unit Secretary
Aldersgate Senior Living
03.2014 - 04.2016
- Direct day-to-day administrative and operational functions for 32-bed facility, providing guidance and leadership to multiple employees
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Established organized filing systems for medical records, expediting access to essential information when needed.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Enhanced patient experience by efficiently managing medical records and coordinating appointments with healthcare providers.
- Streamlined communication between nursing staff and physicians, ensuring timely delivery of accurate information.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and organizational policies.
- Ensured accuracy of physician orders through meticulous transcription and verification processes.
- Placed new supply orders, managed inventory and restocked clerical spaces.
Education
Diploma - Medical Administration
ECPI University, Charlotte, NC, USA
Charlotte05-2008
Skills
- Strong organizational skills
- Trained new employees
- EPIC System
- Authorization (Carelon, Evicore, Novologix)
- Claim edits, MUE
- ICD-10 proficiency
- HIPAA compliance
- Insurance verification
- Medicare advantage regulations
- Analytical problem solving
- Medical billing
- Teamwork and collaboration
Certification
Certification: Certified Revenue Cycle Representative, HFMA 05/2021 (Active)
Timeline
Revenue Cycle Representative
Corewell Health
09.2020 - 02.2025
Appeals Specialist
Concentra Health Services
10.2018 - 09.2020
Home Health Aide
Visiting Angels
05.2016 - 10.2018
Health Unit Secretary
Aldersgate Senior Living
03.2014 - 04.2016
Diploma - Medical Administration
ECPI University, Charlotte, NC, USA
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