NIA HESTER
Atlanta,GA
Summary
Diligent office professional with high emotional intelligence. Known for insightful listening, analytical questioning, and strategic thinking. Provides versatile administrative support that exceeds expectations. Strong work ethic, excels at managing multiple priorities and meeting deadlines without sacrificing quality. Extensive experience in customer care in high-volume professional environments like medical, legal, and accounting entities.
Overview
19
19
years of professional experience
Work History
Case Manager/Settlements Clerk
Kenneth S. Nugent, PC
03.2023 - Current
- Coordinated case management services to ensure effective client support and resource allocation.
- Developed comprehensive care plans tailored to individual client needs and legal requirements.
- Facilitated communication between clients, attorneys, and healthcare providers for seamless service delivery.
- Monitored case progress, identifying obstacles and implementing strategies for timely resolution.
- Resolved complex settlement issues swiftly, minimizing delays in processing time-sensitive transactions.
- Handled account payments and provided information regarding outstanding balances.
Settlements Coordinator/Negotiator
Dimmock& Associates, PC
01.2022 - 03.2023
- Finalizing clients case with the defendant's insurance company to obtain the highest settlement possible
- Maintains communication with clients to guide them though the settlement process to ultimately settle their case
- Negotiating post settlement liens including health insurance, hospital, private medical providers and government provider liens
- Review demand packages with claims adjusters, summarize case facts and create persuasive arguments
Case Manager
Morgan & Morgan
04.2021 - 01.2022
- Influential networking skills that compliment an expert level for client relationship management and maintaining a consistent inflow of business for the firm resulting in the recovery of millions of dollars in damages
- Provides stewardship and customer service to all clients and customers of the firm in a timely and professional manner
- Negotiating settlements and obtaining medical reductions on behalf of clients and documenting final medical and case expenses
- Coordinating health insurance reimbursement with their subrogation department
- Preparing and executing settlement documents, demand packages, maintaining filing systems, as well as making recommendations regarding litigation
Legal Assistant
John Foy & Associates
07.2015 - 03.2021
- Handled all aspects of investigation and case development to include; interviewing potential clients, contacting witnesses, communicating with the police department, and developing business relationships with medical professionals
- Educated clients and monitored the validity and effectiveness of treatment
- Filed documents with online filing systems, prepared demands, monitored negotiations and settlement offers, assisted with medical bill and lien reductions, prepared settlement packets and coordinated client sign outs
Choice Counselor
Maximus
09.2014 - 03.2015
- Provided guidance to members on open enrollment concerns, community referrals, and other related inquiries to ensure a quick and courteous resolution
- Assisted and educated members with understanding their health insurance coverage and guided them through the selection process to ensure they are choosing plans that are the best possible fit for their situation
- Maintained knowledge about state eligibility and enrollment rules and procedures, the range of qualified health plan options and insurance affordability programs
Accounts Receivable
Gessner Anesthesia & Associates
02.2012 - 07.2014
- Managed daily and monthly A/R reports utilizing receivables management systems for billing and collection purposes
- Regulated aging accounts, correspondence, and denials to obtain correct reimbursement for medical services and procedures, this may include; working with ancillary departments to resolve charge edits and update incorrect charges
- Appealing denied claims successfully utilizing clinical documentation, product knowledge, policies and procedural guidelines and other necessary research outlets
- Answered patient billing inquiries, followed up on problem or unpaid insurance claims, collection of unpaid accounts, patient referrals, pre-auths, and other general office duties
Legal Assistant/Collection Associate
Shafer Law Firm
05.2008 - 08.2011
- Communicated with consumers regarding debts owed to clients of the law firm who were in post-lawsuit, legal state of collections; preparing files for additional legal action
- Reviewed cases for arbitration submission and adhered to Fair Debt Collection Practices Act, as well as other applicable state and federal regulations
- Responsible for reviewing potential fraud and utilized background search engines to skip traced parties indebted to clients
- Assisted the collections department in recovery and updated the Attorney and process servers with any updated case information
Customer Service Refund Analyst
HCA Patient Account Services
04.2006 - 04.2007
- Researched overpayments to initiate payer resolutions/discrepancies in the form of expected reimbursement and contractual calculations
- Orchestrated managed care products in a hospital based environment and utilized model based contracts to provide efficiency and reduce bad debts
- Adhered to claims submission requirements, pre-certifications, insurance verifications, applicable co-pays and denied claims and inaccurate or delayed payments and fee schedules
Education
Associates - Applied Sciences, Business Administration
Phoenix University
Office Automation/Business Applications -
Interactive College of Technology
Esthetics Certification -
Georgia Career Institute
No Degree - Electronics And Computer Technology
North Carolina A&T State University
Skills
- Client Relationships and Communication
- E-Filing/Records Management
- FDCPA/HIPAA Compliant
- Critical Thinking and Judgement
- Legal Correspondence and Development
- Notary Public, State of Georgia
- Account Reconciliation
- Risk Management
- Business Development
- Data Entry Analysis
- Complex Troubleshooting
- Case Management
- Documentation proficiency
Timeline
Case Manager/Settlements Clerk
Kenneth S. Nugent, PC
03.2023 - Current
Settlements Coordinator/Negotiator
Dimmock& Associates, PC
01.2022 - 03.2023
Case Manager
Morgan & Morgan
04.2021 - 01.2022
Legal Assistant
John Foy & Associates
07.2015 - 03.2021
Choice Counselor
Maximus
09.2014 - 03.2015
Accounts Receivable
Gessner Anesthesia & Associates
02.2012 - 07.2014
Legal Assistant/Collection Associate
Shafer Law Firm
05.2008 - 08.2011
Customer Service Refund Analyst
HCA Patient Account Services
04.2006 - 04.2007
Associates - Applied Sciences, Business Administration
Phoenix University
Office Automation/Business Applications -
Interactive College of Technology
Esthetics Certification -
Georgia Career Institute
No Degree - Electronics And Computer Technology
North Carolina A&T State University
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