Nichelle Hughes
Mobile,United States
Overview
29
29
years of professional experience
Work History
Referral Specialist
AltaPointe Health Systems
Mobile, AL
04.2025 - Current
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
- Verified insurance benefits and eligibility for [Type] procedures before referring clients.
Unit Secretary
Mobile Infirmary Hospital
Mobile, AL
09.2021 - Current
- Maintain current provider agreements or contracts.
- Prepares any required pre-appointment documents.
- Process and document the consults following proper guidelines/ procedures.
- Obtains medical documentation from community providers.
- Coordinates internal and external care between customers and providers
- Audit authorizations, reviews payments, and reconciles with community providers on outstanding claims.
- Assist patients when arriving at the department for care.
- Fielding phone calls to the unit.
- Maintaining, filing and organizing patient records.
- Scheduling appointments with the healthcare providers within the unit.
- Working with other departments to coordinate care services.
- Handling billing and accepting payments.
- Managing office and medical supplies for the department.
- Reviewing and verifying health insurance.
- Full Time/40 hrs. Weekly
Office Professional
AltaPointe Health Systems
Mobile, Alabama
12.2017 - 09.2021
- Answer telephone
- Receives consumer requests for appointments/information and changes.
- Records all telephone messages accurately and transfers to appropriate person timely
- Handles routine requests from clinicians
- Keys in no shows daily
- Directs consumers to appropriate waiting area
- Handles unscheduled consumers.
- Request consumers chart from medical records
- Notifies appropriate clinician of consumer’s arrival
- Schedules return appointments.
- Reviews DSR for appointment information
- Completes administrative review audits as necessary
- Verifying Insurance
- Passing out prescriptions from the doctor to the Consumer
- Assists with the patient assistance pharmacy forms as needed, which includes communicating with the Consumer regarding proof of income
- Collecting Co-Payments
- Posting Payments to Consumers account
- Write the consumer a receipt for payments taken.
- Preparing deposits to be taken to Finance and Accounting.
- Enter Billing for various programs as needed.
- Entering information into Avatar
- Assist Consumers in receiving compensation for travel from Medicaid when needed
- Completes Admissions, Discharges, and Transfers as needed
- Coordinate appropriate services for consumers in Crisis
- Pass out Daily DSR reports
- Taking Verbal orders to be signed by various medical staff
- Assists with and works with all organization personnel involved with any aspect of release of protected health information to ensure full coordination and cooperation under the organization’s policies and procedures and legal requirements
- Monitor dictation and transcription services
- Full Time /40hrs Weekly
Medical Data Entry Clerk
Miraca Life Sciences
Mobile, Alabama
11.2016 - 12.2017
- Maintain accurate records by following hospital procedures
- Ensure patient charts, paperwork, and reports are completed in an accurate and timely manner.
- Review records for policy compliance.
- Create digital images of paperwork.
- Process admission and discharge records.
- Supply the nursing department with the appropriate documents and forms.
- Complete clerical duties including answering phones, responding to emails.
- Full Time/40 hrs. Weekly
Medical Billing and Collections Specialist
TruBride
Mobile, Alabama
05.2015 - 10.2016
- Sets contact terms on encounters, which meet minimum payment requirements
- Follows up on delinquent formal payment plans
- Prepares encounters for audits and documents and charges with results of audit
- Research self-pay encounters for insurance coverage and forwards information to proper area for encounter update
- Verifies employment and checks probate court for property and estate claims
- Recommend encounters for suit or placement with an outside collection agency or attorney
- Reviews Mobile County Record for court action involving patient encounters
- Submits encounters for estate filing
- Communicate and uses appropriate customer relations skills with physicians, patients, families and personnel in person and via telephone, communicates work-related problems and issues to supervisor or management staff
- Maintains encounter integrity by ensuring that insurance pro-ration, adjustments and transactions are accurate, reconciles encounters from insurance Explanation of Benefits, monitors insurance payments and allowances for proper reimbursement per contract.
- Responsible for processing all medical claims for commercial billing
- Maintains constant ness to the possibility of fraudulent documentation or claims of identity
- Full Time/40hrs. Weekly
Navy Military Training Instructor
United States Navy
United States of America
10.1996 - 05.2015
- Conduct needs assessments and task analyses to determine learning objectives.
- Prepare lesson plans and training materials based on course objectives
- Responsible for improving and modifying the training for assigned courses.
- Conduct training and assess progress of students in meeting desired objectives, including advising and assisting them to improve their performance.
- Prepare and maintain training records, progress reports, qualifications and other documentation as required to certify worker qualifications for audit and historical purposes.
- Leading staff members in providing daily mentorship, team building, fitness, Navy heritage and academic training for over 1,600 apprentice level sailors annually.
- Full Time
Education
Academic Endorsement Diploma -
Ferriday High School
Ferriday, LA05.1996
Medical Assistant - undefined
Fortis College
07.2020
Medical Billing & Coding - undefined
Remington College
Mobile, Alabama04.2015
Timeline
Referral Specialist
AltaPointe Health Systems
04.2025 - Current
Unit Secretary
Mobile Infirmary Hospital
09.2021 - Current
Office Professional
AltaPointe Health Systems
12.2017 - 09.2021
Medical Data Entry Clerk
Miraca Life Sciences
11.2016 - 12.2017
Medical Billing and Collections Specialist
TruBride
05.2015 - 10.2016
Navy Military Training Instructor
United States Navy
10.1996 - 05.2015
Medical Assistant - undefined
Fortis College
Medical Billing & Coding - undefined
Remington College
Academic Endorsement Diploma -
Ferriday High School