NICHELLE SPEIGHTS
Summary
Billing and financial operations professional with substantial experience in banking and healthcare. Proficient in investigating discrepancies, ensuring accurate financial records, and collaborating with cross-functional teams to enhance compliance and quality assurance. Recognized for effectively managing high-volume workloads while maintaining precision in financial documentation.
Overview
1
1
Certification
9
9
years of professional experience
Work History
Sr. Advocacy Coordinator
Capital One
05.2023 - Current
- Investigated complex account and transaction discrepancies, documenting findings and collaborating with fraud, compliance, and internal teams for resolution.
- Review banking transactions, receipts, and account activity for accuracy, variances, risk indicators, and potential suspicious activity.
- Performed account and transaction reconciliations to ensure accurate financial records by researching discrepancies and resolving issues.
- Use Microsoft Excel extensively to organize, review, reconcile, and analyze financial and transactional data.
- Manage a high-volume production workload while balancing accuracy, productivity expectations, prioritization, and time-sensitive case resolution.
- Maintain accurate financial and case documentation while following internal controls, established procedures, compliance requirements, and quality standards.
- Contributed to process improvement and quality assurance through detailed reviews and issue identification in collaboration with cross-functional teams.
Insurance + Surgical Coordinator
Atlantic Vision Partners
12.2021 - 05.2023
- Coordinated insurance verification and pre-authorization processes to support timely approval and financial clearance of surgical procedures.
- Maintained accurate patient, insurance, and financial records, communicating with insurance carriers to expedite claims processing and reimbursement.
- Coordinated administrative and financial requirements among patients, providers, and insurance carriers while managing multiple deadlines effectively.
- Provided financial guidance regarding insurance coverage and payment options while ensuring clear and accurate documentation.
- Supported medical coding and billing activities by reviewing insurance coverage and payment information to ensure accuracy of supporting documentation.
- Researched and resolved billing and reimbursement discrepancies with healthcare providers and insurance companies, supporting timely revenue collection.
Operations Manager - Billing
VCU Medical Center
Richmond, VA
12.2017 - 12.2021
- Managed high-volume healthcare billing and prior authorization workflows while maintaining accuracy,productivity and documentation standards.
- Utilized Availity and insurance payer portals to verify eligibility,authorizations status,claim information and payer requirements.
- Monitored performance measures and quality standards to ensure timely completion of work and consistency in operational results.
- Led hiring, onboarding, coaching, and training of new employees to support staffing needs and standardized procedures.
- Reviewed medical documentation and applied appropriate CPT,E/M and ICD-10 codes to support billing,authorization and reimbursement processes.
- Partnered with team members and other departments to resolve escalated operational issues and improve workflow effectiveness.
- Processed appeals on rejected or partially paid claims, including filing additional paperwork as needed.
- Examined claims, records and procedures to grant approval of coverage.
Education
High School Diploma -
Louis D. Brandeis High School
New York, NY06-2004
Skills
- Account reconciliation and financial documentation
- Microsoft Excel proficiency
- Billing and reimbursement processes
- Accounts receivable management
- Revenue cycle operations
- Transaction review and variance resolution
- Claims processing and insurance verification
- Medical coding and billing expertise
- Compliance monitoring and internal controls
- Quality assurance practices
- Data analysis and process improvement
- Cross-functional coordination strategies
- Training and mentoring initiatives
- Claim denials management
- ICD-10 proficiency
- HIPAA compliance
- Payment posting strategies
- Medical billing practices
- Claim appeals handling techniques
- EOB analysis
Certification
Certified Revenue Cycle Representative | VCU Medical Center | June 2021
Timeline
Sr. Advocacy Coordinator
Capital One
05.2023 - Current
Insurance + Surgical Coordinator
Atlantic Vision Partners
12.2021 - 05.2023
Operations Manager - Billing
VCU Medical Center
12.2017 - 12.2021
High School Diploma -
Louis D. Brandeis High School