Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

NICHOLL TRAWEEK

Castle Rock,CO

Summary

Hardworking Patient Account Representative dedicated to customer service and patient care. Outgoing and flexible team player. Talent for developing creative solutions that satisfy all parties.

Overview

26
26
years of professional experience

Work History

Patient Account Representative

CommonSpirit Health
08.2023 - Current
  • Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
  • Worked with outside entities to resolve issues with billing, claims, and payments.
  • Worked efficiently on claim rejections, claim denials, and no response claims for all UHC/Humana payers.
  • Streamlined billing processes for increased efficiency in managing patient accounts.
  • Conducted regular audits of patient accounts, identifying discrepancies and rectifying errors as needed.
  • Ensured compliance with healthcare regulations while processing claims and managing over multiple patient accounts.
  • Electronically submitted bills according to compliance guidelines.
  • Enhanced patient satisfaction by promptly addressing inquiries and resolving account issues.
  • Identified trends in unpaid accounts, developing targeted solutions for improved revenue recovery.
  • Achieved a significant reduction in aged accounts receivable through diligent follow-up efforts with both patients and insurers.
  • Researched billing errors and discrepancies to initiate corrective action.
  • Promoted a positive work environment by actively participating in team meetings and contributing ideas for process improvements.
  • Worked on a specialized team within Athena on all Utah accounts.

Prior Authorization Specialist

Castle Rock Family Physicians
05.2013 - 07.2023
  • Completed daily super bills for all patients
  • Meet one on one with drug representatives
  • Completed all prior-authorizations for all medications for 4 different providers
  • Peer to Peer reviews
  • Written appeals for medications
  • Worked one on one with all insurance companies
  • Lab billing issues
  • Discount programs for patients that cannot afford their medication
  • Staying current on all medications and their use
  • ICD-10 code training
  • Worked well in a team setting, providing support and guidance
  • Worked effectively in fast-paced environments
  • Managed time efficiently in order to complete all tasks within deadlines
  • Organized and detail-oriented with a strong work ethic
  • Skilled at working independently and collaboratively in a team environment
  • Documented communications and contacts with clients to maintain records
  • Navigated through computer screens to complete and review documents and other forms
  • Communicated with others to obtain and verify eligibility information
  • Stayed current with changes in rules, laws and procedures to maintain timeliness and accuracy
  • Processed appeals for denied services according to company policy guidelines

Referral Specialist

Castle Rock Family Physicians/ Village Medical
05.2013 - 07.2023
  • Ensure all referrals are complete, accurate and processed in a timely manner
  • Act as a liaison between the primary care provider, patients, specialists, and health plans
  • Meet one on one with different specialist groups
  • Provide clerical support for the clinic, including providing patients with financial assistance and other resource information, paperwork, documentation in medical record
  • Processed all referrals for 4 providers in clinic
  • Referrals were all completed through Athena or manually, if needed
  • Monitored trends in patient referrals and reported findings to senior management team
  • Adhered to relevant regulations while processing patient referrals
  • Collaborated with healthcare teams to ensure successful outcomes from referrals
  • Identified potential areas of improvement within the referral process and proposed solutions accordingly
  • Maintained accurate records of all referrals and follow-up activities
  • Utilized customer service skills when interacting with patients, families, caregivers, and referral sources
  • Developed and implemented strategies to increase referral sources for the organization
  • Submitted and maintained all work comp claims for all patients within the practice.

Front Desk Associate

Plum Creek Medical
08.2012 - 05.2013
  • Responsible for checking patients in and out of the medical facility
  • Opening and closing of the facility
  • Running end of the day reports and balancing
  • Answering multi-line phones
  • Verifying insurance via telephone and online
  • Entering new patient information into the computer
  • Reminder phone calls to patients
  • Scheduling patients for 8 different providers
  • Greeted guests in a professional and friendly manner, ensuring their needs were met
  • Resolved guest issues effectively, ensuring a positive customer experience.
  • Answered guest questions and offered referrals to local points of interest.
  • Maintained clean and organized front desk areas to uphold polished company image.

Custodial Account Administrator

Protocols
08.2010 - 02.2012
  • Administration of 140 Medicare/Medical Beneficiary Accounts
  • Annually reporting to CMS for each account
  • Monthly reconciliation for each account
  • Processing/Payment of claims according to Workers Compensation State Fee Schedule
  • Guidance
  • Online banking for bill pay and remote deposit
  • Re-pricing claims when necessary
  • Distribution of funds when account terminates as instructed in the agreement
  • Administration of accounts in accordance with Medicare guidelines
  • Working one on one with each individual beneficiary to make sure all needs are met
  • Reconciled account information and reported figures in general ledger by comparing to bank account statement each month.

Recruitment and Retention Coordinator

Miller-Motte Technical College
12.2008 - 07.2010
  • Responsible for standards of academic progress calculations & percentages
  • Reviewed Early Alert forms, mail Excessive Absence Notices, compile & monitor weekly retention reports
  • Provide student academic advising/counseling as needed in conjunction with Program Directors
  • Ensure all probationary students are counseled at least once each term
  • Assist students with problem-solving & decision-making skills
  • Interview re-entering students to determine readiness & dedication to pursuit of academic goals
  • Create/maintain Master Schedule of Classes
  • Works cooperatively with college staff & administrators to achieve established goals
  • Works one on one with all students with disciplinary issues
  • Established a network of contacts within the industry to source passive candidates for open positions
  • Developed and implemented recruitment strategies to attract qualified candidates
  • Identified areas of improvement in the recruitment process and proposed solutions

Financial Aid Planner

Miller-Motte Technical College
02.2006 - 09.2008
  • Conduct Pre & Post-Loan Financial Aid Counseling for new and returning student loan borrowers
  • Completed FAFSA analysis to determine eligibility, reviewed costs & awarded aid to students
  • Responsible for default management
  • Scheduled all federal aid & student payments in campus database
  • Maintained current knowledge of Cohort Default Rate & verified accuracy as defined by US Department of Education
  • Managed daily operations of Federal Work Study program; overseeing schedules & reconciling time sheets
  • Developed and implemented financial aid policies and procedures to ensure compliance with federal, state, and institutional regulations
  • Advised students on budgeting techniques to manage their finances while attending school

Insurance Billing Representative

Eyesight Associates
06.2002 - 01.2003
  • Responsible for all insurance claims and billing
  • Managed all denied claims and assisted customers in claims resolution
  • Online claims management
  • Conducted periodic audits of customer accounts to verify accuracy of information stored in system databases
  • Resolved customer inquiries related to billing issues promptly
  • Maintained accurate records of all customer interactions and transactions
  • Provided detailed reports on billing activities to management as requested

Insurance Billing Representative

Leavengood Chiropractic
02.2001 - 05.2002
  • Responsible for all insurance claims and billing
  • Managed all denied claims and assisted customers in claims resolution
  • Assisted with all office duties including bookkeeping, filing, and scheduling
  • Opening and closing of the facility
  • Negotiated payment arrangements with delinquent customers according to company policy
  • Performed regular reconciliations of outstanding invoices against monthly statements
  • Utilized problem-solving skills to troubleshoot complex billing issues quickly and effectively
  • Monitored account balances, identified discrepancies, and took appropriate action when needed
  • Processed and submitted customer payments accurately and efficiently
  • Resolved customer inquiries related to billing issues promptly

Paralegal Assistant to Paul Ayerbe

Lovett, Cowart & Ayerbe, P.C.
06.1998 - 03.2002
  • Managed client correspondences, interviews and appointments
  • Responsible for billing, general accounting and file maintenance
  • Assisted with client demands, organizing demand packages, and delivery of demand material to outside agencies
  • Assisted with preparing for trials, hearings, and closings
  • Conducting legal research and gathering relevant information for cases
  • Conducted document reviews including redacting confidential material from filings
  • Processed requests from clients regarding their cases; provided timely responses when possible
  • Conducted interviews with clients to obtain relevant information for cases
  • Attended depositions, hearings and trials as necessary to provide assistance to attorneys
  • Managed calendar system for tracking deadlines associated with litigation matters
  • Maintained a database of case information for quick retrieval of data
  • Provided support to attorneys in the preparation of legal documents and research materials
  • Reviewed documents for accuracy prior to filing with court or other agencies
  • Developed checklists for review of settlement agreements ensuring compliance with regulations

Education

COMPLETED COURSEWORK TOWARDS COMPUTER COURSEWORK -

Miller-Motte Technical College
Chattanooga, TN

Some College (No Degree) -

Central Georgia Technical College
Warner Robins, GA

Some College (No Degree) - LPN

Middle Georgia Technical College
Warner Robins, GA

HIGH SCHOOL DIPLOMA -

Warner Robins High School
Warner Robins, GA
01.2005

Skills

  • Relationship Building
  • Detail-Oriented
  • Computer Applications Proficiency
  • Communication Skills
  • Prioritization
  • Deadline Management
  • Medical Software Proficiency
  • Client Relations
  • Creative Problem Solving
  • Referral Verification
  • Insurance Verification
  • HIPAA Compliance
  • Insurance Billing
  • Medical Billing Understanding
  • Data entry proficiency
  • Team Collaboration
  • Healthcare industry understanding
  • Account Monitoring
  • Decision-Making
  • Attention to Detail
  • Conflict Resolution

References

References available upon request

Timeline

Patient Account Representative

CommonSpirit Health
08.2023 - Current

Prior Authorization Specialist

Castle Rock Family Physicians
05.2013 - 07.2023

Referral Specialist

Castle Rock Family Physicians/ Village Medical
05.2013 - 07.2023

Front Desk Associate

Plum Creek Medical
08.2012 - 05.2013

Custodial Account Administrator

Protocols
08.2010 - 02.2012

Recruitment and Retention Coordinator

Miller-Motte Technical College
12.2008 - 07.2010

Financial Aid Planner

Miller-Motte Technical College
02.2006 - 09.2008

Insurance Billing Representative

Eyesight Associates
06.2002 - 01.2003

Insurance Billing Representative

Leavengood Chiropractic
02.2001 - 05.2002

Paralegal Assistant to Paul Ayerbe

Lovett, Cowart & Ayerbe, P.C.
06.1998 - 03.2002

HIGH SCHOOL DIPLOMA -

Warner Robins High School

COMPLETED COURSEWORK TOWARDS COMPUTER COURSEWORK -

Miller-Motte Technical College

Some College (No Degree) -

Central Georgia Technical College

Some College (No Degree) - LPN

Middle Georgia Technical College

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