NICOLA ADAMS
Queens,USA
Summary
Experienced healthcare revenue cycle professional with over 8 years in medical billing, payment posting, and insurance verification. Specializes in denial management, claims resolution, and accounts receivable follow-up to ensure accurate reimbursement processes. Excels in high-volume environments with expertise in reporting, payer communication, and HIPAA compliance.
Overview
16
16
years of professional experience
Work History
Payment Poster / Eligibility Specialist
Long Island Consultation Center
New York
09.2024 - 01.2026
- Reviewed, analyzed, and resolved insurance claim denials to support accurate reimbursement and timely account resolution.
- Reviewed payer information, claim status, and account details to identify and resolve payment issues, discrepancies, and denial root causes.
- Corrected billing errors and coordinated resubmissions, reprocessing, and appeals, ensuring timely resolution and minimizing revenue loss.
- Posted and reviewed payment-related account activity while supporting eligibility, billing, and revenue cycle workflows.
- Communicated with insurance companies, case managers, and internal departments to resolve payer issues and account discrepancies.
- Maintained detailed documentation of denied claims, payment issues, and resolution steps, ensuring compliance with HIPAA standards.
- Supported accounts receivable follow-up by prioritizing unpaid, denied, and unresolved claims.
- Identified recurring denial and payment issues and supported Excel-based tracking and reporting.
- Utilized AccuMed Cloud, CareCloud, ePACES, Qualifacts, CareLogic, Microsoft Excel, Word, and Outlook to manage tasks.
Medical Billing Specialist
Blanton-Peale Counseling Center
New York
01.2018 - 09.2024
- Managed full-cycle medical billing, including claims submission, denial review, payment posting, adjustment processing, and account follow-up.
- Reviewed insurance payments and account activity to ensure accuracy in billing and optimize reimbursement outcomes.
- Investigated unpaid and denied claims, coordinating corrections and appeals to secure appropriate reimbursements.
- Processed billing adjustments and supported account resolution in accordance with healthcare billing procedures.
- Collaborated with clinical, billing, and administrative teams to resolve account discrepancies and improve operational efficiency.
- Provided patient billing support, including explanation of charges, payment plans, and account resolution.
- Maintained accurate patient account records and followed HIPAA, payer, and departmental requirements.
- Produced billing and accounts receivable reports to monitor financial performance and identify payment activity trends.
- Supported patient registration and insurance verification to ensure accurate claims processing.
Front Desk Receptionist
Blanton-Peale Counseling Center
New York
02.2017 - 01.2018
- Managed high-volume inbound calls, directed patient inquiries, and resolved patient account concerns.
- Scheduled appointments and coordinated communication between patients, providers, and billing staff.
- Registered patients and verified insurance information, ensuring accuracy in billing and eligibility for efficient claim submission.
- Maintained accurate patient records and safeguarded confidential information, adhering to HIPAA regulations to protect patient privacy.
- Supported daily administrative and patient access workflows, contributing to seamless operations in a fast-paced healthcare environment.
Home Care Support Services
All Metro Health Care
New York
05.2010 - 02.2017
- Supported clients in daily living activities, ensuring accurate care documentation and compliance with care plans.
- Coordinated medical appointments and transportation services, facilitating seamless continuity of care.
- Engaged with patients, families, and healthcare providers to address care-related needs and enhance communication.
- Maintained compliance with care plans, documentation standards, and healthcare procedures.
Education
Healthcare Billing, Coding & Systems Training -
Queensborough Community College
New York08-2026
Diploma - Medical Billing
Manhattan Institute
New York01-2019
GED -
LaGuardia Community College
Long Island City, NY01-2011
Skills
- Cash and payment posting
- Medical billing and patient accounting
- Insurance payment processing
- EOB and ERA review
- Claims submission and denial management
- A/R follow-up and claim corrections
- Appeals and resubmissions
- Insurance verification and eligibility checks
- Adjustments and write-off support
- Payment reconciliation
- Posting discrepancy resolution
- Payer communication
- Patient account support
- Revenue cycle operations
- HIPAA compliance
- Excel reporting and Microsoft Office proficiency
- Problem-solving in high-volume environments
Timeline
Payment Poster / Eligibility Specialist
Long Island Consultation Center
09.2024 - 01.2026
Medical Billing Specialist
Blanton-Peale Counseling Center
01.2018 - 09.2024
Front Desk Receptionist
Blanton-Peale Counseling Center
02.2017 - 01.2018
Home Care Support Services
All Metro Health Care
05.2010 - 02.2017
Healthcare Billing, Coding & Systems Training -
Queensborough Community College
Diploma - Medical Billing
Manhattan Institute
GED -
LaGuardia Community College