Nicole "Nikki" Ayers
Bryson City,NC
Summary
Dynamic healthcare professional with extensive experience at Cherokee Indian Hospital Authority, excelling in patient eligibility verification and referral coordination. Proven ability to resolve conflicts and enhance patient experiences through active listening and meticulous attention to detail. Committed to delivering exceptional support in navigating complex insurance landscapes and ensuring comprehensive care.
Overview
17
17
years of professional experience
1
1
Certification
Work History
ACA Insurance Coordinator/Certified Application Counselor
Cherokee Indian Hospital Authority
Cherokee, NC
10.2022 - 03.2025
- Guided patients through the ACA Health Insurance Marketplace.
- Finished annual CMS training to earn Certified Application Counselor status for the FFM.
- Steered applicants through enrollment procedures.
- Screened applicants for TPSP and evaluated subsidy options from the Marketplace.
- Directed tribal members to funded sponsorship opportunities for Part B premiums at the SHIIP office.
- Reviewed patient referrals, chronic issues, and medication costs to determine TPSP eligibility.
- Verified third-party insurance via provider portals for patient eligibility.
- Provided year-round support for health insurance issues regarding changes in income, family size, documentation, or coverage.
- Collaborated with PRC and various healthcare departments to guarantee comprehensive care for patients.
- Clarified distinctions among Medicaid types, Medicare Part A, B, C, and D plans as well as ACA coverage options.
- Collaborated with PRC to solve claims and benefits problems related to BCBSNC ACA policies.
- Managed monthly premium transactions across multiple systems for BCBSNC, Medicare Part B, and binder payments.
Certified Nursing Assistant Med Surg 2
Novant Healthcare
Huntersville, NC
12.2021 - 09.2022
- Monitored vital signs including blood pressure, pulse rate, respiration rate.
- Documented activities and recorded information in EMR system.
- Supplied, collected and emptied patient bedpans on frequent basis.
- Exhibited compassionate care and communication regarding issues surrounding death and dying.
- Answered call lights promptly and responded to patient needs accordingly.
- Provided comfort measures such as back rubs and positioning pillows for added comfort.
- Helped residents walk with or without self-help devices.
Case Management Support
Cherokee Indian Hospital Authority
Cherokee, NC
05.2017 - 09.2021
- Assisted the nursing team by handling office tasks efficiently.
- Coordinated patient appointments with primary care providers.
- Coordinated referrals and consult requests.
- Requested and reviewed office notes for the plan of care.
- Renewed medication orders for provider approval and addressed refill requests for patients.
- Generated DEA reports to assist with running the clinic.
- Collaborated with various teams and departments to enhance patient experience.
- Led training sessions for new case management support staff.
- Exhibited strong capability in utilizing Microsoft Office and specialized healthcare software applications.
Medicare Customer Service Representative
Sitel
Asheville, NC
08.2008 - 12.2012
- Delivered Medicare Advantage benefit details using the summary of benefits.
- Clarified EOBs for members when issues such as claim denials arose.
- Clarified distinctions among Medicare Part A, B, C, and D.
- Explained differences between Medicare Advantage and Medigap policies to customers.
- Adjusted claims as needed for correctness.
- Handled complex calls transferred from agents to reduce caller agitation.
- Showed understanding and continuously updated members during problem resolution.
Education
High School Diploma -
Timber Creek High School
Orlando, FL05-2002
Some College (No Degree) - HIM
Southwestern Community College
Sylva, NCSkills
- Conflict Resolution
- Coordination
- Call center operations
- Active listening
- Account management
- Tracking complaints
- Researching
- Time management
- Attention to detail
- EHR management
- Referral coordination
- Patient eligibility verification
Certification
- BLS CPR/AED Certification from AHA
- Certified Application Counselor CAC
References
References available upon request.
Timeline
ACA Insurance Coordinator/Certified Application Counselor
Cherokee Indian Hospital Authority
10.2022 - 03.2025
Certified Nursing Assistant Med Surg 2
Novant Healthcare
12.2021 - 09.2022
Case Management Support
Cherokee Indian Hospital Authority
05.2017 - 09.2021
Medicare Customer Service Representative
Sitel
08.2008 - 12.2012
High School Diploma -
Timber Creek High School
Some College (No Degree) - HIM
Southwestern Community College
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