Job Search Status
Open to workDesired start date: Immediately
Open To Work
Nicole Bowman
Milwaukee
Work Preference
Summary
Professional with a strong background in eligibility assessment and client service. Skilled in analyzing applications, verifying information, and ensuring compliance with regulations. Known for effective teamwork, adaptability, and achieving results. Proficient in managing caseloads, problem-solving, and maintaining confidentiality with focus on accuracy and efficiency.
Overview
17
17
years of professional experience
Work History
Eligibility Specialist/Medical Claims Processor
BroadPath Healthcare Solutions
11.2022 - Current
- Reduced errors in eligibility determination by conducting regular audits and recons.
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices with the CRM software.
- Resolved complex eligibility issues by collaborating with internal teams and external Providers.
- Verified patient insurance coverage and benefits for medical claims.
Homemaker
Stay at Home Parent
03.2020 - 11.2022
- Ensure household duties are completed in a timely manner.
- Develop, manage, and maintain a budget effectively.
- Coordinate medical care, meals, and social activities.
- Self-motivated, with a strong sense of personal responsibility.
Lead Claims Processor/Lead Customer Service Specialist
Superior Vision
02.2009 - 03.2020
- Oversaw claim processing workflows to ensure compliance with company policies, industry regulations, and HIPAA.
- Trained new representatives and processed 80 -100 vision insurance claims a day (in-network and out of network claims) documented interactions, accepted and posted payments, and maintained HIPAA compliance.
- Assisted providers with pre-authorization, questions regarding their reimbursement checks, reviewed claims submissions, and processed claim payments.
- Verified patients' insurance and assisted with questions regarding their vision benefits, and explanation of benefits (EOB's)
- Expedited payment processing by promptly resolving outstanding issues or discrepancies related to submitted claims.
- Followed up with customers on unresolved issues.
Education
Associate of Science - Health Sciences
Ultimate Medical Academy
Clearwater, FL04-2022
Certificate of Completion - Medical Assistant
Trinity Allied Healthcare
Milwaukee04-2022
Timeline
Eligibility Specialist/Medical Claims Processor
BroadPath Healthcare Solutions
11.2022 - Current
Homemaker
Stay at Home Parent
03.2020 - 11.2022
Lead Claims Processor/Lead Customer Service Specialist
Superior Vision
02.2009 - 03.2020
Associate of Science - Health Sciences
Ultimate Medical Academy
Certificate of Completion - Medical Assistant
Trinity Allied Healthcare