Nicole Grant
Warner Robins,USA
Summary
Multi-faceted, efficient, and dependable professional with over 12 years of management and specialized experience supporting customer service relations, business operations, and various managers to improve internal program operations. Showcasing a proven history of revenue growth and market expansion. Forward-thinking individual with refined interpersonal, time management and multitasking skills. Seeking an organization where I can utilize my education, experience, and on-the-job training (OJT) to present my professional growth and success. As this resume will illustrate, I have proven the ability to learn, adapt, and continuously improve myself in an ever-changing environment, and you will notice that I have the experience, training and education required to perform well.
Experienced with managing reimbursement processes and resolving billing issues. Utilizes analytical skills and attention to detail to optimize reimbursement strategies and ensure compliance. Knowledge of industry standards and effective communication enhances process efficiency and accuracy.
Professional with strong experience in reimbursement processes and healthcare administration. Proven ability to manage complex billing systems, ensure compliance, and maximize revenue recovery. Valued for team collaboration, adaptability, and achieving measurable results. Skills include claims processing, coding, payer relations, and problem-solving. Reliable and responsive to evolving needs in fast-paced environments.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Reimbursement Specialist - Remote
Arkansas Regional Service Center
07.2023 - Current
- Analyze, research and process insurance claims through electronic claims management system in a timely manner.
- Research patient accounts to ensure account integrity, using all available resources and tools (i.e., payer websites, contracts, and internal references). Use critical thinking skills to resolve account denials and payer barriers.
- Take appropriate actions toward account resolution and appropriate balance. This may include actions such as facilitating inter-departmental communication, posting adjustment requests, and providing requested information to insurance payers and/or responsible entities.
- Ensures accurate and complete clean claim submission for both paper and electronic claims.
- Processes claim updates based on direction given by facility or coding liaisons.
- Evaluate electronic insurance rejections to re-transmit with corrected claim information.
- Investigates rebill requests submitted to the billing department and processes these requests when appropriate.
- Responsible for being knowledgeable in Google Suites, Sharecare, Availity, my blue, SSI portal, Fin Thrive, Artiva, HSM, and more.
- Audits claim/accounts for charges, duplications, and overlapped accounts prior to billing, making any necessary adjustments.
- Documents actions taken in collection system.
- Utilize internal computer systems and applications to thoroughly and professionally document all actions taken to reach resolution on account.
- Communicate daily with management about payer trends identified.
- Informs Billing Managers of any charging trends or editing trends and provides examples/education to other departments to reduce errors.
- Ability to perform all other duties as assigned or requested.
Seasonal Tax Expert – Seasonal/Remote
JDA TSG
01.2024 - 04.2025
- Provide tax support and advice over video, phone, and chat, helping customers work on returns, answer tax questions, and assist with technical support.
- Assisting customers in preparing tax returns.
- Completed preparation and filing of tax returns directly for customers choosing full service.
- Providing excellent customer experience using your expertise in tax preparation, technology troubleshooting, and resolving tax issues.
- Carefully document all customer interactions, to ensure understanding of all interactions.
- Completed follow-up on full-service accounts that require additional information and/or documents.
Loan Office Manager
Sunset Finance Company
12.2017 - 07.2023
- Analyze problems; including gathering and identifying factors that contribute to the root cause of the issue, while recognizing and implementing solutions.
- Supervise and evaluate multiple employee job duties and performance, using analytical research to ensure proper number of employees are maintained as well as office diversity.
- Responsible for tracking and analyzing data to ensure compliance with policies and procedures are consistently met while identifying deficiencies and recommending solutions and improvements.
- Manage the coordination and administration of tax preparation with advance loan options on IRS accepted returns, installment loans with refinancing options, and credit builder loans, to assist in establishing or rebuilding credit.
- Perform cost benefit analysis of current and projected promotional events, travel arrangements and seasonal hiring positions.
- Review performance using qualitative and quantitative assessment methods to evaluate and improve office performance as well as advancement programs.
- Serve as a primary representative providing technical information, assistance, and guidance to applicants, borrowers, and lenders concerning eligibility and other requirements for loans, and/or loan/guarantee programs administered by Sunset Management.
- Responsible for reviewing and analyzing various loan service contracts, income tax forms, insurance claims, related documents and materials submitted for adequacy completeness, accuracy of information, and conformity to established procedures and requirements.
- Responsible for being knowledgeable in Microsoft, Excel, Word, CSB Software, PTS Tax Software, PowerPoint, and Outlook 360.
- Performs comprehensive review and in-depth analyses of financial credit data and reporting documents generated to the loan application eligibility, feasibility, creditworthiness, and viability within assigned loan portfolio to determine creditworthiness and approval.
- Oversee preparation of written loan approval determinations or recommendations and determining loan approval as appropriate.
- Provides technical guidance and expertise for complex financial arrangements and itemized billing of loan accounts.
- Responsible for effective customer communications via phone, email, and face to face. While maintaining customers accountability, negotiating payment arrangements, and securing personal loan collateral.
- Oversee and manage over 1600 accounts, including daily collection calls to reduce account delinquency and bad debt.
- Oversee for sales and coordination of refinancing, dual loans, referrals, and tax preparation completion at each contact.
- Develop, organize, and plan all staff training material as well as meetings and training seminars.
- Proper handle all correspondence to customer complaints, loan inquiries, tax related questions, employment opportunities and advancement options.
- Responsible for all employment interviews, completing the hiring process, new hire and staff training, and employee correction evaluations.
- Effectively communicate with all vendors and reps for office supplies and maintenance.
- Responsible for ensuring all employees follow all state, federal, and company guidelines, policies, and procedures.
- Responsible for maintaining office revenue, account size, and bad debt on a monthly and annual basis.
Outside Sales Consultant
Vemo Auto Auction
06.2016 - 11.2017
- Sought out potential customers over all of Georgia to assist in account management.
- Manage and maintain active accounts and reestablish relationships with previous account holders.
- Manage and negotiate sales contacts, amounts and fee pricing.
- Negotiate transport fee prices and scheduling with vendors and dealerships.
- Responsible for maintaining weekly sales goals.
- Handle all customer communication via phone, email, and face to face, to discuss billing questions and/or itemized statement requests.
- Maintain records of sales, leads and customer accounts details.
- Full-Time, 40 hours per wk
Claims Processing Specialist
Geico
05.2015 - 05.2016
- First point-of-contact of total loss auto customers, determining eligibility of coverage and claim status.
- Providing excellent customer experience using your expertise
- Taking high volume of in-bound calls in a timely manner to ensure customer satisfaction.
- Utilize time management skills to work files while assisting in-bound and out-bound calls.
- Verification of customer account details and eligible benefits.
- Claim review and document verification, to work total loss claims to completion.
- Issue payments to lien holders and policyholders.
- Complete title documents and process title to salvage title.
- Collect and maintain quantifiable data and contractual correspondence for policy and claim holders.
Medicare/Insurance Billing Specialist
Magnolia Manor
03.2007 - 01.2015
- Responsible for verification of insurance coverages and eligibility for incoming patient accounts.
- Processing Medicare Part A and B claims for payment for 14 skilled nursing home facilities, while maintaining 88 percent of claim payment ratings.
- Responsible for processing primary HMO, commercial and secondary insurance claims for payment, for 14 skilled nursing facilities.
- Responsible for filing all long-term care claims for 14 skilled nursing facilities, and 12 assisted living facilities.
- Posting of all payment remittances received and making necessary billing adjustments and contractual to ensure correct and proper billing.
- Responsible for working claims to full resolution and payment, including submission of corrected and adjusted UB04 forms and manual electronic billing submissions.
- Assisting registration with verifications of insurance benefits.
- Responsible for working and collection of private pay accounts, including processing of monthly billing statements.
- Utilize customer service skills when discussing account details via phone and face to face.
- Reporting and processing credit account refunds.
- Maintaining compliance with all federal, state and commercial guidelines and procedures.
- Assistance of Medicare and finance auditors with reporting details and account questions and concerns.
Education
BS - Industrial Engineering Technology School of Engineering
Liberty University
Associate Degree of Applied Science - Accounting
South Georgia Technical College
Americus, GA12.2006
Accounting Diploma - undefined
South Georgia Technical College
Americus, GA12.2006
Skills
- Business Management
- AA Accounting
- Medical Billing
- Revenue Cycle
- Operations Management
- Tax Preparation
- Payroll
- Quick Books
- Microsoft Office Suite (365)
- Windows 11
- Windows 10
- Windows 7
- SharePoint
- Adobe
- POS (point-of-sale)
- Commercial Lending Software (CSB)
- PTS Tax Software
- QuickBooks
- Audit Management Software
- Medicare DDE Application
- PTS Tax
- Intuit Expert Portal
- Appeals handling
- HCPCS coding
- HIPAA compliance
- ICD-10 coding
- Claims processing
- Microsoft office
- Insurance verification
- Data recording
- Financial accounting
- Bookkeeping
- Medical billing
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Multitasking Abilities
- Excellent communication
- Organizational skills
- Team collaboration
- Active listening
- Effective communication
- Adaptability and flexibility
- Decision-making
- Cash handling
- Professional communication
- Relationship building
- General accounting
- Customer relations
- Paperwork and documentation
- Payment scheduling
- Documentation skills
- Team building
- Deadline oriented
- Reporting skills
- Task prioritization
- Work Planning and Prioritization
- Analytical thinking
- Collections processing
- Continuous improvement
- Data analysis
- Microsoft Office Suite
Certification
- Bookkeeping Specialist Certification
- Administrative Assistant Certification
- Customer Service Specialist Certification
- Accounts Payable/Receivable Specialist Certification
- Office Accounting Specialist Certification
Timeline
Seasonal Tax Expert – Seasonal/Remote
JDA TSG
01.2024 - 04.2025
Reimbursement Specialist - Remote
Arkansas Regional Service Center
07.2023 - Current
Loan Office Manager
Sunset Finance Company
12.2017 - 07.2023
Outside Sales Consultant
Vemo Auto Auction
06.2016 - 11.2017
Claims Processing Specialist
Geico
05.2015 - 05.2016
Medicare/Insurance Billing Specialist
Magnolia Manor
03.2007 - 01.2015
Associate Degree of Applied Science - Accounting
South Georgia Technical College
Accounting Diploma - undefined
South Georgia Technical College
BS - Industrial Engineering Technology School of Engineering
Liberty University
Summary of Related Skills
- Business Management
- Human Resources
- Technical Competency
- Technology Application
- Human Capital Management
- Recruitment
- Staffing
- Employee Relations
- Developing Others
- Applicant Ratings/Ranking
- Policy
- Labor Relations
- Conducting Interviews
- Customer Service
- Core Competencies
- Talent Pool
- Organizational Awareness
- Hiring
- Policies and Procedures
- Ability to Lead
- Applications
- Resume
- Screening Applicants
- Organizational Behavior
- Diversity & Inclusion
- Continuous Process Improvement
- Administration
- Organizational Performance Analysis
- Oral and Written Communication
- Time Management
- Attention to Detail
- Classification
- Qualification
- Data Entry
- Income Tax Preparation
- QuickBooks
- Bookkeeping
- Payroll
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