Nicole Jackson
Philadelphia,United States
Summary
Integrity based medical administrative professional, patient focused, while revenue driven to accomplish goals.
Overview
15
15
years of professional experience
Work History
OB/GYN Financial Services Specialist
University Of Pennsylvania
Philadelphia, PA
05.2018 - 08.2020
- Processed payments made from previous day.
- Confirmed all patient appointments were verified via insurance, co-payments, or any other essentials have been met.
- Completed referral request, obtain precertification when required.
- Organized peer to peer discussions between insurance companies and physicians.
- Met with patients and caregivers to discuss insurance inquires and out of pocket expenses.
- Correct and adjudicated any claims that were rejected because of front-end billing errors.
- Resolved coding discrepancies, and resubmit claims.
- Coordinated specialized OB/GYN care for Veteran patients along with their care manager.
- Conducted specialized projects, report outcome and submit proven trends to upper management.
Precertification Specialist, Radiology
University Of Pennsylvania
Philadelphia, PA
03.2017 - 05.2018
- Obtained precertification and referrals for all radiology studies.
- Used various insurance portals to obtain authorization, demographics, submit clinical information, and arrange peer to peer meetings.
- Received patient calls to answer appointment inquires.
- Counseled patients on preparation for certain studies.
- Scheduled, rescheduled, and canceled patient appointments.
- Assisted with assigned projects in efforts to decrease billing errors, and increase revenue.
Insurance Verification Specialist
Penn Presbyterian Medical Center
Philadelphia, PA
11.2015 - 03.2017
- Processed, batched, and deposited financials received from various clinical practices.
- Confirm preadmission testing and surgery appointment needs with patients/caregivers.
- Verified insurance benefits, submitted notice of urgent admissions.
- Responsible for coordinating benefit and reimbursement contracts for workers compensation and Motor Vehicle claims.
- Obtained authorization for scheduled surgeries and some Gastroenterology procedures.
- Assisted patients without insurance with Medicaid applications.
- Post-trained new employees and created "welcome buddy" program.
Financial Counselor, Self-Pay
Senior1Care
Bensalem, PA
03.2014 - 08.2015
- Met with families to explain cost of care, insurance reimbursement vs. out of pocket expenses, collect payments, set up payment arrangements.
- Assisted center directors with obtaining payments, that were not collected at time of service.
- Generated bi-weekly invoices and manually mailed them for over 25 center locations, across the U.S.
- Maintained monthly AR reporting spreadsheets for senior management.
- Assisted with formulating financial polices and procedures that enhanced reimbursement and trend reporting.
- Processed refund request ,and credit/adjustment analysis review.
- Posted payments received .
- Satisfied attorney request, legal billing inquires, and sustained outside collection agency updates.
Collection Analyst (temporary)
Planned Parenthood
Camden, NJ, NJ
08.2013 - 03.2014
- Reviewed denied and rejected billing status claims for adjudication.
- Submitted appeals along with clinical to insurance carriers for review and reimbursement.
- Made collection calls to insurance carriers to challenge inadequate denial reasoning.
- Corresponded with patients to ensure information sent to the insurance carriers were accurate.
- Reviewed credit balances and delayed payment trends from specific insurance carriers.
Account Manager
Vascular Access Centers
Philadelphia, PA
04.2009 - 06.2013
- Credentialed multiple interventional radiologist for insurance participation.
- Review and approve small contracts for certain procedures.
- Applied ERA and manual EOB payments to paid claims, along with denial coding.
- Ensured each batch reconciled with the banking deposits at the end of each business day.
- Processed and applied self pay credit card patient payments.
- Processed approved refund request and adjustment request.
- Created and maintained maintenance of all patient payment plans and agreements.
Accounts Receivable Specialist
Tenet Health Systems
Philadelphia, PA
03.2002 - 09.2006
- Made collection calls to insurance carriers for reimbursement.
- Researched accounts with credit balance to determine how to reconcile.
- Trained new employees with daily duties.
- Responsible for keeping team informed of monthly goals.
- Assisted collectors with escalation claims request.
Education
Associate of Science - Human Services
Chestnut Hill College
Philadelphia, PASkills
- EPIC
- NextGen
- Availty
- IDX/SMS
- Navinet
- Promise
- MVP (my medicare)
- EHS
- ADP
- Microsoft Products
- Insurance Portals
Timeline
OB/GYN Financial Services Specialist
University Of Pennsylvania
05.2018 - 08.2020
Precertification Specialist, Radiology
University Of Pennsylvania
03.2017 - 05.2018
Insurance Verification Specialist
Penn Presbyterian Medical Center
11.2015 - 03.2017
Financial Counselor, Self-Pay
Senior1Care
03.2014 - 08.2015
Collection Analyst (temporary)
Planned Parenthood
08.2013 - 03.2014
Account Manager
Vascular Access Centers
04.2009 - 06.2013
Accounts Receivable Specialist
Tenet Health Systems
03.2002 - 09.2006
Associate of Science - Human Services
Chestnut Hill College