Nicole J Stickney
Quilcene,WA
Summary
Insurance specialist skilled in customer service, with strong focus on resolving client issues and providing comprehensive support. Known for effective communication, problem-solving abilities, and adaptability in fast-paced environments. Team-oriented, consistently achieving high standards and delivering results through collaboration and flexibility. Proficient in policy interpretation, claims processing, and maintaining client relationships.
Overview
9
9
years of professional experience
Work History
Caregiver/ Family CEO
Self
12.2022 - Current
- During this time, I helped with daily tasks that included shopping cooking dressing, grooming, personal finances, and medical bills, insurance issues, while maintaining my household
- This allowed me to gain further knowledge and experience in the healthcare setting
- Proficient with my time and organization skills
- Assisted family members with activities of daily living, promoting independence and quality of life.
- Cleaned house, ran errands, managed laundry, and completed weekly grocery shopping.
- Cleaned house, ran errands, managed laundry, and completed weekly grocery shopping
- Contributed to a positive atmosphere within the home setting by engaging in meaningful conversations and recreational activities with family
- Facilitated open communication between family members and healthcare providers, fostering collaborative decision-making regarding patient care.
- Collaborated closely with interdisciplinary healthcare teams, integrating recommendations from professionals into comprehensive patient care plans.
- Managed household finances responsibly, ensuring adequate funds for necessities and special events.
- Coordinated transportation arrangements for school activities, appointments, and other outings as needed.
- Managed homeschool schedules effectively, balancing extracurricular activities with academic requirements for well-rounded development.
- Emphasized practical life skills alongside academics, preparing students for future independence and decision-making abilities.
Remote Medical Claims Processor
Kaiser Permanente
07.2022 - 12.2022
- Adhere to company policies and local, state, and federal guidelines when facilitating insurance processing
- Researched and resolved complex medical claims issues to support timely processing.
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Managed large volume of medical claims on daily basis
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Evaluate insurance policy coverage and calculate respective claim amounts to issue premiums, adjustments, refunds, and more
- Keep track of policy records and perform data entry to maintain accurate client information
- Update and maintain claim files to ensure complete records
- Monitored and updated the records of over # patients, trusted with keeping personal information confidential under all HIPAA policies
Home Manager
Self
03.2020 - 07.2022
- During COVID-19, I cared for my children full-time and homeschooled
- I mastered time management, organization, and communication, scheduling activities, and gained a better knowledge of the Washington State Department of Education, and volunteered with other parents
- Oversaw home inventory of supplies and groceries by tracking use and placing new orders.
- Oversaw meal planning and preparation, working closely with dietary staff to accommodate individual needs while promoting healthy eating habits among residents.
- Maintained a safe and comfortable living environment for residents through rigorous property maintenance and inspections.
- Adapted teaching methods and lesson plans to changing student needs.
- Cultivated a love for lifelong learning by instilling curiosity, exploration, and critical thinking skills.
- Assessed student performance regularly through quizzes, tests, and assignments, providing constructive feedback for improvement.
Front Desk Receptionist
Kingston Eye Care Center
01.2020 - 03.2020
- Greeted patients each day in a professional manner, checking them in and out in an efficient manner while providing exceptional service
- Answered over 30 phone calls daily, taking messages using extensive communication skills to schedule appointments and resolve patient issues
- Organized and processed unique medical forms, able to make copies and scan documents into the computer to attach to records
- Monitored and updated the records of over # patients, trusted with keeping personal information confidential per all HIPAA policies
- Processed claims, sent referrals, checked insurance eligibility for vision benefits
- Enhanced customer satisfaction by providing efficient and professional front desk services.
- Scheduled appointments accurately using reservation software, reducing conflicts or double-bookings.
- Checked patient insurance, demographic, and health history to keep information current.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Helped patients complete necessary medical forms and documentation.
Home Manager
Unemployment
01.2019 - 01.2020
- Provided care for family home while also dealing with personal medical issues
- Managed household finances responsibly, ensuring adequate funds for necessities and special events.
Administrative Specialist
Sunshine Propane
09.2017 - 01.2019
- Provided administrative support by regularly completing 5+ tasks such as mailing, scanning, faxing, copying, and filing
- Major participant in resolving #+ problems, able to handle requests from other professionals by liaising between them and other departments
- Answered #+ phone calls each day, scheduling meetings and travel arrangements for staff members
- Updated and maintained # complex documents including letters, reports, memos, and emails
- Adhered to all # established policies and procedures, especially regarding confidentiality
- Improved customer satisfaction by ensuring timely and accurate propane deliveries to residential and commercial clients.
- Demonstrated expertise in handling emergency situations such as gas leaks or equipment malfunctions professionally, prioritizing customer safety above all else.
- Contributed to a positive work culture by actively participating in team meetings, sharing best practices, and providing constructive feedback to improve overall performance.
- Contributed to team efficiency by collaborating with dispatchers, service technicians, and sales representatives for seamless communication.
- Oversaw the scheduling and dispatching of technicians, maximizing efficiency and minimizing delays in service delivery.
Customer Service Representative
PacificSource Health Plans
05.2016 - 04.2017
- Followed #+ federal and state guidelines for the release of information, checking diagnosis codes for accuracy and appropriateness according to services
- Maintained a clean and organized logging system, coordinating between business department and third party vendors to resolve #+ billing discrepancies
- Accurately completed insurance verification and pre authorization functions, successfully identifying over # errors on claims
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures.
- Collaborated effectively with internal departments like claims adjusters, underwriting staff, allowing seamless coordination between parties involved in the client relationship management process.
Education
General Education Diploma -
College of Western Idaho
Skills
- Customer Service
- Scheduling
- Medical Terminology
- Windows OS
- Conflict Resolution
- Phone Systems
- Insurance terminology
- Attention to detail
- Multitasking
- Claims investigation
- Excellent communication
- Effective communication
- Claims adjustment
- Prior authorization processing
- Appointment scheduling
- Coverage determination
- Insurance coverage verification
- Denied claims identification
- Eligibility determination
- Microsoft Office
- Teamwork and collaboration
Timeline
Caregiver/ Family CEO
Self
12.2022 - Current
Remote Medical Claims Processor
Kaiser Permanente
07.2022 - 12.2022
Home Manager
Self
03.2020 - 07.2022
Front Desk Receptionist
Kingston Eye Care Center
01.2020 - 03.2020
Home Manager
Unemployment
01.2019 - 01.2020
Administrative Specialist
Sunshine Propane
09.2017 - 01.2019
Customer Service Representative
PacificSource Health Plans
05.2016 - 04.2017
General Education Diploma -
College of Western Idaho
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