Nicole Nolin
Lansing,MI
Summary
Experienced credentialing specialist with 11 years in provider credentialing service. Excellent relationship-building, problem-solving and communication skills. Knowledgeable about application requirements for government and private insurance plans, and hospital privileging.
Overview
17
17
years of professional experience
Work History
Credentialing Specialist/Coordinator
Compass Health
East Lansing, MI
04.2021 - Current
- Managed all aspects of provider and facility credentialing for a multi specialty medical group
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Maintained provider CAQH profiles.
- Responsible for all provider initial credentialing and re-credentialing applications with hospitals and insurance plans
- Continuously updated provider information for reporting purposes.
- Developed and maintained courteous and effective working relationships.
- Coordinated with contracting department to resolve payer issues
- Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency.
Patient Care Coordinator
AccuQuest Hearing Centers
East Lansing, MI
04.2011 - 04.2021
- Managed an office of 3 providers and 2 support staff.
- Acted as main point of contact for patients, providers and staff by closely reviewing medical charts and maintaining high levels of communication.
- Established efficient workflow processes, monitored daily productivity and implemented modifications to improve overall effectiveness of personnel and activities.
- Developed team communications and information for weekly staff meetings.
- Compiled and reviewed medical charts.
- Created improved filing system to maintain secure client data.
- Liaised with patients and addressed inquiries, appointment requests and billing questions.
- Maintained confidentiality of patient data and condition at all times to safeguard health information.
- Built strong referral network by developing strategic relationships with general practitioners.
- Oversaw office inventory activities, including ordering and requisitions, stocking and shipment receiving.
- Took copayments and compiled daily financial records.
- Balanced deposits and credit card payments each day.
- Generated monthly statements to check outstanding balances.
- Optimized organizational systems for payment collections, AP/AR, deposits and recordkeeping.
- Responsible for all insurance credentialing and billing.
- Performed billing, collection and reporting functions for office generating over $1,500,000 annually.
- Reviewed and corrected claim errors to facilitate smooth processing.
- Determined proper codes for medical records and patient services.
- Checked insurance eligibility by making appropriate phone calls and online verification processes.
- Worked effectively with medical payers such as Blue Cross Blue Shield, Blue Care Network, Physicians Health Plan, Priority Health, United Health Care, Workers Compensation, and many other commercial insurances to obtain timely and accurate payments.
- Performed targeted collections on past due accounts aged over 30 days.
- Successfully completed yearly in-office insurance audits.
Support Staff
Lansing Community College
Lansing, MI
08.2008 - 04.2011
- Greeted incoming office guests, answered questions and directed individuals to desired locations to enhance team efficiency.
- Helped with administrative support, including managing incoming calls, coordinating files and sorting mail.
- Took detailed meeting minutes, prepared meeting rooms and compiled paperwork to support the program director.
- Kept physical files organized for easy updating and retrieval by authorized team members.
- Interacted with students, prospective students and parents professionally by phone, email or in-person to provide information and directed to desired staff members.
- Took daily attendance, notifying the case manager immediately of any student absences.
- Organized classroom materials to help teachers prepare for daily instruction and activities.
- Coordinated board meetings, including schedules, information preparation and distribution.
- Ordered and distributed office supplies while adhering to fixed office budget.
- Produced high-quality documents, spreadsheets and presentations for internal and student needs.
Education
Political Science
Loyola University of Chicago
Chicago, ILHigh School Diploma -
Okemos High School
Okemos, MI06.2003
Skills
- Patient Relations
- Teamwork
- HIPAA Compliance
- Scheduling
- Medical Records Maintenance and review
- Payment processing
- Organizational skills
- Administrative Supervision
- CPT Coding
- Insurance Knowledge
- Quality Management
- Insurance billing
- Month-end closing procedures
- Office management
- Networking and Partnership Development
- Insurance credentialing
- Hospital privileging
Timeline
Credentialing Specialist/Coordinator
Compass Health
04.2021 - Current
Patient Care Coordinator
AccuQuest Hearing Centers
04.2011 - 04.2021
Support Staff
Lansing Community College
08.2008 - 04.2011
Political Science
Loyola University of Chicago
High School Diploma -
Okemos High School