Nicole Okoduwa

Provides support for members, addresses members' inquiries about benefits and claims. Assisted members in finding providers and connecting them with wellness resources to enhance their healthcare experience.

Led legal research and analysis to support strategic decisions in healthcare compliance.

Developed and implemented policies ensuring adherence to federal regulations and corporate standards.

Advised cross-functional teams on risk management and legal implications of operational practices.

• Coordinated recruiting and onboarding processes, facilitating smooth integration of new hires.
• Managed prior authorization requests for healthcare providers, pharmacies, and patients, effectively handling appeals for denied authorizations.
• Maintain accurate documentation of account activities, utilizing appropriate medical and billing codes.
• Handled incoming phone calls, directing them to appropriate departments or individuals.
• Coordinated appointment scheduling at check-in and check-out to optimize patient flow.
• Assisted visitors by providing information and addressing inquiries to enhance their experience.
• Served as point of contact for internal and external clients, ensuring timely communication and support.

• Coordinated and scheduled medical appointments in collaboration with nursing staff and management, ensuring alignment with individual program plans.
• Coordinated and scheduled medical appointments with nursing staff and management to ensure alignment with individual program plans and timely access to care.
• Conducted daily medication and supply checks and participated in interdisciplinary meetings to enhance comprehensive medical planning.
• Offered emotional support and companionship to individuals during daily activities.
• Helped prepare materials and set up environments for scheduled activities.

• Collaborated with front office staff to verify accurate claims processing information and maintained comprehensive records of insurance, diagnosis, procedures, fees.
• Identified and resolved discrepancies in medical billing and coding, ensuring compliance with regulations.
• Managed payment postings and insurance verifications, researched and resolved denials and EOB rejections within standard billing cycles, and conducted follow-up on insurance claims.

• Coordinated skill-building workshops and social behavior enhancement sessions, fostering residents' personal growth.
• Collaborated with clinical treatment team to implement therapeutic techniques and effectively de-escalated crises.
• Managed residents' medication records, ensuring accurate documentation and adherence to protocols.