Nicole Ortiz-Smith
Locust Grove,USA
Summary
Motivated and detailed-orientated. Eager to apply technical skills, attention to detail, and a commitment to high-quality patient care in a dynamic healthcare setting.
Experienced with medical billing procedures and coding standards. Utilizes strong analytical skills to ensure accurate claim submissions and resolution. Knowledge of insurance guidelines and healthcare regulations, consistently delivering precise billing operations.
Overview
1
1
Certification
8
8
years of professional experience
Work History
RCM Specialist
Chapman RCM Group
Jackson, GA
10.2025 - Current
- Processed and tracked commercial, Medicare, and Medicaid insurance claims from submission through final resolution.
- Verified patient eligibility, benefits, and claim requirements across multiple payers.
- Reviewed medical documentation and billing codes (CPT, HCPCS, ICD-10) for accuracy and compliance with payer guidelines.
- Reviewed denied or rejected claims, identified root causes, and submitted corrections or appeals as needed.
- Analyzed claim documentation for accuracy and compliance with regulatory standards.
- Coordinated claims processing workflows to ensure timely resolution of customer inquiries.
Medical Billing Specialist
Southern Gastroenterology Specialists
Stockbridge, GA
12.2024 - 10.2025
- Ensuring accurate and timely payment for services rendered by healthcare providers
- Submitting claims, tracking payments, resolving billing errors, and maintaining patient records.
- Insurance Verification
- Processed and submitted medical claims to insurance providers, ensuring compliance with regulations.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Reviewed patient accounts for accuracy and completeness, addressing discrepancies promptly.
- Posted and adjusted payments from insurance companies.
Patient Account Coordinator
Lincare Healthcare
McDonough, GA
08.2023 - 11.2024
- Responsible for billing patients DME medical equip
- Handle third payers and patients to manage account receivables balances
- Ensure accurate and timely charge captures for clinic and hospital-based services
- Read denials and EOBs
- Follow up with ins reps regarding denials, incorrect pay, reprocessing claims and appeal
- Handles data entry of all patients demographics and insurance information
- Processed patient accounts efficiently, ensuring accurate billing and reimbursement.
- Coordinated communication between patients, healthcare providers, and insurance companies.
Shipping and Receiving Clerk
GEODIS
05.2021 - 07.2023
- Assisting with the receiving of shipments
- Handling documentation for international customs.
- Acting as administrative support for the shipping department for incoming and outgoing customer calls.
- Receives incoming shipments and checks for accuracy.
- Received incoming shipments into inventory, posted in the online system and placed items in the warehouse.
- Coordinated inbound and outbound shipments, ensuring timely processing and accurate documentation.
- Monitored inventory levels, implementing reorder strategies to maintain stock availability.
Shipping Clerk
PVH CORP Tommy Hilfiger
05.2018 - 01.2021
- Greeting all visitors.
- Transferring calls as necessary
- Taking and ensuring messages are passed to the appropriate staff member on a timely basis
- Assisting the HR team with recruitment, on-boarding and termination processes
- Filing terminated, new/current employees documents
- Responsible for creating badges for new and current associates
- Handling Paperwork
- Proper labels with correct postage are a must in order for shipments to be delivered correctly
- Invoicing
- Retasking small parcels
- Creating load sheets
- Processed shipping documentation for accuracy and compliance with company standards.
- Coordinated logistics operations to ensure timely delivery of products to retail locations.
Education
High school diploma -
ABC Montessori
Medical Billing & Coding - Certification
DeVry University-Chicago/O'Hare
Chicago, IL03-2025
Skills
- Insurance claims
- HIPAA compliance
- Payment posting
- Medical billing
- Medical terminology
- Customer service
- Claim submission
- Insurance verification
- Time Management
- Critical Thinking
- Attention to detail
- Strong work ethic
Certification
- Medical Coding Certification February 2024 to March 2025
- RHIT
- Certified Coding Associate
- Certified Professional Coder
- Medical Billing Certification
- Certified Coding Specialist
- Driver's License
Languages
Interpretation
English
Timeline
RCM Specialist
Chapman RCM Group
10.2025 - Current
Medical Billing Specialist
Southern Gastroenterology Specialists
12.2024 - 10.2025
Patient Account Coordinator
Lincare Healthcare
08.2023 - 11.2024
Shipping and Receiving Clerk
GEODIS
05.2021 - 07.2023
Shipping Clerk
PVH CORP Tommy Hilfiger
05.2018 - 01.2021
High school diploma -
ABC Montessori
Medical Billing & Coding - Certification
DeVry University-Chicago/O'Hare
Additional Information
Authorized to work in the US for any employer