Years of Medical Billing Experience
Hi, I’m
Nicole Pelletier
Medical Billing Specialist
Concord,NH
Summary
Results driven Medical Biller with over 8 years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.
Overview
8
4
Years of Credentialing and Payor Enrollment experience
Work History
BreezyNotes EHREden Prairie, MN
Credentialing and RCM Specialist
09.2020 - 08.2023
Job overview
- Accurately post charges and promptly submit claims to payers, ensuring timely and efficient billing processes
- Demonstrate tenacity in following up on unpaid claims with insurance companies, ensuring proper resolution and reimbursement
- Review claims meticulously, making necessary corrections, and rebilling as needed to maintain accuracy and compliance
- Leverage claims clearing house to review, correct, and resubmit electronic claims when available, streamlining the billing process
- Thoroughly verify insurance coverage, including Medicaid, ensuring proper billing and adherence to billing and coding rules and regulations
- Strive for proper reimbursement for services and procedures provided to valued clients, including Medicaid-covered services
- Efficiently scan documents into Electronic Medical Records (EMR) system, maintaining meticulous records
- Skillfully read Explanation of Benefits (EOBs) to handle billing inquiries and resolve discrepancies effectively
- Proactively contribute to the efficiency of the billing process by taking on additional responsibilities and identifying opportunities for improvement
- Establish and preserve quality relationships with key contacts at payer networks resulting in expedited processing of applications
- Address credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access
- Complete enrollments into Medicaid, Medicare and private insurance plans
- Confirm facility and user credentials to initiate and maintain registration and enrollment processes
- Set up NPI numbers for providers and facilities and updated current profile information
- Perform primary source verifications such as criminal histories, licenses and board certifications
- Apply HIPAA privacy and security regulations while handling patient information
- Process documents and status-change requests, conducting follow-up assessment regarding enrollment inquiries
Talk NYC! Psychotherapy, MHCNew York, NY
Medical Billing Specialist
01.2020 - 08.2020
Job overview
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements
- Performed quality control of data entry system to verify proper posting of claims and payments
- Consistently informed patients of financial responsibilities prior to services being rendered
- Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access
- Completed enrollments into Medicaid, Medicare and private insurance plans
- Maintained informational resources, tracking and documenting requests for updates, certification and credentialing
- Processed documents and status-change requests, conducting followup assessment regarding enrollment inquiries
Healthcare Administrative PartnersPortsmouth, NH
Medical Billing Representative
06.2016 - 06.2019
Job overview
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements
- Prepared and submitted claims to insurance companies electronically and manually
- Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house
- Submitted refund requests for claims paid in error
- Posted charges, payments and adjustments, maintaining an accuracy rate of 99.3%
Atiis LLCNashua, NH
Medical Biller
10.2015 - 05.2016
Job overview
- Applied HIPAA privacy and security regulations while handling patient information
- Reviewed claims for coding accuracy
- Input details into accounts and tracked payments
- Distributed or posted financial data to appropriate accounts and prepare simple reconciliations
Education
Mount Washington CollegeManchester, NH
Some College (No Degree) from Business Administration
University Overview
- 3.7 GPA
- Coursework in financial management, principles of marketing, money and banking, and organizational behavior
Skills
- Medical Terminology
- Data Entry, 60 WPM
- Data Analysis Skills
- 8 years in Accounts Receivable
- 4 years in Credentialing and Payor Enrollment
- Excellent prioritization and organizational skills
- Time Management
- Multitasking and Organization
- Teamwork and Collaboration
- Account Reconciliation
- Clerical Support
- Billing and Collection Procedures
- Critical Thinking
- Account Follow-Up
- HIPAA Compliance
- Payer Contracts
- Operations Support
Timeline
Credentialing and RCM Specialist
BreezyNotes EHR
09.2020 - 08.2023
Medical Billing Specialist
Talk NYC! Psychotherapy, MHC
01.2020 - 08.2020
Medical Billing Representative
Healthcare Administrative Partners
06.2016 - 06.2019
Medical Biller
Atiis LLC
10.2015 - 05.2016
Mount Washington College
Some College (No Degree) from Business Administration
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