Nicole Roberson

Work History

United Health Group, Optum Inc.

06.2019 - Current

Assist health plans in identifying, reviewing, and validating claim overpayments.
Recover claim overpayments within the client's claim system.
Adhered to company and insurance client's guidelines in claims processes and claim closures.
Manage account receivables to ensure timely collection of identified recoveries.
Contributed to a high-performance work culture through active participation in team meetings.
Follow all company procedures to ensure data security.
Professionally and proactively build relationships and maintain contact with appropriate personnel at client site.
Boosted overall productivity by effectively prioritizing tasks based on urgency, complexity, and potential impact on clients.

HSC Health Care System

03.2007 - 12.2018

Managed accounts receivable processes to ensure timely collections and minimize outstanding balances.
Streamlined operations to achieve new efficiencies, improve on-time collections and reduce the number of aging days of receivables.
Confirm long-term care spans were processed for all Maryland Medicaid accounts.
Posted customer payments by recording cash, checks, and credit card transactions.
Maintained accurate financial records by regularly reconciling accounts receivable ledgers.
Established performance metrics for the accounts receivable team, driving accountability and continuous improvement initiatives.
Developed and maintained strong client relationships, fostering trust and open communication.
Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
Coordinated with external auditors to provide necessary documentation and explanations for annual audits.
Managed contract administration, maintained files, validated codes and monitored reporting.
Negotiated contract terms and rates with health plans to increase revenue.
Review and interpret commercial contracts, managed care contracts, state and federal payer billing requirements and regulations to ensure the necessary changes are implemented in the revenue cycle process.
Assist with new software implementations for the health care system.

HSC Health Care System

03.2006 - 03.2007

Coordinated applicant processing and scheduling for admissions, ensuring smooth transitions for prospective patients.
Maintained an effective and productive relationship with referring providers and hospital systems in order to coordinate and improve the daily admission of patients.
Streamlined communication between departments to enhance patient intake efficiency and satisfaction.
Handled insurance claim duties and verified that each met standards of admissions.
Identified and assessed patients needs to achieve satisfaction.
Embraced concepts that enhanced customer satisfaction and employee morale and improvement.
Attended weekly meetings and provided input to senior management on possible ways to improve customer service.

Palisades Eye Surgery Center

07.2005 - 01.2006

Coordinated patient scheduling and appointment confirmations to enhance operational efficiency.
Assisted patients with insurance verification, ensuring accurate information collection and processing.
Obtain medical clearance documentation from referring physicians.
Facilitated communication between patients and healthcare providers for optimal care coordination.
Established strong relationships with referring physician offices by maintaining open lines of communication for seamless coordination of care across providers.
Prepared monthly reports for physician staff meetings.

Chevy Chase HealthCare (Oncology)

08.2004 - 07.2005

Greeted and assisted patients with check-in procedures.
Ensured timely and accurate completion of all required documentation for regulatory compliance, contributing to the overall quality of patient care services provided by the clinic.
Inputted accurate patient insurance, billing and payment information into the system.
Increased patient understanding of treatment plans by providing clear explanations of medical procedures and instructions.
Supported billing department efforts by accurately collecting co-payments, verifying insurance coverage, and addressing financial concerns for patients.
Contributed to a positive clinic environment by consistently displaying compassion, empathy, and professionalism when interacting with patients.

Theracom

10.2002 - 08.2004

Analyzed claims data to identify trends, driving improvements in submissions and reducing denial rates.
Assisted a specialty pharmaceutical company with a Medicare trial program in order to establish polices for a new product.
Distributed reports to gain sales compensation for pharmaceutical representatives.
Escalated any unresolved issues and tracked to resolution.
Delivered timely information to insurance representatives to resolve common and complex issues.
Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.