Nicole Timms
Cleveland,Texas
Summary
Experienced Patient Access Representative with over 10 years of involvement in the healthcare field. Excellent reputation for resolving problems, improving patient satisfaction, and driving overall operational improvements. Adept at collecting patient information, maintaining efficient workflow and coordinating with medical professionals to provide excellent patient services while ensuring financial security. Recognized consistently for performance excellence and contributions to success at Kern Valley Healthcare District.
Overview
12
12
years of professional experience
Work History
Patient Access Representative
UC Davis Health
09.2020 - Current
- Collects and enters patient demographic and insurance data into EMR to establish a clean patient registration for Inpatient & Outpatient procedure Accounts.
- Reviews multiple insurance products for coverage and benefit determination for various types of services.
- Reviews, processes and requests authorizations for multiple specialties.
- Advanced understanding of insurance contracting, networks, coverages and benefits.
- Utilizes numerous online platforms and tools to financially secure accounts by reviewing coverages, benefits, and authorization requirements.
- Uses critical thinking when reviewing accounts for completion.
- Account segmentation and prioritization based off multiple driving points.
- Works with a Team to ensure coverage and equal distribution of workload.
- Assists with maintaining shared information with team members regarding Insurance contacts and criteria & other contacts within UC Davis Health.
- Effectively communicates with all involved healthcare professionals to coordinate the highest level of care for patients.
- Maintains professional relationships with support team members from a vast array of specialty clinics within the UC Health system.
- Attends monthly meetings and actively engages management and team to contribute to the ongoing improvement of the Financial Clearance Department.
- Assists with training of new employees and team members.
- Actively researches and reviews insurance information in an ever changing environment to apply best practice to current accounts.
Rehabilitation Care Coordinator
Kern Valley Healthcare District
12.2015 - 06.2020
- Managed day-to-day operations of Physical Therapy department, as relates to patients and staff members
- Conducted interviews along with department supervisor, trained new office staff to assemble skilled and efficient clinical team
- Conducted yearly performance evaluations for Physical Therapy office staff
- Increased department productivity and patient visits by assisting in process of hiring of additional Therapist
- Managed medical record functions for over 250 outpatients, inpatients, and long term care residents using multiple systems such as Evident, Therassist, and AHT
- Developed department schedules for 5 providers and 2 support staff, organized Paid Time Off to optimize department efficiency and productivity
- Enabled substantial departmental growth by consistent quality care, professional communication with Therapists regarding proper patient treatment
- Improved patient satisfaction and lessened wait times by streamlining new patient registration process
- Organized weekly Utilization Review Committee to assess patient non compliance, authorization and prescription expiration, review active patient list per therapist and discuss and track patient progress and treatment
- Led yearly skills competencies in collaboration with multiple departments throughout facility to teach hands-on Therapy techniques
- Experienced with Medicare, Medi-Cal, Tricare, private insurance companies, and worker compensation for authorization and evaluation of treatment services
- Ensures accuracy in billing, posts patient charges in Evident and Therassist billing systems
- Responsible for provision and administration of specific Physical Therapy treatments under direct supervision of Physical Therapist
- Demonstrates ability to be flexible, organized and function under stressful situations
Admitting Clerk
Kern Valley Healthcare District
10.2014 - 12.2015
- Registered over 35 patients daily for labs, surgeries, radiology, emergency room, inpatient and long term care.
- Scheduled all outpatient services in centralized scheduling system for 5 different departments.
- Arranged forms and charts for each patient.
- Managed all documents needed for registration utilizing Evident EMR.
- Ensured all outpatient orders were correctly signed, dated and coded for appropriate billing of wide range of insurances.
- Calculated collectible amount due for procedures.
- Verified patient details and insurance coverage and collected co-pays.
- Balanced deposits and credit card payments each day.
- Compiled and distributed daily hospital census to all departments electronically.
- Answered phone calls and acted as switch board operator while maintaining excellent customer service under high stress situations.
Patient Access Representative
Kern Medical Center
06.2012 - 10.2014
- Compiled daily inpatient census to be provided to administration and supporting departments for review
- Reviewed and corrected registration errors for over 100 inpatient accounts daily to facilitate smooth claim processing
- Obtained patient insurance information and updated in billing/EMR software
- Verified insurance coverage and collected payments based on coinsurance, deductibles and co-payments for applicable stays and based on individual insurance contractual rates with facility
- Ensured all inpatient stay documentation was correctly recorded for medical necessity
- Submitted inpatient stay notifications to wide variety of insurances including, but not limited to, medi-cal, hmo's and ppo's
- Worked directly with inpatient coordinators as liaison between facility and insurances regarding updates of patient's health status and continuation of treatment
Education
Bilingual (Spanish/English)Proficiency Certificate - Oral, Reading, Writing And Conversational Skills
Bakersfield College
Bakersfield, CA07.2012
High School Diploma -
High Desert Academyy
Benton, CA06.1998
Skills
- Medicare and Medicaid knowledge
- Commercial Insurance
- Insurance Verification & Benefits
- Authorization Requests
- Claim Review & Appeals
- Healthcare staffing
- Healthcare management
- Interpersonal Skills
- Adaptable and Forward Thinking
- Data Entry
- Customer service
- First Aid/CPR
- Medical Terminology
- Bilingual Spanish/English (Oral, Written, Reading and Conversational Skills)
Accomplishments
- 2018 Outstanding Customer Service Award of the Year for Kern Valley Healthcare District
- 2016 Employee of the Year for Kern Valley Healthcare District
- 2011 Employee of the Year for Kern Valley Healthcare District
Timeline
Patient Access Representative
UC Davis Health
09.2020 - Current
Rehabilitation Care Coordinator
Kern Valley Healthcare District
12.2015 - 06.2020
Admitting Clerk
Kern Valley Healthcare District
10.2014 - 12.2015
Patient Access Representative
Kern Medical Center
06.2012 - 10.2014
Bilingual (Spanish/English)Proficiency Certificate - Oral, Reading, Writing And Conversational Skills
Bakersfield College
High School Diploma -
High Desert Academyy
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