Nicole Wright
Washington
Summary
An organized and motivated individual, eager to utilize time management and organizational skills across diverse settings. Seeking entry-level opportunities to enhance abilities while contributing to company growth.
Overview
7
7
years of professional experience
Work History
Cash and Trade
Citi
Newark
08.2024 - Current
- Process applications in a fast past environment
- Mail room
- Scanning
- Tapping
- Data entry
- Prioritized and organized tasks to efficiently accomplish service goals.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
- Completed day-to-day duties accurately and efficiently.
Application Processor
Randstad
Newark
02.2024 - 08.2024
- Process applications in a fast past environment
- Mail room
- Scanning
- Tapping
- Data entry
Fraud Analyst
Discover
Newark
07.2022 - 09.2023
- Reviewed customer profiles for any changes that may indicate fraudulent activities.
- Communicated effectively with customers regarding suspected fraudulent activities or suspicious behavior.
- Maintained up-to-date knowledge of relevant federal laws regarding fraud prevention.
- Provided expert advice on fraud-related issues to internal stakeholders, enhancing the organization's fraud prevention efforts.
- Analyzed customer feedback and transactional data to continuously refine fraud detection models.
- Conducted interviews with customers to verify their identity and validate information.
- Reviewed and verified customer documentation to prevent identity theft and account takeover attempts.
- Communicated with customers and company personnel, utilizing active listening, and interpersonal skills.
- Responded quickly to customer inquiries about possible fraudulent activity on their accounts.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
Care Coordinator
Trinity Medical Associates
Wilmington
09.2020 - 07.2022
- Attended meetings with families and other members of the interdisciplinary team to discuss patient progress and plan for future interventions.
- Provided emotional support to patients dealing with difficult health issues.
- Responded promptly to inquiries from patients regarding their care plans.
- Communicated with patients with compassion while keeping medical information private.
- Coordinated with other health professionals to develop individualized plans of care for patients.
- Explained policies, procedures and services to patients.
- Collaborated with physicians, social workers, and other healthcare providers to provide comprehensive care for patients.
- Educated clients on available resources and services within their communities.
- Monitored and evaluated patient progress, adjusting treatment plans as needed.
- Maintained awareness of government regulations, health insurance changes and financing options.
- Ensured compliance with state regulations related to healthcare service provision.
- Developed individualized service plans based on assessment findings.
- Maintained records management system to process personnel information and produce reports.
- Scheduled appointments for clients with appropriate medical specialists.
- Actively participated in staff meetings discussing best practices in patient care coordination.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
- Worked effectively in team environments to make the workplace more productive.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Prior Authorization Representative
Trinity Medical Associates
Wilmington
04.2019 - 09.2020
- Assessed insurance benefits and determined eligibility criteria.
- Verified patient's insurance eligibility prior to appointment date for payment purposes.
- Maintained accurate records on all prior authorizations requested, received, and denied.
- Evaluated patient eligibility and benefits for requested procedures and medications.
- Educated customers about the prior authorization process including applicable deadlines.
- Communicated with internal teams regarding changes in policy or procedure related to prior authorization process.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Provided customer service to patients and healthcare providers, answering questions related to prior authorization and insurance coverage.
- Trained new staff on prior authorization procedures and company policies.
- Collaborated with insurance companies to clarify coverage details and resolve issues related to prior authorization.
- Coordinated resolutions for issues and appealed denied authorizations.
- Notified ordering providers of denied authorizations.
- Coordinated with pharmacy staff to ensure medications requiring prior authorization are processed correctly.
- Processed appeals for denials in accordance with established procedures.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Made outbound calls to insurance companies, patients and physicians to perform eligibility checks for patients.
- Negotiated with drug manufacturers and insurance providers to obtain coverage for off-label or non-formulary medications.
- Scheduled patient appointments, diagnostic specialty appointments, tests and procedures.
- Followed up on pending prior authorization requests to ensure timely processing.
- Submitted prior authorization requests electronically or by phone to payers.
- Completed day-to-day duties accurately and efficiently.
- Updated and maintained databases with current information.
Call Center Representative
Trinity Medical Associates
Wilmington
04.2018 - 04.2019
- Liaised between customers and retail buyers to expedite orders and meet customer demands.
- Prepared and evaluated CRM reports to identify problems and areas for improvement.
- Conferred with customers by telephone or in person to provide information about products or services and take orders.
- Processed payments from patients for copayments or other fees related to their care.
- Followed HIPAA guidelines when handling confidential patient information.
- Trained new employees on best practices for working in the call center environment.
- Researched medical codes to ensure accurate billing practices were followed.
- Entered patient data into electronic health records accurately and efficiently.
- Educated patients on proper use of medications, treatments, and follow-up care instructions.
- Collected deposits or payments and arranged for billing.
- Ensured compliance with HIPAA regulations when handling confidential patient information.
- Answered patient inquiries, provided information on services, and directed callers to appropriate personnel.
- Collaborated with physicians, nurses, and other staff members as needed.
- Maintained up-to-date knowledge of healthcare industry trends and regulations.
- Maintained strong call control and quickly worked through scripts to address problems.
- Performed outbound calls to remind patients about upcoming appointments.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
Education
Certificate of Technical Studies -
Harris School of Business
Wilmington, Delaware04-2018
High School Diploma -
Smyrna High School
Smyrna, De07-2010
Skills
- Time management
- Team collaboration
- Problem solving
- Process optimization
- Record keeping
- Appointment scheduling
- Insurance verification
- Patient education
- Task prioritization
- Interpersonal skills
- PPE use
- Excellent communication
- Problem resolution
- Relationship building
- Communication
- Team building
- Medical records
- EKG
- Vital signs high volume calls
- Medications
Timeline
Cash and Trade
Citi
08.2024 - Current
Application Processor
Randstad
02.2024 - 08.2024
Fraud Analyst
Discover
07.2022 - 09.2023
Care Coordinator
Trinity Medical Associates
09.2020 - 07.2022
Prior Authorization Representative
Trinity Medical Associates
04.2019 - 09.2020
Call Center Representative
Trinity Medical Associates
04.2018 - 04.2019
Certificate of Technical Studies -
Harris School of Business
High School Diploma -
Smyrna High School