Summary
Overview
Work History
Education
Skills
Timeline
Generic

NICOLE D. NASH

SAN ANTONIO,TEXAS

Summary

Human Resources and HealthCare administrative professional with proven experience in both corporate and office environments supporting physicians, human resources, records management, payroll and employment law; excellent attention to detail, strong organizational skills and the ability to manage multiple assignments successfully in a fast paced and changing environment.

Overview

31
31
years of professional experience

Work History

02.2022 - Current
  • Maintain claims inventory goals by accurately processing claims for assigned workload
  • Processing all claim types for assigned workload, maintaining a 10 day or less turnaround time
  • Interpret and understand Plan Document provisions
  • Maintain HPS process
  • Maintain Zelis process
  • Handle subrogation cases
  • Work priority queue and various other claim queues within priority queue

OWNER/TRAINER/MENTOR

FIRE DRIVEN
12.2012 - Current
  • Coach and mentor client on both fitness and lifestyle changes that enable clients in living a healthier, happier lifestyle
  • Coordinate personal workouts and boot camps for various experience levels and ages
  • Conduct fitness assessments and provide nutrition outlines
  • As a mentor I assist parents along with their children in helping to get youth college ready
  • Provide community service and networking opportunities
  • Counsel and provide youth with outlets to express themselves
  • Director of local dance team that does outreach both locally and in the state of
  • Texas
  • Schedule and track community service hours for youth to use on college resumes
  • Schedule both fitness and lifestyle boot camps for clients
  • Network with other programs with like objectives to empower youth.

HR TEAM LEAD

WELLS FARGO, RANDSTAD
09.2020 - 02.2022
  • Handle incoming calls from internal team members in a call center environment
  • Responsible for Attendance tracking
  • Coaching of Team members
  • Answering questions on payroll, benefit plans, policies, programs and online tolls associated with human resources
  • Educate team members on human resources related topics.
  • Liaised between multiple business divisions to improve communications.
  • Collaborated with entire human resource department to discuss new ways to recruit top talent.
  • Updated HR database with new employee information, changes in benefits and other details.
  • Coordinated technical training and personal development classes for staff members.
  • Collaborated with legal and compliance teams to review paperwork, obtain feedback and procure available information for new training processes.
  • Managed benefits enrollment by answering questions and aiding employees with login details.
  • Oversaw exit interviews and off-boarding process for resigned and terminated employees.
  • Prepared new hire letters, employee contracts and corporate policies.

HR MANAGER

TASHA’S TAXES
01.2019 - 05.2020
  • Maintains office services by organizing office operations and procedures, controlling correspondence, designing filing systems, reviewing and approving supply requisitions, and assigning and monitoring clerical functions
  • Answered phone lines and directed calls
  • Scheduled all appointments and maintained calendar
  • Maintained filing systems
  • Maintained correspondence and supply requisitions
  • Managed employee tasks
  • Payroll
  • Motivated employees through special events and incentive programs.
  • Implemented performance reviews and motivational strategies to elevate HR team results.
  • Supervised and mentored direct reports and developed talented HR teams.
  • Managed employee disputes by employing conflict resolution techniques.
  • Advised executives on best practices for employee growth and productivity goals, consistently helping companies improve retention.
  • Led decision-making and implementation of HR policies, procedures, programs and functions.
  • Recommended, initiated and finalized HR actions regarding faculty and staff position management, compensation and employment postings, hiring proposals and new hire onboarding.
  • Guided leaders and employees on company policies, programs, benefits and salary administration.
  • Created vision and goals for HR team and motivated staff to achieve excellence in customer support and core HR processes.
  • Implemented standardized programs and policies, driving smooth operations, employee retention and engagement.
  • Oversaw legal compliance with federal, state and local laws and regulations in addition to compliance with company policies and procedures.

INSURANCE REPRESENTATIVE/HR Personnel

CENTENE
04.2018 - 01.2019
  • Handled incoming calls assisting members, doctors and medical personnel
  • Handled insurance claims
  • Asked discovery questions necessary to complete reports accurately
  • Handled Insurance Registration and customer accounts
  • Gave benefits information, comparisons and quotes
  • Scheduled doctors appointments
  • Updated doctors appointment schedules and requests
  • Handled third party billing

HR CORPORATE TRAINER

AETNA HEALTHCARE
04.2016 - 04.2018
  • Recruited, interviewed and trained new hires for clients service representatives position
  • Supervised all new hire teams and groomed them until passing on to new supervisors
  • Created the curriculum for training
  • Maintained and approved team work hours and time off
  • Handled Team Lead position as well as Quality Assurance when New Hire classes weren't being done
  • Screened Applicants for upcoming positions.
  • Coordinated with engineers and corporate leadership to identify training and development opportunities to improve safety and optimize performance.
  • Collected information about company objectives and employee deficiencies in order to assess training needs.
  • Developed engaging and entertaining presentations to maintain employee attention and improve impact of training.
  • Authored, updated and implemented training procedures.
  • Developed effective training manuals, modules and teaching aids.
  • Monitored employee progress and gave feedback to management and additional training requirements.
  • Led cross-functional training for external and internal clients and created all training materials and exams.
  • Reviewed effectiveness of programs and proposed updates to maximize success.
  • Handled onboarding background checks and drug screenings.
  • Provided managers with interviewing, hiring, promotion and termination standards to maintain process consistency.
  • Supported performance evaluation program through scoring framework development.

MEMBER SERVICE REP

LEADING EDGE PERSONNEL, FIRST HEALTH CARE
08.2015 - 03.2016
  • Responsible for incoming calls from clients, members and medical staff assisting with benefit eligibility, insurance claims, medical and pharmacy benefits
  • Performs primary care provider change requests as per requirements for medicaid/medicare
  • Assists in processing claims and appeals for benefit payment
  • Inform medical staff of member eligibility for services rendered per benefit plan
  • Processed benefit enrollment for affordable health care

ADMINISTRATIVE SPECIALIST II

TRI, PERSONNEL, San Antonio Housing Authority
STARR
08.2014 - 01.2015
  • Key Responsibilities : Under direction, is responsible for performing a wide variety of professional administrative duties in support of the activities and services of an assigned department; coordinates office services and provides information and assistance to the public regarding the assigned department or division
  • Work is performed under established policies and office procedures with some latitude
  • Performs complex and confidential administrative functions including developing and typing taped dictation or written correspondence
  • Prepare presentations, composes and responds to internal and external correspondence, memos, purchase requisitions, payment requests and other department forms and documents.

HR Executive/Administrative Assistant

LEADING Edge Personnel
09.2013 - 08.2014
  • Attend assignments giving by agency in various administrative environments
  • Responsibilities range from recruiting, training, office communications, phone calls, benefits and scheduling
  • Team Lead for non profit organization Eastside Promise
  • Recruiting, training, payroll and handled front office duties
  • Benefits Intake specialist for Community First
  • Answered calls regarding benefits and ICD-9 coding
  • Insurance scheduler for Wellmed
  • Called clients and scheduled them for required testing under the Medicare guidelines.
  • Updated spreadsheets and created presentations to support executives and boost team productivity.
  • Responded to emails and other correspondence to facilitate communication and enhance business processes.
  • Documented and distributed meeting notes to identify, analyze and improve workflows.

PATIENT CARE SECRETARY

VITAS HOSPICE
06.2009 - 04.2012
  • Administrative coordinator in charge of a team of Healthcare workers ranging from Physician, Clergy, Social Worker and CNA’s
  • Managed scheduling for team and all Office communications
  • Responsible for all Office logistics through the use of their interoffice system and Microsoft Outlook
  • Coordinator over all direct patient support responsible for registration, code of compliance, medical records, Medicare/Medicaid compliance, creating patient charts and input of all information into system for electronic filing for auditing purposes
  • Answered all phone calls and screened accordingly for Healthcare staff
  • Scheduled visits and relayed patient/family request to appropriate staff member
  • Handled all Customer Service issues and resolved concerns of patients, families and clients which consisted of Nursing Homes, Rehabilitation Centers, and Hospitals
  • Ordered all supplies and equipment requests of clients
  • Dispatched all pharmacy requests to appropriate staff
  • Organized and kept record of all required training for staff including certifications and licensing
  • Organized all meetings for team ranging from the agenda, attendees and ordering any special request (i.e
  • Food, learning material, requested records from Physicians)
  • Kept Physicians informed of all deadlines and code of compliances that need to be met
  • (i.e
  • Benefits requirements, Medicare and Medicaid)

PATIENT SERVICES COORDINATOR

Pediatrix
04.2008 - 01.2009
  • Administrative coordinator in a fast-paced, deadline driven environment for a team of physicians, healthcare consultants and nursing staff; managed patient scheduling, office logistics through Microsoft Outlook and use of interoffice systems
  • Project coordinator over direct patient support responsible for new patient care packages, medical records, creating patient charts and electronic filing in compliance with auditing procedures
  • Supported Accounts Receivable with daily auditing and money management log for each physician; handled updates of insurance price adjustments and daily bank deposits
  • Updated and maintained the inter-office calendar, staff information log and physician information
  • Collaborated with the Office Manager to maintain and order office supplies
  • Performed general clerical duties and backup to office receptionist assisting in photocopying, faxing, mail distribution and filing.

Registrar and Office Coordinator

Methodist Healthcare
07.2006 - 01.2008
  • Administrative support to the Director of Bariatric and Outpatient Medicine; responsible for the daily office operations including staff communications, records management and equipment maintenance
  • Human resources liaison for the office registrar department and managed employee time reporting, scheduling and benefits
  • Managed doctor’s and nurse manager’s scheduling, training meetings and customer service concerns
  • Oversaw office financials for direct medical group ensuring accuracy and end-of-day batches to hospital finance
  • Conducted new hire training on patient care, scheduling and insurance procedures
  • Vendor relations coordinator for all new and existing vendors
  • Inter-departmental communications link ensuring excellent and consistent patient care
  • Responsible for patient pre-qualifications and insurance verifications.

Human Resources Senior Records Clerk and Payroll Agent

AT&T/SBC Services
02.1999 - 05.2006
  • Supported internal customers within the AT&T corporation; responsible for the day-to-day service and administration, analysis and support for a wide scope of benefits services, taxes and payroll administration coordinating and processing a high volume of data input
  • Reported to the HR
  • Generalist and Payroll Contact Manager
  • Administer policies, procedures, and programs to comply with corporate policies related to employee relations and/or employment
  • Efficiently and accurately ensure that the Human Resources department and essential duties were maintained and in conformance with AT&T’s high quality of performance standards
  • Processed internal forms i.e
  • Hiring, separation, wage increase, promotion using Sap Gui, Legacy, Span and E-Link systems
  • Handled payroll inquiries via phone and paper requests; correcting errors and producing off-cycle reprints
  • Administered team member morale survey on a monthly basis; assisted in the coordination of monthly team member appreciation functions
  • Worked in a highly confidential environment and maintained confidentiality of all payroll and Human Resources information.

Customer Care Representative

Citigroup Inc
02.1998 - 02.1999
  • Incoming customer service specialist within a fast paced, high volume call center; responsible for Citibank customer base providing product education, updated and maintained customer information and helped retain customers by identification of problem areas and offering immediate resolve
  • Answer customer inquiries and complaints concerning services, products and billing with highest degree of courtesy and professionalism
  • Meet quantity and quality goals as assigned to include daily inbound quotas as assigned
  • Continually maintain working knowledge of company products, service and promotions
  • Payments and update customer information.

DEGREE BENEFITS, HR LEAD BENEFIT CLAIMS EXAMINER

01.1990
  • Orchestrated smooth and efficient program development by collaborating cross-functionally across departments.
  • Gathered and organized printed materials required for program participation.
  • Organized and managed program development from conception through successful execution.
  • Collaborated with claims department and industry anti-fraud organizations to resolve claims.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Handled complaints and grievances using negotiating and problem-solving skills.
  • Designed program implementation and maintenance plan.
  • Interviewed claimants and witnesses to gather factual information.
  • Conducted workplace compliance training to reduce liability risks and operate effectively.
  • Contributed to annual performance appraisals by working with supervisors to achieve consistency and compliance with established procedures.
  • Reviewed existing policies and procedures to make recommendations for enhancing work productivity, recruitment, hiring processes and talent management.

Education

High School Diploma -

Judson High School
San Antonio, TX
05.1990

Skills

  • HRIS & Payroll Systems Experience:
  • Sap Gui, Legacy, Span, E-Link Systems, QicLink System, and VBA System
  • Business and Employee development
  • HR Processes and policy improvement
  • Training Needs Analysis
  • Regulatory Compliance
  • HR Policies
  • Payroll and Benefits Administration
  • MSOffice (Word, Excel, Access, PowerPoint & Outlook)
  • Internal/External Customer Service Experience
  • Excellent interpersonal, verbal and written communications skills
  • Benefit Claims Adjuster
  • Liability Determinations

Timeline

02.2022 - Current

HR TEAM LEAD

WELLS FARGO, RANDSTAD
09.2020 - 02.2022

HR MANAGER

TASHA’S TAXES
01.2019 - 05.2020

INSURANCE REPRESENTATIVE/HR Personnel

CENTENE
04.2018 - 01.2019

HR CORPORATE TRAINER

AETNA HEALTHCARE
04.2016 - 04.2018

MEMBER SERVICE REP

LEADING EDGE PERSONNEL, FIRST HEALTH CARE
08.2015 - 03.2016

ADMINISTRATIVE SPECIALIST II

TRI, PERSONNEL, San Antonio Housing Authority
08.2014 - 01.2015

HR Executive/Administrative Assistant

LEADING Edge Personnel
09.2013 - 08.2014

OWNER/TRAINER/MENTOR

FIRE DRIVEN
12.2012 - Current

PATIENT CARE SECRETARY

VITAS HOSPICE
06.2009 - 04.2012

PATIENT SERVICES COORDINATOR

Pediatrix
04.2008 - 01.2009

Registrar and Office Coordinator

Methodist Healthcare
07.2006 - 01.2008

Human Resources Senior Records Clerk and Payroll Agent

AT&T/SBC Services
02.1999 - 05.2006

Customer Care Representative

Citigroup Inc
02.1998 - 02.1999

DEGREE BENEFITS, HR LEAD BENEFIT CLAIMS EXAMINER

01.1990

High School Diploma -

Judson High School

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NICOLE D. NASH