Nieves L. Adams
Panama City Beach,FL
Summary
Detail-oriented medical biller with a proven track record in enhancing productivity and executing tasks efficiently. Expertise in medical billing and pre-certification standards, as well as insurance claims management, paired with proficiency in various billing software. Strong time management and problem-solving skills contribute to seamless billing processes and accurate coding practices. Committed to delivering exceptional customer service while maintaining a professional work ethic.
Overview
16
16
years of professional experience
Work History
Family Services Coordinator
Kent-forest Lawn Funeral Home & Cemeteries
Panama City, FL
06.2024 - Current
- Organized and monitored funeral arrangements, including paperwork, flowers, casket selection, and other services.
- Maintained accurate financial records related to pre-need contracts or trust accounts in accordance with state laws.
- Maintained records related to funerals including contracts, invoices and payments received.
- Ensured that all legal requirements were met prior to burial or cremation services being performed.
- Answered phone calls from family members, friends, vendors, and other contacts regarding funeral arrangements.
- Coordinated with families to ensure that all details were attended to in a timely manner.
- Worked effectively in team environments to make the workplace more productive.
- Identified needs of customers promptly and efficiently.
- Updated and maintained databases with current information.
Senior Medical Billing Specialist
NHC HomeCare, Murfreesboro
Panama City, FL
10.2011 - 12.2023
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
- Processed invoice payments and recorded information in account database.
- Applied HIPAA privacy and security regulations while handling patient information.
- Submitted claims to insurance companies.
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
- Maintained detailed documentation of all activities related to the precertification process.
- Resolved any discrepancies identified during the precertification process.
Patient Care Coordinator/ Office Manager.
Northland Hearing Center / The Hearing Shoppe
Panama City, FL
05.2009 - 07.2011
- Troubleshot and resolved complex customer service issues to enhance patient and family experience.
- Maintained comprehensive patient records, ensuring accuracy and confidentiality.
- Communicated with patients to ensure quality of care and develop care plans.
- Facilitated communication between patients and healthcare teams, acting as a primary point of contact.
- Cultivated positive relationships with patients to help facility meet satisfaction scores and patients obtain best possible care.
- Followed up with discharged patients after they left the facility to ensure they were receiving adequate post-care support.
Education
High School Diploma -
St. Mary's Of The Assumption
Elizabeth, NJ06-1991
Skills
Fluent in English and Spanish, with exceptional customer service and clerical experience; computer literate, experienced with multi-line phones, fax machines, copy machines, Excel, Word, as well as numerous medical programs Extensive experience in medical billing, medical insurance/collections, credit processing, pre-certification, referrals, as well as administrative and office management procedures
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
References
References available upon request.
Timeline
Family Services Coordinator
Kent-forest Lawn Funeral Home & Cemeteries
06.2024 - Current
Senior Medical Billing Specialist
NHC HomeCare, Murfreesboro
10.2011 - 12.2023
Patient Care Coordinator/ Office Manager.
Northland Hearing Center / The Hearing Shoppe
05.2009 - 07.2011
High School Diploma -
St. Mary's Of The Assumption