Nikishia Hunter
Pflugerville
Summary
Skilled Insurance Verification Specialist with experience in verifying insurance coverage, understanding policies, and processing claims. Strengths include strong analytical skills, attention to detail, and ability to work under pressure. Proven record of improving efficiency in handling claims and enhancing customer satisfaction through timely resolution of disputes and issues.
Overview
9
9
years of professional experience
1993
1993
years of post-secondary education
Work History
Registrar
St. David's Medical Center
Austin
08.2025 - Current
- Coordinated with medical staff to ensure timely patient check-ins.
- Utilized electronic health record systems for data entry and management.
- Addressed patient inquiries and resolved registration issues efficiently.
- Maintained confidentiality of patient information in compliance with regulations.
- Scheduled appointments and followed up with patients as needed.
- Collaborated with team members to streamline registration processes.
- Ensured compliance with all applicable laws, regulations, standards, and policies related to registrar activities.
- Registered patients for diagnostic appointments, surgeries and medical consultations using electronic health record system.
- Communicated with insurance companies to clarify coverage details and requirements.
- Verified insurance information for patient records in a timely manner.
- Assisted patients in understanding their insurance benefits and responsibilities.
- Coordinated with healthcare providers to gather necessary documentation for claims.
- Maintained organized records of verification requests and responses for auditing purposes.
- Entered data in EMR database to record payer, authorization requirements and coverage limitations.
- Navigated through multiple online systems to obtain documentation.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Evaluated policies and procedures related to Insurance Verification activities.
- Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability.
Insurance Verification Specialist
Harbor Health Medical Group
Austin
10.2022 - 08.2025
- Verified insurance information for patient records in a timely manner.
- Communicated with insurance companies to clarify coverage details and requirements.
- Reviewed patient files to ensure accurate data entry and compliance with policies.
- Coordinated with healthcare providers to gather necessary documentation for claims.
- Maintained organized records of verification requests and responses for auditing purposes.
- Interpreted Explanation of Benefits statements from various insurers and communicated relevant information with other departments as needed.
- Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.
- Assisted in resolving claim issues related to billing and reimbursement inquiries.
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
- Conducted regular audits of patient accounts for accuracy of demographic data.
- Performed daily audits of submitted claims to ensure compliance with industry standards and regulations.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Utilized electronic medical records (EMR) systems for documenting verification processes.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Maintained up-to-date knowledge of insurance policies, including Medicare and Medicaid.
- Ensured compliance with federal and state regulations regarding insurance verification.
- Responded to patient inquiries regarding insurance coverage and billing issues.
- Developed and maintained professional relationships with insurance representatives.
- Resolved insurance-related issues and discrepancies to prevent claim denials.
- Collaborated with healthcare providers to communicate insurance coverage and authorization details.
- Conducted follow-ups with insurance companies to expedite verification processes.
- Assisted in training new staff on insurance verification procedures and best practices.
Patient Access Representative
Ascension Medical Group
Austin
04.2017 - 10.2022
- Collected and verified patient information for accuracy and completeness.
- Scheduled appointments efficiently using electronic health record systems.
- Applied HIPAA privacy and security regulations while handling patient information.
- Collected co-pays and other payments from patients at time of service.
- Scanned documents into electronic medical records system.
- Answered phones promptly in a professional manner.
- Communicated financial obligations to patients and collected fees at time of service.
- Explained various admission forms and policies, acquiring signatures for consent.
- Organized and maintained records by updating and obtaining both personal and financial information from patients.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Collaborated closely with team members to achieve project objectives and meet deadlines.
- Verified insurance information for patient records in a timely manner.
- Coordinated with healthcare providers to gather necessary documentation for claims.
- Researched third party payer guidelines related to prior authorizations, coding and billing processes.
- Liaised between physician, site of service and billing department to obtain appropriate documentation.
- Scheduled and confirmed patient appointments and consultations.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
- Compiled and coded patient information or data in appropriate computer system.
- Communicated with patients with compassion while keeping medical information private.
- Transmitted medical records and other correspondence by mail, e-mail, or fax.
- Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
- Transcribed recorded practitioners' diagnoses and recommendations into medical records.
Education
Billing And Coding
Austin Community College
Austin, Texas, TX 01.2021 - 06.2021
Central High School
Beaumont, TXSkills
- Electronic health records
- Insurance verification
- Medical coding
- HIPAA compliance
- Customer relationship management
- Effective communication
- Problem solving
- Claims processing
- Conflict resolution
- Time management
- Higher education administration
- Report generation
- Academic advising
- Admissions support
- Verification and eligibility
- Maintaining documents and records
- Medical terminology
- Electronic health record specialist (CEHRS)
- Health information systems
- Patient scheduling
- Healthcare reimbursement
- Multitasking
- Billing procedures
- Health informatics
- Electronic medical record software
- Medical records analysis
- Team building
- Medical documentation
- Registered health information technician (RHIT)
- Heartsaver CPR AED
- Information security
- Critical thinking
- Task prioritization
- Active listening
- Interpersonal communication
- Clinical data management
- MEDITECH EHR software
- Continuous improvement
Timeline
Registrar
St. David's Medical Center
08.2025 - Current
Insurance Verification Specialist
Harbor Health Medical Group
10.2022 - 08.2025
Billing And Coding
Austin Community College
01.2021 - 06.2021
Patient Access Representative
Ascension Medical Group
04.2017 - 10.2022
Central High School