NWANI THOMPSON
DALLAS,TEXAS
Summary
Highly efficient Medical Biller with extensive experience in Full Revenue Cycle, Medicaid/Medicare billing, collections, and refunds delivering exceptional customer service. Ability to analyze accounts and negotiate effectively, ensuring timely reimbursements and compliance. A self-starter committed to enhancing operational efficiency and resolving complex billing issues while maintaining high integrity.
Overview
14
14
years of professional experience
Work History
Patient Financial Services Senior
Christus Health
04.2023 - 02.2025
- Processed daily refund payments accurately and efficiently.
- Evaluated customer refund requests and determined eligibility based on company policies.
- Trained new refund specialists on company processes, policies, and best practices related to handling refunds.
- Communicated regularly with team members and management.
- Collaborated with other departments to resolve customer refund disputes or issues.
- Confirming reconciled/ canceled checks to resolve discrepancies.
- Executed stop-payment orders to prohibit processing of incorrect refund checks.
- Mailed statements for non-reconciled checks.
Account Representative/Collections
National Partners in Healthcare
11.2019 - 08.2022
- Phone insurance companies for status on outstanding claims.
- Process and follow up on appeals to insurance companies.
- Phone patients for payment or payment arrangements on outstanding balances, including bringing down AR below 180 from 2+ years.
- Print and re-file claims as needed.
- 85% - 90% rate on appeals and reconsideration with all payers.
- Answered incoming patient, insurance company and physician office calls regarding the balance.
- Research/audit patient accounts.
- Meet productivity standards as set by the department.
- Payment processing.
- Training new employees.
Medical Billing Specialist
24HR Quality Home Healthcare
05.2018 - 10.2019
- Processing Billing verified billing amount and type of services for bill submission.
- Verified eligibility and benefits for all referred new and recertified patients.
- Requested all authorization for new admitted patients and recertified patients.
- Reviewed patient's summary for services from doctors' offices, hospital, marketing team.
- Followed up on all pending authorization, denials, appeals, and requested Peer to Peers on patient behalf.
- Proficiency in websites for insurance payers.
- Act as a liaison between clinical staff, referring to physician offices and insurance payers and patients.
- Provides ongoing communication and training to physician offices, patients/families and others for necessary to resolve insurance authorization related departmental issues.
Medicare Billing Specialist
Jordan Health Services
06.2016 - 03.2018
- Ensure that all billing is sent/transmitted, and that payments or reimbursements are received in a timely manner.
- 80%-90% rate on collection denied claims, including with appeals and reconsiderations with all payors.
- Correct all returned or denied billings prior to re-submitting to payor.
- Balance all individual billing according to the client's care plan.
- Review billing forms for accuracy and completeness before sending them to payors.
- Maintain an itemized billing record each month for each client that indicates the services provided.
- Receive payments/reimbursement reports for accuracy; identify errors and correct errors prior to resubmitting to the payor.
- Communicate with payors when necessary to facilitate reimbursement.
- Maintain current accounts receivable aging report for each program.
- Track and monitor the monthly rejection reports.
- Maintain knowledge of each payor's billing/reimbursement guidelines.
- Assist in the training of all personnel involved in the billing process.
Government Medicaid and Medicare Billing Specialist
Behavioral Health Group
05.2015 - 06.2016
- In-depth knowledge of billing and revenue-cycle processing
- Collect, post and manage patient account payment
- Verify initial eligibility
- Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission
- Compile coding and clinical documentation trends to create training documents
- Review delinquent accounts and call responsible parties for collection process
- If acclaim is denied due to incorrect coding, conduct medical records research and correspond with insurance companies and healthcare professionals to resolve the issue
- Research health plans, patient charts, payment correspond
- Investigate insurance fraud and report if found
- Communicate with clinical personnel as needed, about clinical documentation updates, changes, and requirements
Government Medicaid Billing Specialist
Intrepid USA Home Health
11.2013 - 04.2014
- Performs all billing services in accordance with state/federal regulations; compliant with plan of care/treatment; and consistent with professional practice.
- Coordinates accumulation and verification of all necessary documentation required for billing
- Followed up on all pending authorization, denials, appeals, and requested Peer to Peers on patient behalf.
- Proficiency in websites for insurance payers.
- Act as a liaison between clinical staff, referring to physician offices and insurance payers and patients.
- Provides ongoing communication and training to physician offices, patients/families and others for necessary to resolve insurance authorization related departmental issues.
Medical Billing Specialist
Medicaid Coordination Service at Dallas Independent School District
09.2010 - 11.2013
- Help Dallas Independent School District to obtain reimbursement for certain health related services provided to children that are in special education and Medicaid eligible.
- Responsible for knowing all compliance requirements for Medicaid in the Public Schools.
- Maintain accurate student database and inform supervisor of any student's changes in status eligibility of students Medicaid/Chip.
- Prepare students' files and staff requirements for annual MIPS audit.
- Maintain confidentiality regarding student records and personal information.
- Generated student's forms & reports for billing process of service claims by six weeks for payment, & status of claims submission to help keep account of outstanding claims for reimbursements.
- Ensured all bills submitted in a time efficient and accurate manner.
- Answered phones, route calls and take messages.
- Processed accurate 250-500 transactions in a single day.
- Billed on 65,000 special education students in the school district and received 725.87 per student.
- Followed up on denials and unpaid claims and processed refunds.
Education
Accounting
University of Arkansas at Pine Bluff
Skills
- EPIC
- INFOR
- ONBASE
- MEDITECH
- CONNANCE
- HOME CARE HOMEBASE
- TMHP
- Waystar (ZIRMED)
- AVAILITY
- WELLMED
- Microsoft Word, PowerPoint, Outlook, Excel
Timeline
Patient Financial Services Senior
Christus Health
04.2023 - 02.2025
Account Representative/Collections
National Partners in Healthcare
11.2019 - 08.2022
Medical Billing Specialist
24HR Quality Home Healthcare
05.2018 - 10.2019
Medicare Billing Specialist
Jordan Health Services
06.2016 - 03.2018
Government Medicaid and Medicare Billing Specialist
Behavioral Health Group
05.2015 - 06.2016
Government Medicaid Billing Specialist
Intrepid USA Home Health
11.2013 - 04.2014
Medical Billing Specialist
Medicaid Coordination Service at Dallas Independent School District
09.2010 - 11.2013
Accounting
University of Arkansas at Pine Bluff