Nyeisha McNeal
Missouri City,TX
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims. Responsible Medical Claims Processor with strong attention to detail and juggles multiple tasks. Bilingual go-getter committed to handling claims expeditiously.
Overview
15
15
years of professional experience
Work History
Medical Claims Specialist
Sutherland Healthcare Solutions
08.2019 - Current
- Submitted electronic/paper claims documentation for timely filing.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
Correctional Officer
Texas Department Of Criminal Justice
06.2016 - 07.2019
- Searched cells of inmates to identify and confiscate contraband and other prohibited items.
- Escorted inmates to and from cells, court, hospitals, and medical appointments.
- Observed and supervised inmates throughout visits, meal time, recreation, phone calls, and showers.
- Conducted routine and emergency head counts.
- Tracked inmates through head counts, visitor logs, and scheduled activities.
Certified Nursing Assistant
The Colonnade Senior Living
04.2012 - 04.2016
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Delivered individualized patient care by recording vital signs, documenting observations, administering treatments, and evaluating patient needs.
- Utilized therapeutic communication, empathy and active listening skills to encourage and develop positive relationships with patients.
Daycare Teacher
Kids 'R' Kids
03.2008 - 04.2012
- Sanitized toys and play equipment each day to maintain safety and cleanliness.
- Maintained tidy environment to comply with cleanliness and sanitation standards.
- Engaged with children on individual basis to build positive relationships and promote learning.
- Assisted in preparation of meals and snacks to provide children with proper nutrition.
- Instructed children in health and personal habits, such as eating, resting, and toileting.
- Actively encouraged children to develop their communication, problem-solving and social skills.
Education
No Degree -
Grambling State University
Grambling, LANo Degree -
Houston Community College
Houston, TXHigh School Diploma -
Thurgood Marshall High School
Missouri City, TX05.2006
Skills
- Work Organizing and Prioritizing
- Fee Billing
- Provider Relations
- HIPAA Procedures
- Amount Calculation
- Insurance Policy Coverage Knowledge
Timeline
Medical Claims Specialist
Sutherland Healthcare Solutions
08.2019 - Current
Correctional Officer
Texas Department Of Criminal Justice
06.2016 - 07.2019
Certified Nursing Assistant
The Colonnade Senior Living
04.2012 - 04.2016
Daycare Teacher
Kids 'R' Kids
03.2008 - 04.2012
No Degree -
Grambling State University
No Degree -
Houston Community College
High School Diploma -
Thurgood Marshall High School