T. Nicole Watson
NOBLESVILLE,IN
Summary
I am a highly motivated and adaptable employee who possesses exceptional interpersonal skills. I have a strong work ethic and excel at learning new skills quickly while working effectively without supervision.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Patient Account Representative
Community Health Network
Indianapolis, IN
04.2018 - Current
- Generated monthly reports of all claims activity for management review
- Run daily reports to capture all aged and current denials to prioritize my day
- Perform follow-up on unpaid or rejected claims through phone calls, payer chat, or written correspondence with various commercial and government insurance companies
- Research complex billing issues and provide resolution promptly
- Collaborate with front office staff to ensure that the proper information was received for claims processing
- Develop proper guidelines for billing, disputing, and appealing to multiple payers
- Resolve complex insurance issues by communicating with providers, patients, and third-party payers.
- Review and process medical insurance claims to ensure accuracy of information and compliance with established regulations
- Conduct interviews and assist with training for new hires
- Review EOBs statements submitted by insurance companies for accuracy against provider's charges
- Manage unpaid, underpaid, and overpayment claim reports
- Proficient in using medical office software and electronic health records (EHR) systems
- Experience providing administrative support in a healthcare setting, including managing patient information, coordinating referrals, and maintaining confidentiality
- Comprehensive knowledge of payer portals for multiple carriers and an ability to efficiently navigate them
- Developed detailed knowledge of third party payers' reimbursement policies and processes
- Participate in special projects as assigned by supervisor related to process improvement initiatives
- Ensure compliance with applicable local, state and federal regulations governing healthcare reimbursement processes
- Verify accuracy of medical coding for services rendered by healthcare providers
- Work closely with insurance companies to obtain authorization for services rendered
- Submit claims to insurance companies
- Participate in workshops, seminars and training classes to gain stronger education in industry updates and federal regulations
- Process refunds accurately according to established guidelines
Customer Care Representative III
Anthem Blue Cross and Blue Shield
Indianapolis, IN
04.2015 - 04.2018
- Responsible for fielding customer concerns via telephone and written correspondence
- Excellent written and oral communication skills with the ability to communicate effectively with colleagues at all levels of the organization
- Analyzes problems using computerized systems (i.e., gathering information and troubleshooting, recordkeeping, first call resolution)
- Managing large amounts of inbound and outbound calls promptly
- Develop and maintain positive customer relations
- Ability to coordinate with various departments within the company to ensure customer requests and questions are handled appropriately
- Language coordination for members that needed interpreters
- Meet personal/team qualitative and quantitative targets
- Demonstrated respect for the privacy and confidentiality of patient’s protected health information
- Mastered experience in WGS, Facets, and a host of additional systems needed for daily job functions/tasks
- Followed up on customer inquiries not immediately resolved by providing timely updates on the status of their requests
- Assisted customers in navigating through website features and functions to locate desired information or products
- Participated in team meetings to discuss strategies for improving customer satisfaction levels
- Escalated unresolved issues requiring further investigation or specialized expertise
- Educated customers where applicable to alleviate need for future contact
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions
Transportation Services
Durham School Bus Services
Indianapolis, IN
04.2014 - 04.2015
- Ensured safety of students by following all traffic laws and regulations
- Maintained bus cleanliness, inspected for mechanical problems, and reported any issues to supervisor
- Performed pre-trip inspections of the bus according to established procedures
- Transported students to school in a timely manner while keeping assigned route schedule
- Assisted with loading and unloading of passengers as needed
- Followed all safety protocols when transporting students with special needs or disabilities
- Communicated effectively with parents regarding student transportation issues
- Reported student behavior incidents promptly to the appropriate personnel
- Developed positive relationships with students through friendly interactions
- Complied with district policies and procedures concerning student discipline
- Kept up-to-date on changes in local roads, traffic patterns, construction projects., that may affect routes or schedules
- Managed time efficiently so that routes are completed within allotted timespan
- Attended staff meetings and training sessions regularly for professional development purposes
- Operated bus safety lighting to increase safety during bus stop boarding and departing
- Acquired and maintained certification in basic first aid and CPR
Education
Health Science: Medical Coder And Biller Certification - AMCA -
Purdue University Global
West Lafayette, INSkills
- Data Entry
- CPT / ICD-10 Coding interpretation
- Medical Billing
- Administrative Support
- Precertification
- Medical Records review and interpretation
- Microsoft Office Suite
- HIPAA Compliance
- Healthcare regulations
- Insurance Verification
- Claims Management
- Program understanding and advisement
- Medical terminology knowledge
- Account Reconciliation
- Revenue Cycle Management Processes
- EPIC EMR
Certification
Medical Coder & Biller Certification May 2022 - current
References
References available upon request.
Timeline
Patient Account Representative
Community Health Network
04.2018 - Current
Customer Care Representative III
Anthem Blue Cross and Blue Shield
04.2015 - 04.2018
Transportation Services
Durham School Bus Services
04.2014 - 04.2015
Health Science: Medical Coder And Biller Certification - AMCA -
Purdue University Global
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