Nicole Jeffries
Fairland
Summary
Dynamic Medical Billing Specialist with extensive experience at IU Health, adept at resolving denied claims and ensuring accurate billing. A quick learner who thrives in high-pressure environments, I excel in complex charge corrections and patient communication, consistently delivering timely results and fostering strong relationships with insurance providers.
Overview
11
11
years of professional experience
Work History
Medical Billing Specialist
IU Health
07.2020 - Current
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Delivered timely and accurate charge corrections.
- Precisely evaluated and verified benefits and eligibility.
- Located errors and promptly refiled rejected claims.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Liaised between patients, insurance companies.
- Started as Commercial specialist for first year. Then was Anthem specialist for the next 4. We are now working with MDwise, MHS, Caresource MCD, Ambetter, Ambetter MHS, Caresource Marketplace and MHS Medicare.
- Trained in Complex Charge Corrections
- Trained in Assurance Edits
Medical Billing Specialist
Major Hospital
01.2018 - 07.2020
- Prepared billing correspondence and maintained database to organize billing information.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Precisely evaluated and verified benefits and eligibility.
- Posted and adjusted payments from insurance companies.
- Evaluated patients' financial status and established appropriate payment plans.
- Located errors and promptly refiled rejected claims.
- Identified and resolved patient billing and payment issues.
- Verified insurance of patients to determine eligibility.
- Collected payments and applied to patient accounts.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Liaised between patients, insurance companies, and billing office.
- Communicated effectively and extensively with other departments to resolve claims issues.
Medical Billing Specialist
St Francis Hospital
05.2015 - 01.2018
- Collected payments and applied to patient accounts.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Filed and updated patient information and medical records.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Liaised between patients, insurance companies, and billing office.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
Revenue Auditor
Indiana Grand Casino
08.2014 - 05.2015
- Investigated discrepancies discovered during auditing process.
- Audited total cash flows and reported revenues daily.
- Trained newly hired employees to promote understanding of company's processes, procedures and deadlines.
- Implemented all auditing information into Excel spreadsheets.
- Maintained compliance with internal control system.
- Scrutinized and recorded revenue for services and products.
- Analyzed data and findings to prepare reports detailing financial information.
Education
CDA(Child Development Associate ) - Early Childhood Education
IUPUC
Columbus, IN01-2010
Skills
- Quick learner
- Eager to acquire new knowledge
- Always willing to help where ever I can
- Experience in most payers
- Thrives in high-pressure environments
Timeline
Medical Billing Specialist
IU Health
07.2020 - Current
Medical Billing Specialist
Major Hospital
01.2018 - 07.2020
Medical Billing Specialist
St Francis Hospital
05.2015 - 01.2018
Revenue Auditor
Indiana Grand Casino
08.2014 - 05.2015
CDA(Child Development Associate ) - Early Childhood Education
IUPUC