Juah Nimely

BFA, AAS

Columbus, OH *****

adsiap@r.postjobfree.com

+1-614-***-****

An experienced, detailed oriented professional that specializes in Health Information Management Ready to sit for the RHIT exam

Authorized to work in the US for any employer

Work Experience

Medical Records Specialist

CoventBridge Group - Grove City, OH

January 2022 to Present

• Provides clerical and administrative support for the Medical Records review team and Program Integrity

(PI) Departments

• Contribute to improving healthcare delivery by identifying and eliminating fraud, waste and abuse. Apply HIPAA processing procedures for medical records

• Receive, process, and sort incoming medical records from USPS, FedEx, UPS, Fax, CD, flash drives, emails and assigned drives

• Open and correctly route all medical record receipts in accordance with distribution and workload processes

• Process all incoming medical records from healthcare providers and sort beneficiary information

• Scan records, upload CDs and other electronic media into the processing system

• Validate each batch and perform quality checks per medical records procedure, applying keen attention to details

• Electronically Record filing and retrieval

• Prepare and send completed records to offsite storage

• Retrieve records from storage for managers, clinical supervisors, report lists, and as directed by the Medical Records Manager

• Assist with QC processes or other tasks as assigned by the Medical Records Manager

• Fulfill PI Mailing requests, quality check requests to ensure HIPAA compliant handling of Protected Health Information (PHI), and respond with confirmation of mailing to requestor

• Maintain a neat, organized work area

• Attend required education and training programs

• Comply with departmental policies and procedures

• Perform other duties as assigned by the Medical Records Manager Founder-Creative Director

LA BEJAI LLC - Columbus, OH

May 2013 to Present

Established in 2013, specializes in resort loungewear. Debt Collector

TSI - Transworld System, Inc - Columbus, OH

March 2021 to January 2022

• Communicate with consumers by telephone and approved written correspondence to attempt to bring resolution to unpaid medical/non medical accounts through payment arrangements, settlements, or using the pay in full method when the opportunity presents itself

• Provide thorough, efficient, and accurate account updates on computer files for each call made or received.

• Demonstrate effective skip-tracing techniques by locating consumer contact information.

• Counsel delinquent consumers to assist in finding funds to meet their payment obligations.

• Knowledge, understanding, and compliance with all applicable Federal, State, and Local laws and regulations relating to job duties.

• Knowledge, understanding, and compliance with company policies and procedures.

• Maintain knowledge of functional area and company policies and procedures.

• Provide feedback to management concerning possible problems or areas of improvement.

• Perform other duties as assigned by management.

Enrollment Specialist

Automated Health Systems - Columbus, OH

December 2020 to May 2021

• Enroll consumers into Medicaid managed care plans and Mycare Ohio

• Opt in/Out Medicare consumers

• Interview consumers for Medicaid renewal via phone and submit info into caseworker system

• Work multiple county web portals systems to assist consumer and educate them

• Verify benefits via OIES and MITS

• Receive inbound calls

• Practice HIPPA rules and regulations

Account Resolution Specialist

Medassist, A Firstsource Company - Columbus, OH

July 2019 to February 2021

• Work on behalf of Premier & Trihealth coordination of benefits team

• Make accurate notation of payments posted in client systems (Epic) by insurance

• Utilize healthcare insurances web portals for claim status and patient eligibility status

• File claims using all appropriate forms and attachments

• Bill health and auto insurance

• Insurance/Patient follow up when claim is denied

• Correct/Resubmit claims as needed

• Check in Epic if Payment (s) have posted

• Research account denials and file written appeals, when necessary.

• Evaluate the information received from the client to determine which insurance to bill and attain necessary attachments or supporting documentation to send with each claim

• Research account information to determine the necessary attachments or supporting documentation to send with each claim.

• Ensure the integrity of each claim that is billed

• Document in detail all efforts in CUBS system and any other computer system necessary

• Work out of the WIP system in CUBS

• Utilize Dual monitors

Medical Information Management Student Intern

OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER - Columbus, OH June 2016 to July 2019

• Work within the Medical Information Management Department (MIM)

• Submit monthly coding productivity log to the coding managers

• Code outpatient charts using ICD-10-CM and PCS codes

• Utilize various encoders and the EPIC EHR system to code and medical bill patients

• Operate Citrix Receiver to access and manage EPIC's EHR system

• Utilize OnBase to digitize (scan/document image) and index unstructured medical records

• Perform quality assurance in OnBase for indexed medical records, follow by transporting the indexed records to the EHR management system

• Working closely with coding managers and coding quality analyst team on medical claims

• Support in training new hired interns

• Verify Physicians by researching them on google, and searching patient charts in Epic's EHR

• Fax top priority agreements/denial or appeals to insurance companies such as Aetna, UnitedHealthcare HMS, Quitclaim, and Omni Claim, along with requested supportive documents to prove why medical charges are accurate.

• Knowledgeable about Explanation of Benefits (EOB) and Remittance Notification

• Submit requests for missing Physicians to be place in the EHR system

• Check and follow up with emails frequently, using Microsoft outlook

Education

Associate in HEALTH INFORMATION MANAGEMENT TECHNOLOGY Columbus State Community College - Columbus, OH

January 2016 to May 2019

CERTIFICATE in HEALTH INFORMATION MANAGEMENT TECHNICIAN Columbus State Community College - Columbus, OH

January 2016 to December 2016

BACHELOR'S DEGREE in FASHION DESIGN

Columbus College of Art and Design - Columbus, OH

May 2008

High school or equivalent in HIGH SCHOOL STUDIES

Eastmoor Academy - Columbus, OH

August 2001 to June 2004

Skills

• Citrix Receiver, Epic Systems/ EHR System (3 years)

• Encoder/ Optum Enterprise Computer-Assisted Coding, 3M (3 years)

• Cpt Coding, ICD-10-CM, ICD-10-PCS (3 years)

• OnBase Document Management System (3 years)

• OnBase Document Management System (2 years)

• Microso Office & Adobe Creative Suites (10+ years)

• Oral and Wrien Communicaon Skills, Creative Problem Solver, Multitasker, Team Liaison, Active Listener, Detailed Oriented, and Research (10+ years)

• Billing

• Call Center

• Typing

• Problem Solving

• Outlook

• Microsoft Excel

• Word

• Retail Sales

• Communications

• Adobe Illustrator

• Digitization

• CAD

• Graphic Design

• Document Management

• Insurance Verification

• Medical Records

• EMR Systems

• Illustration

• Managed Care

• HIPAA

• Medical Terminology

• Adobe InDesign

• Databases

• Quality Assurance

• Adobe Photoshop

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