Nicole L Scott

773-***-****

ad2nio@r.postjobfree.com

Objective

Dedicated and technically skilled business professional with a versatile support service skillset developed through experience as an interim admitting supervisor, lead patient service associate, patient access representative, and business office associate.

Assist with resolving challenges with innovative solutions and process improvements to increase efficiency and customer satisfaction.

Offering experienced computer skills in MS Office Suite (Word, Excel,) Epic, Salesforce, and other applications/systems

Skills:

Multi-line phone systems

Insurance verification process

Customer Service Excellence

Excellent communication skills

Medical Terminology

Reimbursement analysis

Maintain medical records.

Team Oriented

Ability to Multitask

Medical Terminology

Dispute Resolution

Prior Authorization

Multiline Phone Use

Typing (45 WPM)

Data Entry Specialist

Printer, Copier, Fax

Microsoft Office Suite

Handled high volume calls

Education:

Associate degree - Ashford University-Chandler, AZ

Certification:

Certified Application Counselor – Marketplace

Assist consumers in navigating the health insurance system to find the most affordable coverage that meets the consumer’s needs and understanding new programs, taking advantage of consumer protections.

Professional Experience:

Excelgens- AbbVie- Illinois April 2023 to Present

Patient Assistance Counselor I - Remote

Investigate patient’s insurance coverage when applicable by conducting payer calls, utilizing insurance intel and web tools.

Review financial documents for completion to assist with assessing program eligibility.

Provide subject matter expertise on medical and prescription insurance coverage, medication prior authorization process, and alternate financial assistance opportunities for patients.

Apply AbbVie Patient Assistance Program standards to each case to render the appropriate decision of approval or denial into the program.

Conduct the outreach process to obtain missing information that is required to complete an application assessment.

Ensure all patient cases are documented in the Customer Relationship Management System (CRM) in accordance with all business rules and policies.

Receive and handle incoming calls from patients and HCPs.

Complete renewal and year end recertification’s process as determined by the AbbVie Patient Assistance Program

Readily assists on special project within job scope to improve reimbursement optimization when requested by management.

Advocate Aurora Health- Illinois Jan 2020 to Mar 2023

Patient Financial Advocate - Remote

Identified available assistance programs and coordinates with patient to complete paperwork and applications for any potential coverage(s).

Interviewed uninsured patient to assess for qualifying financial needs.

Communicates patient liability clearly and accurately while adequately explaining concepts such as deductibles, coinsurance, and/or copayments and how they may affect the cost of care.

Continues follow-up efforts to obtain funding source for patient’s health services.

Works in conjunction with state social worker and/or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patient’s eligibility.

Provide patients with personalized estimate of their financial responsibility based on their insurance coverage prior to service.

Request upfront payment toward self-pay mounts, including estimated out of pocket costs and outstanding previous balances.

Establishes payment arrangements in advance of scheduled services when applicable, communicating due dates and the amount of each installment.

Advocate Medical Group - Illinois June 2018 to Jan 2020

Patient Financial Counselor

Reviews the financial status of patient scheduled for service and determine which customers would benefit from financial counseling and decide with patient Service Representative Staff on patient prior to the time of service of the scheduled appointment date.

Works directly with Physicians and patient service representative staff to answer questions,

Provide technical information, and/or resolve any business operations issues in-order to ensure effective and efficient flow of charges and information from the assigned Health Center in the fee-for-service revenue cycle.

Communicates and coordinates with Center management on any coaching provided to Center Operations Associates on effective financial operations.

Assists patient Service Representative Staff in resolving all patient invoices/encounters returned to the Center for missing, incomplete, or incorrect billing information including patient, insurance, service and/or coding information.

Loyola University Health Systems April 2016 to June 2018

Precertification Specialist

Verify insurance for accuracy using Master Payor listing for billing.

Obtained and managed prior authorization requests for inpatient and outpatient services.

Contact self-pay patients regarding financial responsibility to set up payment arrangements for services.

Answered incoming calls from patients, physicians, insurance companies and clinical staff to manage prior authorization requests.

Creates appropriate referrals to attach to pending visits.

Review and analyze clinical data needed to obtain authorization for medical services.

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