Nicole Hurst
Previous Business Office Manager/Medical Biller
Lancaster, KY 40444
***********@*****.***
I have 20 years of experience, including as a Business Office Manager, as a Medicare AR Collections Specialist, as an Authorization Specialist, as a Medical Biller, and as a Patient Accounts Associate in industries including, Accounting, Research, Management, and Related Services, Educational Services and Health Services. I was recently the Business Office Manager at a Long Term Care Facility. At that same facility I was also the HR/Assistant Business Office Manager for six weeks before being promoted to the Business Office Manager position. As HR I did the payroll for over 90 employees, I did weekly orientations where I went over policies and procedures, benefits, FLMA, and retirement. I hold a Diploma degree in General Studies from East Jessamine High School. I am authorized to work in the US for any employer.
Work Experience
Business Office Manager
Landmark of Lancaster - Lancaster, KY
September 2022 to April 2024
I worked as the Business Office Manager at a nursing and rehabilitation facility. I updated the Census, posted insurance payments and resident liabilities daily to accounts, provided assistance in getting residents approved for Long Term Care Medicaid. I verified insurance for Long Term Care and therapy for all of the residents. I did withdrawals and deposits as well as balanced the resident’s Trust checking accounts, and handled other manager duties.
Insurance Authorization Specialist
Kenney Orthopedics - Nicholasville, KY
October 2019 to August 2022
I verify patient’s insurance participation and identified any policy exclusions of orthotics & prosthetics. I gathered documentation for medical necessity required for pre-certifications / pre-authorizations.I communicated effectively with all Kenney Orthopedic offices and staff. I obtained pre-certification / pre-authorizations and filing appeals on denied pre-certification / pre-authorizations. I promptly verify receipt of any submitted requests for pre-certifications / pre-authorizations. I communicated effectively with all payers to receive accurate patient policy information. I utilized all available payer websites to track the progress of pre-certifications pre-authorizations. I did follow up with submitted requests of pre-certifications / pre-authorizations in a timely manner and other duties as assigned.
AR Follow Up Rep
Kentucky Medical Services Foundation - Lexington, KY
October 2016 to January 2019
I worked aged and denied claims for Commercial insurances. I sent appeals and reconsiderations to try
and receive payments that were owed. I perform routine clerical duties and applied my knowledge of all of the systems used to perform my duties.
ROI Specialist
Medicopy Services, Inc - Lexington, KY
September 2015 to March 2016
I copied medical records and maintained confidentiality of all medical records information. I delivered and
retrieved medical records upon request. I responded to release-of-information requests. I obtained correct
authorizations for record requests. I performed routine clerical duties. With my previous knowledge of medical terminology I was able to apply that when gathering those records by looking for request needing, certain ICD-9-CM, CPT, HCPCS codes. Because of this I exhibited strong attention to detail.
Business Office Rep
Aerotek
August 2014 to October 2014
I worked aged accounts on Medicare and Commercial insurances from a spread sheet. I worked
denied EOB's from Medicare and wrote up appeals to Medicare as well as making copies for reconsideration's and redeterminations to Medicare.
Medicare AR Collections Specialist
Conifer Health Solutions
May 2013 to September 2013
I worked aged accounts from a work list, a spread sheet, or an email. I followed up on zero pay accounts
to find out why Medicare didn't pay whether it is due to the COB information on the CWF, non-covered
charges, or MSP issues. I contacted the patient if they needed to update their COB information with
Medicare. I corrected account issues and requested the Medicare claims to be re-billed, or bill the patient
in certain situations. I placed accounts on a spreadsheet for either the medical records department, the
charge audit department, or the modifier department. I viewed the ADR list in the Medicare system to
know what information is required for payment. I worked the credit balance report and corrected Medicare
adjustments so the account would have the correct balance.
Patient Accounts Associate
Methodist Medical Center of Illinois - Peoria, IL
January 2011 to November 2012
I billed medical claims using UB04 and HCFA 1500 via paper and electronic. I scanned EOB's into an electronic
filing system. I requested medical records for appeals and claims. I followed up on aged claims to prevent
untimely filing. I answered patient phone calls. I also put together list of aged claims and re-filed or wrote off
amounts to correct denials.
CSA Liaison
Medical Reimbursements of America(MRA)
May 2010 to January 2011
I expedited the placement of medical claims by means of hard copy documents or system assignment
through an insurance plan code, financial class, and/or a vendor agency. I assisted hospital personnel
with questions about MRA activity including request or outstanding issues. I forwarded all incoming
correspondence to MRA from attorneys and/or insurance carriers. I closed accounts in the hospita’sl system
when remaining balances are recoded in accordance with hospital collection policies. I provided UB04's,
HCFA 1500's, itemized statements, face sheets, and account notes to MRA as well as other information
needed, i.e., medical records, EOB's, etc.
Billing Associate
Central Kentucky Radiology, Lexington
August 2008 to December 2009
I worked denied claims for Kentucky Medicaid and all commercial insurances. I re-filed corrected claims.
I faxed medical records through fax and email. I scanned medical records and attached them to the
patient's chart. I also answered patient phone calls.
Billing Associate
Kentucky Diabetes Endocrinology Center
September 2004 to June 2008
I coded HFCA 1500 claims and submitted them to the insurance companies. I posted insurance and patient payments to the patient’s accounts. I worked and re-filed
corrected claims. I wrote appeals and submitted with documentation for denied claims to the insurance companies. I faxed medical record requests. I received medical records and EOB’s that I filed in the patient’s charts.
Education
Diploma in General Studies
East Jessamine High School
1999
Skills
• CLERICAL (20+ years)
• CPT (20 years)
• ICD-10 (10+ years)
• ICD-9 (20 years)
• FILE (20 years)
• Accounts Receivable (20 years)
• AR (20 years)
• Medical Billing (20 years)
• Receivables (20 years)
• Accounts Payable (20 years)
• Cash Application (20 years)
• Medical Records (20 years)
• EMR Systems (20 years)
• Hospital Experience (10+ years)
• Insurance Verification (20 years)
• Medical Scheduling (20 years)
• Medical Office Experience (20 years)
• Medical Receptionist (20 years)
• Data Entry (20+ years)
• Medical Terminology (20 years)
• Phone Etiquette (20+ years)
• Microsoft Outlook (20+ years)
• Medicare (20 years)
• Communication skills (20+ years)
• 10 key typing (20+ years)
• Basic math (20+ years)
• Time management (20+ years)
• Organizational skills (20+ years)
• HIPAA (20+ years)
• Customer service (20+ years)
• Microsoft Excel (20+ years)
• Microsoft Office (20+ years)
Certifications and Licenses
KY Driver's License
November 2021 to November 2025
Additional Information
Skills
Adr, Assets Recovery, Attention To Detail, Balance, Clerical, CPT, Credit, Email, English, Fax, File
Management, Financial, ICD-9, ICD-10, Insurance, Lotus Notes, Personnel, Policy Analysis, Programming,
Spreadsheets, Telephone Skills
Languages
English