Billing Specialist Medical Biller

Nakicia Walton

773-***-****

**************@*****.***

Certified Professional Coder (CPC) 01435757

Key Skills

Proficient in ICD-10-CM, CPT, and HCPCS billing and coding; Experienced with EHR systems (Epic, Medisoft, Nextgen). Accomplished utilizing insurance portals for claim resubmissions, claim status, eligibility and appeals; Collections; Leadership and training. Knowledgeable in HIPPA Regulations.

Highly organized and detailed oriented; Excellent communication and problem-solving skills. Ability to manage multiple tasks and prioritize effectively.

PROFESSIONAL EXPERIENCE

Above and Beyond Family Recovery Center October 2024-Current

Medical Billing Specialist

•Enforce actions with Impact to ensure that CMHC NPI

is active and billable within HFS Medi for medical services

•Verify insurance for treatment of care

•Bill claims through CollabMD for proper reimbursement

•Follow up with insurance to resubmit claims on denials and corrected claims

•Make sure that CPT and ICD-10 are accurate and correct

Prevea Health/Medix Agency March 2024-April 2024

Payment Posting & AR (Contract)

•Posted Electronic and manual payments

•Pulled checks from Commerce to add to Epic to upload, process and post to patient accounts

•Worked on undistributed payments and zero pay for resolution

•Corrected errors for clearance to post

Carle Hospital/Addison Group July 2022-December 2022

Medical Insurance Representative (Contract)

•Corrected Claim edits for resubmission of claim

•Worked credits for proper posting of payment to accounts

•Followed up with insurance via portals and phone for status of claims

•Made corrections on claims regarding denials for reconsideration

Midwest Anesthesia and Pain Specialist March 2021-April 2022

Medical Biller and Collection Specialist (Contract)

•Followed up on aged accounts for resolution

•Wrote off accounts that were past timely filing

•Contacted insurance companies for status of claims

•Forwarded patient statements for payment of co-pays, co-insurance and deductibles

Boncura/Edward Hospital June 2020 – February 2021

Worker’s Comp & TPL Biller / Collections

•Checked Status of claims and arbitration cases by phone

•Resubmitted claims via paper and fax with medical notes attached

•Wrote off accounts denied for timely filing after investigation

•Created worker’s Comp accounts after insurance verification, adjusted remaining balance after worker’s Comp payment had posted to account

•Contacted Attorney’s regarding cases that were in litigation with upcoming court appearance

Nationwide Credit and Collections November 2019 – May 2020

Medical Biller / Collections

•Checked status on all claims and made the necessary adjustments

•Resubmitted claims that had not been received electronically and paper

•Forwarded accounts to coding and payment work queues for denial and payment resolution

•Generated end-of-day reports for production update

Plano Vision Center June 2018 – November 2019

Medical Biller / Tech

•Submitted medical and vision claims to in-network insurance plans

•Verification of insurance, followed up on insurance denials and patient responsibility

•Pre-screened patients - auto refractor, tonometry, Optec and blood pressure

•Front desk operations - Answered calls, scheduled appointments, checked in patients and pulled charts

Ally Reimbursement Specialist May 2017 – June 2018

Medical Biller / Independent Contractor

•Resubmitted corrected claims to Medicaid and Medicaid IPA’s/managed care

•Timely follow-up on denied claims for accurate reimbursement

•Appealed denials with supporting documentation

•Daily contact with insurance via phone and online portals for status of claim

Loyola University Medical Center May 2016 – April 2017

W/C Biller & Collector (Contract)

•Daily Charge Review to ensure claims were submitted to the appropriate payor

•Submitted claims with proper documentation - Progress notes, ECG, radiology, surgery and Lab reports attached for W/C reimbursement

•Followed up with claims adjuster and insurance company for status of claims with no response

•Updated patient information provided by claims adjuster, hospital notes and insurance company

Wolcott wood and Taylor November 2015 – May 2016

Medical Biller (Contract)

•Submission of electronic claims through Nebo E-Care

•Payment Posting for Medicaid, Medicare, commercial and patient accounts

•Verified patient eligibility

•Followed up with various insurance carriers to recover maximum reimbursement

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