Nakia Richardson
Virginia Hospital Center
White Plains
11
years of professional experience
Seeking Care Representative I role with 8 years of experience in billing activities, client communication, data entry, customer service, data comparison & relationship building. Proven expertise in research missing information and billing data entry, with a strong background in insurance verification and patient service. Detail-oriented and proficient in multi-tasking, ensuring accurate and efficient billing processes.
Work History
Insurance Verifications
4 Years 5 Months- Conducts verification and obtains authorization for scheduled services through coordinated email requests, ensuring pre-authorization requirements are met.
- Completes and codes a minimum of 30 encounters daily and 150 weekly in EPIC, maintaining accurate documentation and updates in the system.
- Confirms third-party billing information, including coverage certification, policy details, and claim addresses, making necessary corrections to ensure error-free claims.
- Verifies and updates patient registration information, ensuring all patient, guarantor, and insurance plan details are accurately reflected in EPIC.
- Email & Chat Support for Patient Portals
Clinical Operations- PRN
1 Year 3 Months- Responded to inquiries related to medical cases via telephone and written correspondence, ensuring thorough documentation for accurate tracking and analysis.
- Coordinated with various departments to handle customer requests efficiently, consistently meeting or exceeding quality and productivity standards to enhance customer satisfaction.
- Managed complex customer interactions independently and updated insurance data accurately, adhering to confidentiality and procedural guidelines.
- Chat & Email Support for patients and their portals
PSR Team Lead
1 Year 3 Months- Coached team members to achieve goals and develop essential skills, while enhancing team strengths and addressing weaknesses.
- Organized team initiatives, resolved conflicts, and managed team scheduling to ensure daily task completion and progress evaluation.
- Chat support for patient portals
Patient Service Representative III
6 Months- Facilitated efficient patient flow by scheduling appointments and making reminder calls, while also managing patient check-in processes including verifying insurance coverage and collecting co-payments.
- Maintained accurate and up-to-date patient records, processed credit card payments, and balanced daily cash deposits, ensuring financial integrity and compliance with departmental policies.
- Email & Chat Support for Patient Portals
- Assisted patients by screening for financial assistance eligibility, preparing necessary documentation, and responding to queries, contributing to improved patient satisfaction and streamlined administrative processes.
Surgical Poster
6 Months- Coordinated and managed the preparation and delivery of patient medical charts and authorizations for surgical procedures, ensuring compliance with CPT, ICD-10, and modifier requirements.
- Conducted insurance verifications and prior authorizations, facilitating seamless communication with physicians to optimize surgical scheduling and patient care.
Patient Services Representative II
11 Months- Conducted insurance verification and managed patient check-in/check-out processes, ensuring accuracy in payment posting and collection of copays.
- Coordinated scheduling for psychologists and psychiatrists, while handling referrals and authorizations, utilizing CRM, CPS, SAP, and Value Options systems to streamline operations.
Senior Customer Care Rep III
8 Months- Utilized medical terminology knowledge and proficiency in ICD-9 and CPT codes to effectively address and resolve inquiries in a high-volume call center environment, ensuring a professional and empathetic response to all callers.
- Maintained confidentiality and handled sensitive information with integrity, while leveraging strong interpersonal and communication skills to deliver exceptional service and enhance member and provider satisfaction.
Education
Bachelor - Healthcare Management
Skills
Task Oriented
Detail Oriented
Excellent Multi-Tasking
Proficient Communication
Customer Relations
Excellent Verbal and Written Skills
Reliable
Self-Motivator
Positive Outlook on Situations
Proficient in WordPerfect
MS Word
Typing Speed: 40wpm
Excel
PowerPoint
Lotus
Knowledge of Sale Force & SAP
Administrative Experience
Facets
Pega
EBiz
Ebill
Ge/Idx
Epic
Nexgen
Artworks
Navinet
Availity
Medicare & Medicaid System
Worked With Several Different CRM Systems
Organized
Excellent Listening Skills
Fast Learner
Excellent Leadership Skills
Excellent Customer Service Skills
Sales of Print & Online Advertising for Verizon Yellow Pages for 2 Yrs
Strong Leadership Abilities
5+ Yrs. Of Inside Sales Rep. Experience
Call Center
Customer Service
Attention To Detail
Time Management
Problem Solving
10 Key Skills
Alpha-numeric Data Entry
Chat & Email Support
Customer support
Goal-oriented mindset
Customer relations
Data entry proficiency
Client relationship building
Client services
Records management
Paperwork processing
Client service
Timeline
Insurance Verifications
Virginia Hospital Center
03.2022 - CurrentRead More
Clinical Operations- PRN
Children’s National Medical Center
01.2021 - 04.2022Read More
PSR Team Lead
Shady Grove
06.2020 - 09.2021Read More
Patient Service Representative III
Sinai Hospital
12.2019 - 06.2020Read More
Surgical Poster
Medstar Union Memorial Hospital PACC (Contractual)
06.2017 - 12.2017Read More
Patient Services Representative II
Chase Brexton Healthcare
01.2016 - 12.2016Read More
Senior Customer Care Rep III
Johns Hopkins Healthcare
06.2015 - 02.2016Read More
Columbia Southern University
Bachelor from Healthcare Management
Read More