Nicole Jones Email and Phone Number

Managed credentialing and benefit verification processes, ensuring provider fileswere compliant with regulatory requirements.• Oversaw onboarding processes, including background checks, documentation,and training for new clinicians, maintaining strict adherence to HIPAA standards.• Conducted regular audits of provider files for accuracy and completeness,ensuring compliance with federal and insurance regulations

Communicated and coordinated patient care for City Hospital of White Rock Lakeand AMITA hospital systems.• Trained and supervised coordinators on procedures, policies, and confidentialitylaws, ensuring adherence to HIPAA regulations.• Assisted hospital patients with scheduling, data entry and record keeping, utilizedNextGen for recording data with billing/coding, and understanding program benefits.Collaborated with providers and insurance payers to resolve benefit-relatedissues, ensuring smooth patient care processes and timely pre-authorizations.• Utilized NextGen to maintain accurate billing and coding data, supportingseamless patient referrals and claims submissions.

Provided Medicare plan and prescription benefit support, verifying eligibility andresolving billing inquiries efficiently.• Ensured compliance with HIPAA during benefit verifications and assisted withprior authorizations and claim submissions for Medicare patients.• Documented patient referrals and resolved outstanding balances, contributing tothe efficiency of the billing process.