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Nicole Wilcox is a Vice President of Payment Integrity at Humana at Humana. She possess expertise in process improvement, medicare, health insurance, managed care, management and 9 more skills.
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Vice President, Payment Integrity OperationsHumana Jun 2024 - PresentLouisville, Kentucky, Us -
Avp, Healthcare Quality Reporting & ImprovementHumana May 2021 - Jun 2024Louisville, Kentucky, Us
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Director Medicare Risk AdjustmentHumana Nov 2019 - May 2021Louisville, Kentucky, UsResponsible for leading staff, strategic planning, budgeting, operations and metrics for multiple teams responsible for Medicare & Medicaid Risk Adjustment Encounter Submissions within the Healthcare Quality Reporting & Improvement Organization at Humana. Responsible for ensuring claims data is accurate, complete and sent timely to meet CMS & Stare requirements driving compliance and revenue. Partner closely across the enterprise with organizations such as Claims, Policy, Contracting, Finance, Data Analytics, Information Technology, Compliance, Provider Education, Retrospective & Prospective Review, etc.
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Director, Claims Cost ManagementHumana Mar 2006 - Nov 2019Louisville, Kentucky, UsDirector in Claims Cost Managment Organization. Held several positions including Leading Internal Clinical Audit Teams consisting of a team of over 300 data analytics experts & process owners, physicians, nurses, coders, pharmacists and teams that managed the day to day internal processes and relationships of greater than 20 vendors on our external audit teams. Led the Clincal Fraud Team. Managed the operational teams involved with innovation, strategy & implementation of new concepts and technology. Led claims and data experts who specialize in research of healthcare trends, claims patterns, systems and regulatory policies to identify fraud, waste and abuse. Responsible for the teams that manage the code edit claims process and the vendors. Managed the vendor dataming team and the relationship owner with those vendors. Worked with onsite and remote onshore associates and offshore associates.
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Senior ConsultantBkd Cpas & Advisors 2003 - 2006Springfield, Missouri, UsProvided Consulting services to healthcare organizations related to billing, coding, staffing, change management, operations, revenue cycle management, etc. Managed staff and Consulting Engagements from start to finish. -
Bone Marrow Transplant RnUniversity Of Kentucky Hospital 1998 - 2003
Nicole Wilcox Skills
Nicole Wilcox Education Details
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University Of KentuckyHealth/Health Care Administration/Management -
Illinois State UniversityNursing
Frequently Asked Questions about Nicole Wilcox
What company does Nicole Wilcox work for?
Nicole Wilcox works for Humana
What is Nicole Wilcox's role at the current company?
Nicole Wilcox's current role is Vice President of Payment Integrity at Humana.
What is Nicole Wilcox's email address?
Nicole Wilcox's email address is nw****@****ana.com
What is Nicole Wilcox's direct phone number?
Nicole Wilcox's direct phone number is 502-580*****
What schools did Nicole Wilcox attend?
Nicole Wilcox attended University Of Kentucky, Illinois State University.
What are some of Nicole Wilcox's interests?
Nicole Wilcox has interest in Electronics, Traveling, Gardening, Reading, Travel, Collecting.
What skills is Nicole Wilcox known for?
Nicole Wilcox has skills like Process Improvement, Medicare, Health Insurance, Managed Care, Management, Project Management, Strategic Planning, Data Analysis, Nursing, Healthcare, Medicaid, Physicians.
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