Nisha Wright Email & Phone Number

Under minimal supervision I ensure customer satisfaction by providing timely and accurate information, by making appropriate decisions regarding claims, patient records, and provider data, and/or financial determinations. While following federal and state regulations I ensure confidentiality and discretion with handling sensitive information. In addition, I provide knowledge of supported medical plans, eligibility requirements, coverage requirements, enrollment issues, assistance with appointment scheduling, medical and pharmacy coding in order to navigate and resolve claims adjudications, assist with authorizations, assist patients with premium billing info, and assist healthcare providers with financial inquiries and concerns. Maintain productive working relationships with employees, retirees and active duty family members and providers. Communicate with third party collections agencies. Possess strong interpersonal skills on a consistent day to day basis.

In this position I facilitated account billing in accordance with payer guidelines. In addition, I audited invoices, compliance issues and government requests. I also performed a wide range of leadership task such as assisting with information gathering and analysis for internal risk management and audit processes, resolving account discrepancies and prepare adjustments and refunds for approvals as necessary. Assisted review nurse by auditing medical documents to ensure government policies were being followed to ensure approvals of medical procedures. Identify inconsistencies and inaccuracies in the physician's report. Contact physicians to inform and or request additional information requested by review nurse/ clinic staff. Log medical record in EMR system etc.

My responsibilities included processing up to 55 incoming calls daily within a high volume call center, authorizing clinical procedures, verifying vision insurance benefits/ eligibility and assisting members and providers with claims, statuses and other inquiries.

As a customer service rep my responsibilities included but were not limited to, answering incoming calls daily, assisting members with eligibility and benefits, assisting providers with claim payments, retractions and authorizations for eye wear & additional vision care services etc.

Inbound/Outbound calls in a high-volume call center, authorizing clinical procedures, verifying vision insurance benefits/ eligibility and assisting members and providers with claims status and other inquiries.

answering inbound/outbound calls in a high volume call center, scheduling appointments and setting up transportation for elderly patients, assisting providers with medical/pharmacy claims, authorizations, eligibility and assisting leadership with clerical tasks/correspondences as needed. I was recognized by management for achieving the highest intake of calls on a weekly basis and was rewarded gift certificates.

My responsibilities included assisting providers/clients with insurance eligibility, verifying medical and dental insurance benefits and processing workman's compensation, medical and dental claims.

My responsibilities as a temporary employee through an agency included auditing employee/dependents to determine eligibility status and scanning confidential documents into the data base system.

My responsibilities as a temporary employee included operating a multi-line phone system to address issues and inquiries from commercial and residential clients, providing customer support to schedule large and additional waste pick-ups and handling any discrepancies within my jurisdiction and requesting aid as needed.

While temporarily employed, my responsibilities included examining medical claims for accurate payments, making any needed adjustments and completing at least 350 accounts per day for Medicare part A & B claims.

My responsibilities included serving as the face of the company by greeting and screening visitors/clients, operating a multi-line phone system to transfer incoming calls to appropriate personnel, referring routine matters to appropriate parties for action and follow up, assisting management with special projects as needed and performing conventional administrative duties such as sorting and distributing mail, faxing, organizing and maintaining confidential documents, scheduling appointments and maintaining purchase orders for necessary office supplies.

My responsibilities as a temporary employee included answering questions regarding benefits eligibility, following up with providers/members about billing/payment concerns, analyzing benefit data for accuracy, examining medical claims and processing 60 inbound/outbound calls combined.

Associate Of Applied Science, Health Information/Medical Records Technology/Technician

Education record

Education record

Medical/Clinical Assistant