Nicole Shields Email & Phone Number

Charlotte, North Carolina, United States

Charlotte, North Carolina, United States

I support and mentor groundbreaking individuals as they find their balance in life and spirituality.

Work From Home

Update customer files and databases.Consult with customers by telephone or in person to provide information, take orders, answer questions and handle complaints.Investigate and follow up on customer problems.Document outcomes and steps taken.

Fort Mill, South Carolina

• Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.• Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.• Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payers. Researches and resolves any electronic claim denials.• Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods. • Resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. • Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers. • Reports any reimbursement trends/delays to supervisor • Processes any necessary insurance/patient correspondence. • Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians. • Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process. • Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation. • Communicates effectively to payers and/or claims clearinghouse to ensure accurate and timely electronically filed claims. • Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action. • Typically receives little instruction on day-to-day work, general instructions on new assignments.• Performs related duties as assigned.

Charlotte, North Carolina Area

• Prepares, reviews, and processes new account paperwork for establishing complex standard, fee based, and advisory brokerage accounts• Obtains missing information or required documentation from representatives.• Monitors and takes action on work received through assigned queues. • Performs requested account maintenance, such as address updates, beneficiary changes, representative changes, etc. • Assists fellow associates with escalated issues and problems.

Charlotte, North Carolina Area

• Utilized multiple computer systems simultaneously to log and track calls, as well as customer issues. • Handled customers concerns accurately and effectively.• Completed first issue resolution while implementing strict compliance guidelines. • Consulted clients on financial account management.

• Managed setting and confirming appointments for clients.• Engaged with clients to set-up OnStar service.• Maintained rotating shifts to cover business needs.• Trained fellow representatives to ensure proper customer satisfaction.

Fort Mill, South Carolina

 Provided recommendations to management for Customer relations improvement. Ensured that information was obtained, documented in detail and available for access for quality and review Performed outbound communications to appropriately interface with insurance administrators, physician’s offices, patients and internal personnel. Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers. Reports any reimbursement trends/delays to supervisor (e.g. billing denials, claim denials, pricing errors, payments, etc.). Processes any necessary insurance/patient correspondence. Provides all necessary documentation required to expedite payments.This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.

Charlotte, North Carolina

 Used fraud detection software and analyzed data as a part of the investigation process. Investigated credit card fraud or abuse of cardholder information. Established and maintained working relationships with all appropriate law enforcement and regulatory personnel. Conducted comprehensive interviews with providers, subscribers and witnesses to obtain information on ongoing investigations

Charlotte, North Carolina

 Conducted administrative services for multiple clients. Performed benefit calculations, consulted with participants on pension plan provisions and payment elections, coordinated monthly pension payments with trustees and maintained client databases. Utilized active listening skills, strong organizational skills and used empathy to address clients’ needs on a daily bases. Preformed new employee orientation and maintained confidentiality of all information provided. Used knowledge of HIPAA,ERISA,COBRA, Section 125 and DOL regulations, defined benefits and health and welfare benefits Learned, referenced and applied product knowledge information. Directed calls to appropriate individuals and departments Asked open ended questions to asses customer needsEDU