Medical Biller Process Improvement
Resume:
Juah Nimely
Process-driven, himt specialist with experience in revenue cycle management
sector. Able to take initiative, lead collaborative projects, work seamlessly with colleagues and a passion for formulating process improvement plans in which create results.
Reynoldburg, OH 43068
****.*******@*****.***
EXPERIENCE
Viaquest Psychiatric & Behavioral Solution, Dublin, OH
(remote) — Medical Biller
March 2024 - present
● Responsible for all aspects of billing including, but not limited to collecting necessary billing documentation, preparation, posting payments
● Responsible for collection of all client company accounts, proactive research of troubled client accounts and communication with operations and third-party partners regarding client accounts
● Responsible for filing paper correspondence
● Follow up daily on billing practices for assigned payers and assist team members as needed
● Complete other duties as assigned by management
● Identify and meet deadlines
Healthcare Medical Billing Consultant, Columbus, OH — October 2023 - March 2024
● Trained clients how to bill claims; Identified delinquent accounts, patterns and how to collect payment
Ohio Gastroenterology Group, Reynoldsburg OH — Lead Pro Fee Medical Biller (office visits)
January 2023 - October 2023
● In charge of 6 offices, I work closely with 38 providers to provide clinical documentation improvement education. I performed daily audits of progress notes and medical claims to target common documentation and coding errors that can affect revenue
● Created process improvement templates to effectively communicate/educate providers
● Contributed to generating an estimate revenue of $836,888 monthly, under 6 months of employment by billing 2677 office/televisit medical claims
● Cleared 7 months of backlog within a week
● Set personal daily goal of maintaining claims deficiencies rate at 0%
● Created no show rescheduling fee claims and communicate daily with the scheduling department
SKILLS
Medical Billing, Coding,
Accounts Receivable,
Insurance Verification,
Insurance Follow up, Appeals
SOFTWARES
OPTUM ICD 10 CM, CPT,
HCPCS
EPIC utilized for coding, Re-
billing, verifying insurance
eligibility and reviewing
claims remittance
ECW used to create, code,
query, verifying insurance
eligibility, payment posting
and billing medical claims
Microsoft Excel Spreadsheet
utilized to track productivity
and document payment
Advance Track validate/QA
medical records
OnBase validate/QA medical
records
LANGUAGES
English
● Delegated patient eligibility check and Insurance calls
(coordination of benefits) as needed to speed up the billing process, providing a team work atmosphere and a chance to educate if needed
Coventbridge Group, Grove City — Fraud & Waste Medical Records Technician
January 2022 - January 2023
● Developed an electronic QA process improvement plan which accelerated team productivity
● Completed two cases a day through QA & Validating over 5,000 pages of medical records a day.
● Collaborated with PI and Medical Review team to resolve case issues
Transworld Systems, Columbus OH — Medical Debt
Collector
March 2021 - January 2022
● Met monthly assigned collection goals and auditors satisfaction ratings
● Formulated affordable payment plans with 85% of patients, leading into full account payments on high dollar accounts
● Enforced HIPAA rules and regulations to protect patients confidential information
Medassist A Firstsource Company, Columbus OH — Account Resolution Specialist
July 2019 - February 2021
● As a coordination of benefits specialist, I billed hospital facility claims for Trihealth and Premier on the coordination of benefits teams
● Provided daily communication with insurance companies to obtain claim status, payments and contacting patients to either update their COB, obtain insurance info or update their demographics
● Verified patient’s insurance eligibility in Epic or insurance web portals
The Ohio State University Wexner Medical Center,
Columbus OH — Medical Information Management Student Intern
June 2016 - July 2019
● Utilized ICD-10 CM, ICD-10 PCS and HCPCS Level l & ll to engage with and assist both inpatient and outpatient specialists at OSUWMC
● Coded high volume monthly bill drops
● Scanned and validated medical records for epic
● Created training SOP for scanning and validating records in Onbase
EDUCATION
Columbus State Community College, Columbus OH —
Associate of Science
January 2016 - May 2019
Health Information Management Technology
Columbus College of Art and Design, Columbus OH — BFA August 2004 - May 2008
Fashion Design
Eastmoor Academy, Columbus OH —High School Diploma August 2000 - May 2004
High School Studies
CERTIFICATIONS/CREDENTIALS
Columbus State Community College, Columbus OH —
HIMT Certificate
January 2016 - December 2016
● RHIT (in process)
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