Nicole A. VanDeventer
Brighton
Summary
Dynamic Billing Specialist excelling in claims management and customer support excellence. Skilled in account reconciliation, and effective communication. I consistently enhance processes and resolve complex billing issues, ensuring the accuracy of payments and improved patient satisfaction. Committed to fostering positive relationships and driving operational success.
Overview
32
32
years of professional experience
Work History
Billing Specialist (Contracted)
Liaison Billing
Centennial
08.2024 - 04.2025
- Daily new patient account set up in billing system
- Verification of benefits and eligibility
- Daily posting of insurance payments
- Process patient payments
- Claim follow up including claim denials, corrections, and appeals
- Worked incoming mail
- Monthly account review prior to release of patient statements
- Patient chart review when necessary to validate appropriate billing
- Claim scrubbing to ensure release of clean claims
- Communication with insurance companies, providers, facilities, case managers, and patients regarding insurance, account status, and authorizations
Billing Specialist
Red Rock Recovery Center
Lakewood
01.2020 - 08.2024
- New patient set up in billing system
- Charge entry & electronic claim filing (commercial insurance & private pay)
- A/R insurance claim follow up
- Verification of benefits
- Assist Admissions team with financial documents and to secure payment for unique situations
- Generate and send patient financial agreements for signature (electronically)
- Process payments and set up recurring payment arrangements in credit card processing system
- Work with patients and/or the financially responsible party to establish payment arrangements
- Account review for specific inquiries and/or refund requests
- Generate and submit refund requests for approval (insurance and patient)
- Coordinate w/ various departments throughout patient's treatment (Admissions, Utilization Review, Clinical and Leadership)
- New employee training
- Establish new processes & procedures as necessary
- Verbal and written communication to/from patients and responsible parties regarding their accounts
- Educate patients about their insurance coverage (i.e., benefits, deductibles & out-of-pocket amounts)
- Patient collections to include various outreach attempts regarding outstanding balances
- Quarterly strategy and goal setting meetings with management and leadership (CEO and CFO)
Billing Specialist
ABC Medical Billing
Westminster
07.2015 - 01.2020
- New patient set up in billing system
- Charge entry & electronic claim filing (commercial insurance & private pay)
- Payment posting and adjustments based on contracted fee schedules
- Patient billing
- Process payments
- Follow-up on insurance denials to determine proper resolution for payment
- Create and submit appeals with supporting documentation
- Research benefits coverage related to claims processing discrepancies
- Work various reports (claim status, aging, and collections)
- Process records requests from attorneys and third-party payers
- Collaborate with all levels of staff on process improvement strategies
- Special projects as needed
Customer Care Rep III
Wellpoint/Anthem Blue Cross
Denver
07.2009 - 07.2015
- Responded to customer inquiries (providers and members) via phone and written correspondence regarding claim status, provider contracts, and eligibility and benefits
- Documented inquiries received and outcomes or routed to the appropriate department for further review and resolution
- Researched and analyzed data to address operational challenges and customer service issues
- Assisted in increasing member engagement into appropriate programs and benefit offerings (Ex: chronic medical conditions)
- Problem resolution, standard and customized report generation, and coordination of mailings
Relationship Manager
Fiserv Investment Support Services
Denver
01.2007 - 01.2008
Contract/Compensation Specialist
Metlife Group, Inc.
Denver
01.1993 - 01.2006
- Supervisor, Mutual Fund Operations
- Supervisor, Licensing and Registration
Education
Medical Administrative Assistant Certification -
Pima Medical Institute
Denver, CO01.2007
General Education Degree -
Colorado Department of Education
Denver, CO01.1992
Skills
- Customer support excellence
- Interpersonal communication
- Oral and written communication
- Research and problem-solving
- Account reconciliation
- Microsoft Office proficiency
- Claims management
- Leadership capabilities
Timeline
Billing Specialist (Contracted)
Liaison Billing
08.2024 - 04.2025
Billing Specialist
Red Rock Recovery Center
01.2020 - 08.2024
Billing Specialist
ABC Medical Billing
07.2015 - 01.2020
Customer Care Rep III
Wellpoint/Anthem Blue Cross
07.2009 - 07.2015
Relationship Manager
Fiserv Investment Support Services
01.2007 - 01.2008
Contract/Compensation Specialist
Metlife Group, Inc.
01.1993 - 01.2006
Medical Administrative Assistant Certification -
Pima Medical Institute
General Education Degree -
Colorado Department of Education
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