Vironica Niles

• Communicated with clients and service providers to provide updates on work progress.
• Resolved customer complaints and issues to drive satisfaction and loyalty.
• Coordinated and monitored service activities to confirm work met all requirements.
• Assessed customer needs and developed solutions to meet needs.
• Maintained accurate records and full compliance with government regulations and agency guidelines.
• Initiated contact with appropriate service providers to request referrals and followed up to confirm appointments.
• Educated staff on organizational mission and goals to help employees achieve success.
• Evaluated staff performance and provided coaching to address inefficiencies.

• Provided exceptional customer service to patients, answering questions and addressing concerns.
• Verified insurance eligibility and coverage for patients.
• Entered patient demographic and insurance data into electronic medical record system.
• Filed and maintained patient records in accordance with HIPAA regulations.
• Managed patient registration process, confirming data accuracy and completeness.
• Built and maintained positive working relationships with patients and staff.
• Took copayments and compiled daily financial records.
• Assisted patients in filling out check-in and payment paperwork.
• Applied administrative knowledge and courtesy to explain procedures and services to patients.
• Used IDX and Rev Cycle to schedule appointments.
• Balanced deposits and credit card payments each day.
• Resolved billing inquiries and disputes in timely fashion.
• Answered incoming calls, scheduled appointments and filed medical records.
• Verified patient insurance eligibility and entered patient information into system.
• Provided excellent customer service to patients and medical staff.
• Greeted and assisted patients with check-in procedures.
• Processed payments using cash and credit cards, maintaining accurate records of transactions.
• Trained new staff on filing, phone etiquette and other office duties.
• Facilitated communication between patients and various departments and staff.
• Responded to inquiries by directing calls to appropriate personnel.
• Compiled and maintained patient medical records to keep information complete and up-to-date.

• Answered multi-line phone system, routing calls, delivering messages to staff.
• Restocked supplies and placed purchase orders to maintain adequate stock levels.
• Executed record filing system to improve document organization and management. Develop xray films and scan them to the radiologist.
• Scheduled office meetings and client appointments for staff teams.
• Sent billing to nursing homes.
• Did xrays at city morgue.
• Call nursing back with reports.

• Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
• Navigated multiple computer systems and applications to find information.
• Answering multiple phone lines.
• Scheduling appointments.
• Fitting of Post mastectomy products
• Communicated with clients regarding account services, statements, and balances.
• Logged call information and solutions provided into internal database.
• Maintained and managed customer files and databases.
• Type up medical necessity forms for prior authorization.
• Coding and billing durbable medical equipment.
• Once month going to medicaid to follow up on prior authorizations and claims.

Processes the insurance component of a patient's obligation using the third-party claims processing and payment rules. Bills claims appropriately.

Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines and no response claims to resolve outstanding accounts.

Analyzes credit balances on patient accounts and resolves. Responds to refund request letters from insurance carriers.

Identifies process improvement opportunities and participates in improvement plans.

Works on special projects as needed.

May review the work of others.

Performs other duties as assigned.