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Nicole Horton

Expertise In: Orthopedic

Name : Nicole Horton
Experience : 8
Specialty : Orthopedic
Location : Surprise,AZ
Description :

 Nicole Horton has eleven years of medical billing and coding experience. She seeks a role where she can showcase all her skills.
 
Skills:

  • Lytec
  • Centricity
  • MacPractice
  • MPV – Contract Management

Experience:

  • Duties Included: answering multiple telephone lines and transferring the calls to the designated employees, making patient appointments for both the general surgeons and the vascular surgeons, coordinating scheduling tests and procedures with various hospitals, verifying insurance, data entry for new patient accounts, work check out for the vascular team to collect co-pays / deductibles / coinsurance for office visit or procedures that may have been provided in the office, collecting payments on patient accounts for balances either at appointments or by phone, coding patient office visit(s) and surgery charges based on doctor’s documentation, entering all of the office visit charge slips for all 7 surgeons responsible for daily office charges and surgery charges being entered, auditing the surgery schedules to verify that all surgeries had been billed to the insurance company or to the patient, electronically sending claims to insurances in a timely manner, work account receivables / payables, sending statements and financial aid letters to those that had surgery with no insurance on emergency basis, auditing patient accounts, appealing claims / redetermination requests with insurances, problem solving rejected/invalid claims, follow up on insurances regarding outstanding claims, responsible for the insurance aging reports, appealing claims to insurances, corresponding with worker’s compensation claims, correspondence with the patient’s regarding issues with their insurance, responsible for paging the doctor needed by the facility when they contact the office, building future and maintaining current relationships between office and Baylor Medical Center at Garland, Baylor Medical Center at Plano, Doctor’s Hospital, Lake Pointe Medical Center, Richardson Regional, Presbyterian Hospital of Rockwall, and local surgery centers, respond to email - patients, peers, management, helping transition the office to electronic medical records, helping the office remain HIPPA compliant, experience with all major insurances primary and secondary, experience with Medicare and Medicaid.
  • Duties Included: answering multiple telephone lines and transferring the calls to the designated employees, making patient appointments, verifying insurance, data entry for new patient accounts, taking electronic phone notes from patients and routing to corresponding nurse / doctor, checkout patients, work account receivables / payables for all 4 doctors, enter charge slips, enter patient / insurance payments, faxing / copying needed documents, auditing patient accounts, coding patient office visit based on doctor documentation, appealing claim denials with insurances, filing all claims electronically, problem solving rejected claims, follow up on insurances regarding outstanding claims, with insurance aging and patient aging reports, working collection accounts, setting up meetings with drug representatives, training new employees, building future and maintaining current relationships between office and the Lakepointe Medical Center and Presbyterian Hospital of Rockwall,  helping transition office to electronic medical records, helping office to become more HIPPA compliant
  • Duties Included:  answering multiple telephone lines and transferring the calls to the designated employees, making patient appointments, verifying insurance, data entry for new patient accounts, checkout patients, work account receivables / payables for 3 doctors, enter super bill charges, obtain pre-certifications for surgical procedures for both office and hospital, enter insurance / patient payments, obtain prescription authorizations, handle online prescriptions (denial / approval), schedule surgeries or hospital procedures, accessing surgery reports online, faxing and copying needed documents, auditing patient claims, coding patient claims, appealing claim denials with insurances, filing claims electronically online, working rejected claims, sending statements online electronically monthly, follow up with insurances regarding outstanding claims, work insurance aging and patient aging reports, handling patient billing problems with the lab, working collections - patients / insurance, checking in vendors with medical supplies, setting up meetings with drug representatives, sort and filing mail to the designated person, handling the vendor accounts, preparing nightly deposit, training new employees, assisting nurse with room prep, triage medical problem phone calls from patients, keeping quick books up to date, filing insurance / Medicaid claims online when possible or electronically, building future and maintaining current relationships between office and the Baylor Women’s Center,  helping office to become more HIPPA compliant, experience with all major insurances primary and secondary, experience with Medicare and Medicaid.

Certifications:

  • Medical Insurance Claims Billing & Coding Certificate, Richland College
  • Diploma, Garland High School
  • Medical Law and Ethics, Richland College
  • Medical Terminology I, Richland College
  • Medical Terminology II, Richland College
  • Medical Office Procedures, Richland College
  • Human Disease & Path physiology, Richland College
  • Medical Insurance & Coding (ICD-9 & CPT), Richland College
  • Computers in Healthcare, Richland College
  • Advanced Coding (ICD-9 & CPT), Richland College
  • MPV Certification, Practice Management Software Online
  • CPR Certification, CPR Institute Inc.
  • Youth Protection Certification, Boy Scouts of America
  • Safe Swim Defense Certification, Boy Scouts of America