Nakia M.

Experience

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  Genoa Healthcare

  Oct 2006 - Mar 2008

  AR Specialist/ Collector/ Liasion

  I achieved experience as a specialist for over 55 pharmacies within the mental health system, and succeeded in the following tasks:• Provide training on the Prodigy PMS as well as policy and procedure training to the billing department.• Completing numerous special projects for my manager and supervisor as well as special tasks at the request of the CFO.• A/R, manual and online claims submission, Gross Margin Report analyzing and sending errors for correction, paper billing and HCPCS coding.• Team liaison for all issues and matters in regards to the billing team.• Back up for my supervisor for new pharmacist orientation of billing department policy and procedure. Show less

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  Byram Healthcare

  Mar 2008 - Mar 2009

  Regulatory Biller/ Collector

  At this medical supply company I accomplished the following for 11 payers on a government billing team:• Knowledge of payer operations, contracting, claims processing, reimbursement rates, and other details such as quantity allowable and frequency limits on supplies.• Keeping abreast of payer’s issues and trends to provide accurate and up to date reporting to upper management regarding monthly reimbursement totals.• Perform and monitor full revenue cycle, and any other projects or duties given by my superiors.• Provide individual and group training on updates regarding payers and any new procedures. Show less

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  Southlake clinic

  Mar 2009 - Jun 2011

  Biller/ AR

  In this medical group of both Primary Care and specialist physicians, I have maintained: • Over 70 payers; private and government, that makes up the A/R within the Misys Practice Management System (PMS). I perform general clean-up of this system as our company has implemented a new PMS, NextGen (EHR).• Billing by both electronic claims submission and paper- consisting of primary, secondary and tertiary payers.• Perform and monitor major components of revenue cycle, and problem solving with payer provider relations.• Refer to payer contracts and reimbursement rates for procedures and account research.• Analyze and review medical records, built and maintained Remicade new patient charts.• Insurance verification; request predeterminations and prior authorizations. Show less

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  Valley Medical Center

  Aug 2011 - Jun 2012

  Health Information Management - Medical Records

  • Ensure the medical record is transferred from paper to electronic format by scanning it in the EHR.• Perform quality review the forms of the record for errors, inconsistencies, missing documents, poor source documents and more.• Telephone Release of Information request by other medical entities.• QA of documents imported from the Birth center system.• Paper records collections from all nursing units in facility.

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  Accelecare Wound Centers, Inc.

  Jul 2012 - Nov 2013

  • In charge of QA of Meddata Billing System (MBS).• Physician liaison/ trainer on MBS (40+ physicians).• Manager of Payer Authorizations (HMOs, Med Advantage Plans) of SNFs and Outpatient Centers.• In charge of claims management and timely submission from physicians.• I assure records retrieval / completion to assist with compliance program regulations.• Productivity reporting/ analysis to upper management• “Right hand” to VP of RCM, perform various projects given• Communicator to various Program Directors’ regarding RCM issues of their facilities.• Work closely to Client Services Director of outsourced billing company to assist in management of team RCM operations and functions and troubleshooting.Recently added duties of working with the Director of IT to assist with EHR implementation, liasion to over 200 SNFs regarding utilization of system, maintenance, trouble shooting and overall general duties as assigned including privacy and security responsibility. Show less

  • EHR Implementation Coordinator/ AWP

    Jul 2012 - Nov 2013

  • Revenue Cycle Management Coordinator, Insurance Verification,Compliance, EHR

    Jul 2012 - Sept 2013
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  Maxwell IT

  Aug 2014 - Nov 2014

  Applications Specialist

  Projects, client training, consulting and troubleshooting on EHR and Practice Management applications.

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  PAML

  Feb 2015 - Jun 2016

  Senior Billing Coordinator

  Facilitates the work of the Billing Department and Marketing staff, maintaining client satisfaction while reducing/ preventing missing billing information. Responsible for the education of Paclab, Service Centers, Members and assigned clients, etc; acting as liaison between the organization and the client on billing requirements. Responsible to evaluate preocesses and ensure improvement in the collection of accurate billing information. Troubleshoot both routine and complex billing issues. Receives, resolves, and follows-up with the most complext customer issues that cannot be resolved immediately.I am actively involved in the ORC (Outreach Coordinators and Quality Assurance) monthly meetings with included business partners/members; as well as monthly operations meetings within different PACLAB regions with included partners/affiliates. Show less

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  DaVita Kidney Care

  May 2017 - Apr 2018

  Payroll Systems Specialist

  Performs configuration and setup work to support system functionality of the PeopleNet and Workday applications; functions as subject matter expert for business functionality as it translates to these applications.• Tests updates of PeopleNet and Workday system configuration to production client. • Ensures proper use and access controls to the automated PeopleNet and Workday applications as directed and required by the Payroll Office. • Assists in troubleshooting and resolving technical system failures in the automated PeopleNet and Workday applications.• Develops and maintains reports within the automated PeopleNet and Workday systems in support of payroll functions. • Ensures that the service level agreement between departments and the Payroll Office is maintained.• Designs, communicates and implements regular and recurring training sessions for teammates and supervisors on proper payroll processing procedures in the PeopleNet and Workday applications. Documents training performed and any issues or concerns that may arise from training. • Develops and maintains PeopleNet and Workday application training material and user guides for end-users, approvers and Payroll Office staff.• Assists in the drafting of policies and procedures that will help improve company payroll activities, the internal control environment and PeopleNet and Workday systems processing methods which are more efficient and effective than those currently in use. • Ensures compliance with policy & procedures, employee confidentiality laws, and federal, state and local laws as it pertains to compensation and benefits.• Ability to maintain absolute confidentiality concerning information accessed.• Other duties and responsibilities as assigned. Show less

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  AFFINITY HEALTH CENTER

  Dec 2019 - Feb 2021

  Revenue Cycle Manager

  Manager of Revenue Cycle department and processes.Certification in Community Health / Coding and Billing (ARCHPRO)Execution of leadership in project managementResponsible for company adherence to medical billing compliance policy, billing policy updates, and updating existing/ writing new policy and procedures related to Revenue Cycle.Overseer of medical, dental and behavioral health claims adjudication and follow-up, and payment posting of outsourced billing company.Supervise direct reports on claims scrubbing, deposits and reconciliation of payments.Conduct monthly reviews of staff to enable development in position.Collaborate across departments to promote streamlined billing process.Work with payer contacts regarding updates, HEDIS measures, and billing issuesCredentialing process developmentAuthored telehealth guide for providers during COVID crisis. Providers able to commence telehealth services in under 30 day time constraint.Assist in eClinical Works billing system building and execution.Affiliate of and collaborate closely with SCHPCA increasing FQHC knowledge through networking. Show less

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  Housing Development Corp-Rock Hill

  Mar 2021 - May 2023

  Board Member
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  Genesis Healthcare, Inc.

  Mar 2021 - Jul 2021

  Director Billing Operations
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  ProMed Healthcare, PLLC

  Aug 2021 - Jul 2022

  Chief Administrative Officer (CAO)
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  Meduit | Driving Revenue Cycle Performance

  Jul 2022 - Jan 2023

  Director Of Insurance
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  Northwest Kidney Centers

  Jul 2023 - now

  Revenue Cycle Supervisor