Nikkisha Jacobs
@nkjacobs
I resolve complex healthcare claims, denials, authorizations, and reimbursement barriers across payer types.
United StatesWhat I'm looking for
I've managed complex revenue-cycle workflows at Kaiser Permanente’s Central Patient Financial Office, resolving insurance verification, authorization, claim-dispute, denial, reimbursement, and patient financial-service issues in a remote environment.
I investigate payer requirements, medical-necessity criteria, clinical documentation, and reimbursement discrepancies to identify root causes and reduce revenue leakage. I support Medicare, Medicaid/Medi-Cal, commercial, Workers' Compensation, and high-volume patient access workflows, including 40+ daily eligibility and benefits verifications.
Earlier, I handled financial clearance and diagnostic authorizations at Muir Orthopaedic Specialists and managed DME/respiratory accounts receivable, appeals, and Medi-Cal resolution at Pacific Pulmonary Services. I bring hands-on Epic/HealthConnect experience and work closely with clinical teams, billing departments, payers, patients, and case managers to move complex accounts forward.
Experience
Work history, roles, and key accomplishments
Managed complex revenue-cycle workflows including insurance verification, prior authorization, payer follow-up, and denial investigation. Served as a Medi-Cal specialist for complex California Medicaid eligibility and reimbursement issues.
Diagnostic Coordinator
Muir Orthopaedic Specialists
Aug 2015 - Nov 2016 (1 year 3 months)
Managed authorization and financial-clearance activities for specialty diagnostic procedures, including eligibility verification and payer requirement review. Coordinated physician orders, scheduling, and external facilities to prevent coverage-related delays.
Revenue Representative / Medi-Cal Specialist
Pacific Pulmonary Services
Jan 2012 - Dec 2015 (3 years 11 months)
Managed accounts receivable, payer follow-up, denial investigations, and appeals for DME/respiratory accounts. Served as a Medi-Cal specialist for California Medicaid eligibility and reimbursement workflows.
Education
Degrees, certifications, and relevant coursework
Massachusetts College of Pharmacy and Allied Health Sciences
Healthcare Administration
1997 - 2000
Completed healthcare administration coursework at Massachusetts College of Pharmacy and Allied Health Sciences from 1997 to 2000.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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