Customer Service Medical Billing

Joshlyn Hardy

**** ******* ****, **********, ** *7407

336-***-**** • *********@*****.***

Medical Billing & Coding Management Professional with over 10 years’ experience in

successfully leading effective team members in A/R follow up of medical claims, provider

credentialing, patient billing, refunds, collections, and customer relations.

Profile

•More than 10 years’ successful experience with health care claims, medical terminology,

medical coding, pre cert authorizations, referrals, and verifications, customer service,

and trouble shooting

•Leader and Trainer with exceptional written and verbal communicational skills, and

immense problem solving skills, handle difficult, escalated issues and calls with ease.

Team player, reliable, detail oriented, great organizational, multi tasking and excellent

communicational skills

Other technical, skills and systems knowledge

•Proficient in Microsoft Word, Excel, Power Point, Ten Key, Accounting, Computerized

Accounting, Business Communications, and Payroll

•Real Med, Health Port, Eclinical Works, Next Gen, IDX, IntelliJET, Unet, and Ibaag

Professional Experience

MED3000 2012 Current Team Lead Medical

Billing/Refunds

Leading a team of over 25 A/R representatives in medical billing and accounts

receivable in achieving and exceeding daily production goals for a large out of state

pediatric facility

Perform audit reviews on team members to ensure accurate and efficient billing and

timely resolution of outstanding claims for reimbursement of services rendered and

commonly covered by State Medicaid and Capitation programs, which successively

aided in reducing days in A/R by at least %25

Establish and maintain relationships with payment posters and practice managers to

promote prompt resolution of claims and related issues facilitating best

communication practices and resolution for all areas of medical billing

Research websites and payer bulletins to assure appropriate and current billing

formats are being used. Create and review unpaid claim and aging reports to identify

payments, denials and other trends and communicate accordingly to support and

reduce A/R trending issues. Assist with developing action plans to assure timely

collection and succeed in decreasing patient and insurance collections

Assist Manager and or Director with weekly/monthly spreadsheets and reports to

identify and address issues of concern and training needs for the team which has

helped to decrease denial and error rates

Review and approve patient and insurance refunds. Post timely, bundling, capitation,

and duplicate adjustments as needed to also aid in lowering A/R. Conduct and

support successful job interviews of candidates that are most qualified to help meet

and exceed company required production goals

Eagle Physicians and Associates 2008 2012 Medical Billing/Refunds/AR

Coordinator

Worked accounts receivable and follow up and carefully processed requested and

voluntary refunds to insurance companies and patients in various medical systems to

aid in working A/R backlog

Handled numerous inbound and outbound calls from patients, and insurance

companies using multiple medical systems such as Health port, ECW, and Real Med.

Assisted with insurance and patient inquiries on statements and explanation of

benefits to achieve client satisfaction. HIPPA compliance trained. EDI, HIM, and

EMR experienced and knowledgeable

Filed ICD 9, CPT, and HCPC claims on HCFA 1500, and UB92 facility claims to a

variety of primary, secondary and tertiary insurance companies. Posted patient

payments, and major electronic and paper payments and denials from Medicare,

Cigna, BCBS, UHC, Medicaid, Med Cost and various other insurance companies, in

rapid timeframes, and follow up with collections accounts

Assisted with provider enrollment, credentialing, verification, and updating to obtain

proper contracting with various insurance companies

Exported and print daily, weekly, and monthly account reports for multiple specialty

practice such as Cardiology and Gastroenterology

Joshlyn Hardy • 336-***-**** • *********@*****.*** • Page 2

United Healthcare 2006 2008 Rapid Resolutions Expert

Leader

Assisted with interviewing, hiring, motivating, and encouraged a cooperative team

work environment to meet organizational goals

Accommodated steady and high volume inbound calls. Processed numerous, faxes,

verbal and written request for members and employees

Reliably exceeded call center statistics in conjunction with multitasking. Within one

and half years was promoted from customer service answering calls and multiple

member inquires up to a Rapid Resolutions Expert Leader handling the same role as

customer service adding the responsibilities of taking escalated phone calls, while

analyzing and processing simple and complex insurance physicians, facilities and

laboratories claims in rapid time frames

Supported in various developmental training for new hire employees and worked

independently as a telecommuter

AT&T/Cingular Wireless 2002 2006 Customer Service

Representative II

Successfully interacted with customers while taking consistent inbound calls,

retention team calls, supporting in employee development by mentoring. Consistently

met call center statistical requirements including being acknowledged as “Top Quality

Customer Service Professional”

Researched, answered, and resolved customers billing, technical system and cellular

phone issues

Promoted from Customer Service Representative I to Customer Service

Representative II, Save Team, and Mentor within two and a half years with the

company

Education

Brookstone College of Business

Major: Accounting Systems Technology Graduate

Educational Honors: President's List, Perfect Attendance, GPA 3.8, and Served as an

Elected Student Ambassador

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