Access Coordinator Billing Specialist

JOSELYN M SEXTON

CAREER PROFILE

Experienced professional with 20+ years’ Customer Service and

Collections Management, physician billing and coding experience. Excellent communication, leadership and team building skills and experience. Professional Experience

Recently, I worked a three month contract position as a Billing Specialist. ConnectiveRX in Pittsburgh, PA. 2021

● The Monteverde Group, LLC, Pittsburgh, Pa. 5/29/2018 - 2019 Project Manager New Business

Manage 30-50 life insurance and financial case’s on-going. Responsible for the initial Medical Underwriting. The Monteverde Group is a Wealth Management Company working with local businesses and owners to evaluate their financial needs.

Allegheny Health Network, Pittsburgh, Pa 11/1/2017 - 4/6/2018 Operations Manager Customer Service and Collections Department Managed 38 employees and 2 Supervisors responsible for Customer Service calls, as well as outbound collection calls. Handled the daily TCN dialer campaigns. Responsible for hiring, disciplinary action, payroll, staff escalations, training, and daily motivation. The first quarter 2018 we posted 1.9 million in collections. This is the highest ever in the history of Allegheny Health Network's collection and customer service department

Follow-Up Specialist II 11/1/2015 - 11/1/2017

A part of the Blue Cross Team responsible for resolving denied claims, billing and coding in EPIC, Invision and Meditech. Became a part of a specialty group, Eligibility and Denial for all payers. We are responsible for making sure that the insurance attached to the account is active, and the insurance order is correct. We are responsible to work with all Payers, Vendors and Patients to make sure the claim is paid appropriately. We handled all the hospitals in the network. Financial Counselor 9/5/2014 -11/1/2015

Responsible for insurance verification, pre-authorizations, estimates, collections, direct billing issues to the appropriate departments. Assist patients will MA applications, Charity Care Application. Traveled all Hospitals in Network as well as the Health and Wellness Pavilion.

BrightStar Home Health, Mt Lebanon, Pa 10/6/2013 – 9/1/2014 Office Coordinator/ Human Resources

Responsible for hiring skilled and unskilled staff to care for our clients. Processed all state and federal background checks, all unemployment claims, workers compensation claims, all corrective active, assisted with payroll. Responsible for all compliance issues with the Department of Health Quick Med Claims, Pleasant Hills, Pa 03/25/2013 - 10/1/2013 Billing Specialist

Responsible for Billing all UMASS Memorial EMS Transportation claims, They are located in Massachusetts. I do all follow-up as well as pre-billing. This accounts bills on average 500 to 600 trips a month.

UPMC Children's Hospital, Pittsburgh, Pa. 01-26-2013 to 03-05-2013 Patient Access Coordinator Internship

Responsible for the initial registration of all patients and ambulances coming into the Emergency Department. If patients were being admitted I did VMS for all families. I also worked in Same Day Surgery preparing the next days surgeries paperwork. This was an internship.

Goodwill Keystone Area, Harrisburg, Pa. 9/2005 - 4/2011 Program Manager

Responsible for the contract/compliance with the Department of Transportation. We employed 50 disabled individuals at 8 driver license centers in Central Pennsylvania. Duties included but not limited to hiring, firing, payroll, scheduling,and yearly program budget. I was a Goodwill Keystone Area customer service trainer for all staff.

MCI, Harrisburg, Pa. and Towson, Md. 1993 - 2005

National Accounts Service Manager

Promoted to manage account relationships and servicing issues for several Fortune 500 accounts generating more than $50 million in annual revenue. Held full responsibility for customer satisfaction and end-to-end customer support on a 24/7 basis. Directed, trained and motivated a staff of six National Account Service Consultants.

National Accounts Service Consultant

Successfully managed a customer base that generated more than $1 million annually. Provided end-to end customer support on a 24/7 basis. Tracked and maintained over 105% monthly revenue, coordinated billing, implementation, network support, contracts and delivery. Participated in the business development of new opportunities.

EDUCATION

Everest Institute, Pittsburgh, Pa. Graduated March 5, 2013 Medical Coding and Billing

University of Pittsburgh

Business Administration/Marketing

Allegheny Community College, Pittsburgh, Pa.

Business Administration/Marketing

Indiana University of Pennsylvania, Indiana, Pa.

REFERENCES AVAILABLE UPON REQUEST

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