Medicaid Billing and Credentialing Specialist
Resume:
Lisa A. Hardy
Kaplan, LA *****
Cell 337-***-****
To obtain a challenging position that offers advancement opportunities.
Abbeville General Hospital
Abbeville, LA
Medicaid Biller
08/24 to present
Responsible for all aspects of Medicaid billing for Molina and LA Healthcare Connect
Audit account for reasons of unpaid insurance balances
Submit any necessary information to the insurance for payment on charges
Appeal any unpaid discrepancies
Audit for refund on account
Print and forward HCFA to insurance
Transfer, write off, input payments on account if distributed or posted incorrectly
Insurance collection calls
Post payments
Resource Management Services
Lafayette, LA
Billing Coordinator
12/2022 to 6/2024
Responsible for all aspects of credentialing of providers for ALL insurances including Medicare and Medicaid, refunds and billing
Filling all paperwork to have provider credentialed with insurances via either paper or insurance portal
Billing of mental health claims
Posting of ALL payment whether auto or manual
Audit accounts for proper payment
Mapping of system for correct billing
Abbeville General Hospital
Abbeville, LA
Credentialing Coordinator
07/19 to 12/2022
Responsible for all aspects of credentialing of providers for ALL insurances including Medicare and Medicaid, refunds and client billing
Filling all paperwork to have provider credentialed with insurances via either paper or insurance portal
Auditing credit balance report and sending request to have credits refunded if needed
Auditing client bills and mailing invoices
Posting of client invoice payments
Assist in payment posting, if needed
Assist with any sorting mail and distributing to billers
Will assist with any task where help is needed
Vanderbilt University Medical Center
Nashville, TN
SR Reimbursement Specialist
9/18 to 6/19
Responsible for all aspects of auditing accounts in credit balance and refunding.
Work undistributed report - audit account and refund
Audit account in credit balance/Refund insurance or patient, whoever is needed
Charge verification form - form sent to billing coordinator of a department when copay is taken and there is no charge on account for date of service
Post payments as needed when payments department is behind
Any money left undistributed from payment posted must be researched and refunded if needed
Handle all checks that are returned for void
Acadiana Computer Systems
Lafayette
Billing Specialist
11/05 to 8/18
Responsible for all aspects of the billing process for eight (8) different Anesthesia accounts
Work outstanding balance reports for all insurance
o Medicare
o Medicaid
o Private
Audit account for reason of unpaid insurance balances
Submit any necessary information to the insurance for payment on charges
Appeal any unpaid discrepancies
Audit for refund on account
Print and forward HCFA to insurance
Transfer, write off, input payments on account if distributed or posted incorrectly
Insurance & patient collection calls
Post payments
Medical Coding
Willstaff Worldwide/ACS (TEMP SERVICE)
Lafayette
Billing Specialist
8/05 to 11/05
Responsible for all aspects of the billing process for four (4) different accounts
Work outstanding balance reports for all insurance
o Medicare
o Medicaid
o Private
Audit account for reason of unpaid insurance balances
Submit any necessary info to the insurance for payment on charges
Appeal any unpaid discrepancies
Audit for refund on account
Print and forward HCFA to insurance
Transfer, write off, input payments on account if distributed or posted incorrectly
Insurance & patient collection calls
Accel Protection & Technologies/Argus Security
Scott
Office/Accounting Manager
10/02 to 7/05
Responsible for all aspects of the office process
Accounts Receivable/Collections via QuickBooks Pro
Accounts Payable via QuickBooks Pro
Complete payroll process including taxes via QuickBooks Pro
Deposits
Ordering supplies
Answering 10 line phone, routing calls to appropriate personnel
Month-End process
Sales tax
Keep accurate/up to date employee records
Vanderbilt University Medical Center
Nashville
Physician Billing Coordinator/ UCHS/VHCC
11/00 - 6/02
Responsible for all aspects of the billing process
Assist with administrative duties; supervise one (1) employee
Charge entry in GUI, process claims, processing of denied claims
Accounts payable/receivable
Post payments via Epic
Ordering of supplies
Deposits
Process all month end reports
Audit account for reason of unpaid insurance balances
Submit any necessary info to the insurance for payment on charges
Appeal any unpaid discrepancies
Print and forward HCFA to insurance
Transfer, write off, input payments on account if distributed or posted incorrect
Reimbursement Specialist - Vanderbilt U. Med. Center
3/98 - 10/00
Responsible for all aspects of auditing accounts in credit balance and refunding.
Undistributed report - audit account and refund
Credit report - audit account and refund
Audit account in credit balance/Refund insurance or patient, whoever is needed
Mail/letters from insurance company wanting money back - audit account and refund
Refund/Recoupment letters - letters to insurance company when recoupment is done a fter a refund has already been processed and mailed
DB2 report - audit account and refund
Charge verification form - form sent to billing coordinator of a department when copay is taken and there is no charge on account for date of service
Post payments as needed when payments department is behind
Any money left undistributed from payment posted must be researched and refunded If needed
Handle all checks that are returned for void
Education
Kaplan High School
Gulf Area Technical Institute
Account Clerk degree
(Outstanding top graduate - GPA 3.73)
Volunteer Tax Course (VITA)
Organizations
Future Business Leaders of America (FBLA)
Vocational Industrial Clubs of America (VICA)
Treasurer
References
Available on request.
Contact this candidate