April Ballard

Work History

Mphasis Corporation

07.2022 - 02.2023

Processed medical insurance claims under Medicare Advantage Plans (SNF, LTC, Hospital, Primary Care, Dental, Vision)
Utilized numerous different systems to price and adjudicate claims; checked claim and documentation for accuracy and validity
Followed processing guidelines, including verifying prior authorizations, timely filing requirements, fee schedules, and benefit matrix rules
Identified and dispatched claims to other departments for corrections or review; followed up to ensure issues were resolved timely and accurately and escalated where needed
Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims and achieved 100% accuracy while meeting daily quota.

Pediatric Advanced Therapy

09.2021 - 07.2022

Managed Medicaid and Medicaid MCO inventory for 7 busy therapy clinics
Posted payments via EFT, paper checks, and in person with patients/over phone
Resolved billing inquiries and provided timely responses to enhance customer satisfaction
Researched and resolved billing discrepancies to enable accurate billing; filed appeals when needed
Assisted with training new employees and continued mentoring to promote development
Identified payment trends and adjusted billing processes accordingly to ensure payment

US Physical Therapy

09.2019 - 04.2020

Billed medical claims daily for multiple high volume physical therapy office locations
Maintained diligent follow up and documentation
Generated and distributed monthly customer statements; prepared accounts to be sent to collections
Balance cash, credit, adjustments, and EFT payments daily for each location
Posted payments and processed refunds
Researched billing errors and discrepancies, made corrections and resubmissions, and filed appeals
Exceeded daily quota and accuracy requirements

Delaware North Company

06.2015 - 06.2018

Maintained inventory counts of all merchandise in stand during game days
Ensured proper levels of merchandise throughout game and placed re-orders as necessary
Balanced cash and credit card transactions and resolved any variances or discrepancies
Provided outstanding customer service to all guests to ensure a world class experience was had by all
Answered customer questions about products and services, helped locate merchandise, and promoted key items
Monitored customers for signs of security concerns and escalated issues to onsite police officers

Ensemble Health Partners

06.2016 - 06.2017

Processed medical claims from various hospital facilities to ensure proper adjudication and payment from Medicare, Medicaid and commercial insurance payers
Corrected claims using company designed software and insurance payer websites; made phone calls to payers when needed to resolve more complex claim issues
Concentrated on aging claims to reduce older inventory and on high dollar claims to ensure timely resolution
Applied payments via EFT, billed secondary and tertiary insurances
Frequently asked to assist with special projects and assisted in mentoring new hires due to quality of work. Exceeded quality standards.

Chamberlin Edmonds

06.2007 - 05.2014

Managed multimillion-dollar inventory of hospital accounts to secure payment from state and federal government programs
Supervised team of onsite and offsite employees to ensure resolution of claims by following company guidelines
Compiled, analyzed, and presented monthly reports to Director that summarized in detail all measured areas of performance
Prepared various other reports for members of management and direct reports
Created and enacted action plans ensuring all areas of opportunity are explored
Worked closely with hospital management staff to ensure contractual agreements were met and surpassed while providing needed support to field staff
Involved in interviewing and hiring process as well as training and mentoring program
Scheduled and attended regular meetings with Department of Social Services to further develop working relationships.