Bianka Hernandez
Rex,GA
Summary
Seasoned Team Lead with in-depth knowledge in managing diverse teams to drive operational efficiency. Skilled in strategic planning, project management, and conflict resolution. Notable for cultivating productive work environments and fostering professional growth among team members. Previous roles demonstrate significant contributions to process improvements, increased productivity, and business growth.
Overview
14
14
years of professional experience
Work History
Account Resolution Gov't Team Lead
Wellstar Heath System
Marietta, GA
02.2023 - Current
- Offered training and support to keep team members motivated and working toward objectives.
- Reviewed team member adjustments.
- Collaborated with management to ensure successful execution of special assignments.
- Provided support to colleagues regarding account issues.
- Coordinated meetings aimed at analyzing and resolving recurring denials.
- Evaluated needs of departments and delegated tasks to optimize overall production.
- Facilitated training sessions for new employees on company policies and procedures.
- Trained new staff in relevant processes and procedures.
- Implemented strategic plans to enhance team performance and productivity.
- Maintained positive working relationship with fellow staff and management
Acct Follow up Rep II
Wellstar Healthcare System
Marietta, GA
01.2019 - 02.2023
- Responsible for tracking trends and providing root cause analysis for denials received from traditional Medicaid.
- Responsible for working on eliminating denials and decreasing the volume of denied accounts.
- Contact Medicaid to resolve the no-response claims.
- Track payer issue trends to resolve the cause of denials.
- Assist management with reports and special projects.
- Serve as a liaison between billing, revenue integrity, and coding to have claims submitted properly.
- Work on daily Medicaid accounts for follow-ups.
Denial Specialist
Conifer Health Solutions
Marietta, GA
10.2016 - 12.2018
- Responsible for tracking trends and providing root cause analysis for denials received from Medicaid and Medicaid CMOs.
- Responsible for working on eliminating denials, and decreasing the volume in denied accounts.
- Contact Medicaid and Medicaid CMO payers to resolve the no-response claims.
- Track payer issue trends to resolve the cause of denials.
- Assist management with reports and special projects.
- Serve as a liaison between billing, revenue integrity, and coding to have claims submitted properly.
- Work on daily Medicaid accounts for follow-ups.
Third Party AR Specialist
Piedmont HealthCare
Atlanta, GA
02.2015 - 10.2016
- Highly focused on the resolution of insurance processing errors and denials.
- Request relevant information from the appropriate revenue cycle and clinical departments as required through the course of the A/R follow-up process.
- Ensure that all third-party and self-pay payments, adjustments, and denials are posted in a timely manner.
- Actively work on Credit Balance and Aging of AR Reports, including Underpayments and Overpayments.
- Research and investigate ICD-10 codes for which insurance companies disallow.
- Daily focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate.
Reimbursement Specialist
Southern Regional Medical Center
Riverdale, GA
01.2011 - 07.2014
- Worked on denials and pursued aggressively to recover accounts not paid timely, and underpayments.
- Assisted Revenue Cycle leadership with day-to-day follow-up and collection activities, as well as any special projects that may arise.
- Assisted Revenue Cycle leadership with day-to-day follow-up and collection activities, as well as any special projects that may arise.
- Validated insurance and patient liabilities, and ensured the system reflects correct liabilities. Worked on 250-300 accounts a week.
- Worked 250 to 300 accounts a week.
- Made sure claims were billed with the correct ICD-9-CM codes.
- Verified appropriate payers were billed: primary, secondary, tertiary, etc., by reviewing EOB data previously noted by the EOB Analyst or initiating the EOB review.
- Provided feedback to other departments to foster performance improvement.
- Actively participated in team meetings.
Education
Associates of Applied Science - Health Information Technology
Devry University
06.2011
Skills
- Proficient in English and Spanish
- Computer literate
- Clerical skills
- Energetic
- Fast learner
- Great organizational skills
- Microsoft Word
- Microsoft Excel
- Microsoft PowerPoint
- Internet
- Exceptional communication skills
- Writing skills
- Relationship building
Accomplishments
- Have met project deadlines consistently.
- Have received high scores in exams/testing.
- Have achieved personal goals.
References
Available upon request.
Timeline
Account Resolution Gov't Team Lead
Wellstar Heath System
02.2023 - Current
Acct Follow up Rep II
Wellstar Healthcare System
01.2019 - 02.2023
Denial Specialist
Conifer Health Solutions
10.2016 - 12.2018
Third Party AR Specialist
Piedmont HealthCare
02.2015 - 10.2016
Reimbursement Specialist
Southern Regional Medical Center
01.2011 - 07.2014
Associates of Applied Science - Health Information Technology
Devry University
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