Crystal Hardin
Henry County School District
Fayetteville,GA
1
Certification
17
years of professional experience
Dedicated and passionate Customer Service Specialist with proven track record successfully leading student discussions and providing individualized instruction. Communicates effectively with administrators, faculty and parents. Well versed in educational standards and innovative teaching methods
Work History
Data Clark/ Registar
3 Months- Processed student enrollment data accurately and efficiently to ensure timely updates in school records.
- Maintained organized filing systems for student records, enhancing retrieval speed and accuracy.
- Assisted in data entry tasks using PowerSchool software, ensuring precise reporting of attendance figures.
- Collaborated with administrative staff to streamline document processing workflows, improving overall operational efficiency.
ADMINISTRATIVE SUPPORT/SUBSTITUTE TEACHER VIRTUAL
5 Years 11 Months- Assisted principal in overall school administration, managing critical duties in principal's absence to ensure continuity of operations
- Develops a desirable climate for learning and takes effective measures to maintain it
- Conducts safety inspections and safety drill practice activities and prepares procedures to follow
- Organizes and serves on school-based committees and assists with orientation of new employees
- Assisted with disciplinary issues within the building and followed up on special cases.
- Assists with disciplinary issues within the building and follows up on special cases, as necessary
- Planned and organized assemblies, special events and other scheduled events
- Analyzes and utilizing assessment data to improve student achievement while recording information and uploading information to database.
APPEALS & CLAIMS REPRESENTATIVE/REVENUE MANAGEMENT REP.
1 Year 6 Months- Analyzed and resolved verbal and written claims root cause and authorization appeals from providers and pursue resolution of formal grievances from members
- Reviewed and documented member/provider complaints, grievances, and appeals for effective resolution tracking
- Prepared response letters for members and provider complaints, grievances, and appeals
- Maintained organized files on appeals and grievances, coordinating with Grievance and Appeals Committee for timely resolutions
- Works closely with contacts at health plans to resolve short payments on accounts in a timely manner
- Follows up on accounts via phone, email and payer site to ensure received and in process, reporting status of all active claims
- Supported pay-for-performance programs through data entry, tracking, and organizing information to facilitate program success
- Assisted with HEDIS-Medicare productivity functions including data entry, calls to providers' offices, and claims research teams.
PATIENT FINANCIAL ANALYST SPECIALIST
6 Months- Produces routine analytical reports for management and writes basic SQL and ad hoc reports to support Patient Financial Services
- Produced analytical reports for management and authored SQL and ad hoc reports to enhance support for Patient Financial Services
- Ensured compliance with all State, Medicaid, and Medicare regulations.
- Evaluated and authorized end-user requests for system modifications and offered alternative solutions to address calculation discrepancies.
MEDICAL BILLING REIMBURSEMENT REP.
6 Months- Executed billing procedures and followed up on claims for commercial health insurance, workers' compensation, third-party claims, and government payers to ensure timely reimbursement.
- Managed document follow-ups in practice management billing software, resolving errors related to additional charges and claim denials to enhance accuracy.
- Utilized ICD 10 coding/CPT Codes and submitted corrected claims with documentation needed
- Appealed improperly denied claims and collaborated with coder to determine correct diagnosis-related claims, improving overall claim acceptance rate.
LEAD SR. REIMBURSEMENT SPECIALIST-MEDICARE & MEDICAID
1 Year 2 Months- Communicated with third party payers to ensure proper reimbursement on patient accounts, identifying and preparing adjustments and write-offs as appropriate
- Communicated with third-party payers to ensure proper reimbursement on patient accounts, identifying and preparing adjustments and write-offs.
- Followed up on daily correspondence, including denials and low pays, via telephone and written communication to check claim status and inform payers and patients.
- Interpreted payer contracts to ensure accurate payments, processed refunds and claim adjustments, and generated weekly and monthly reports.
MEDICAL OFFICE MANAGEMENT - BILLING
2 Years 1 Month- Performed home care claims processing with responsibility for billing home care services to Medicare, private pay and third-party payers for reimbursement and collections
- Resolved billing errors to ensure clean claim submission, enhancing reimbursement process
- Maintained aged receivables within Ecumen standards and confirmed that deposits were made and posted.
- Exercised good judgement toward account resolution and documents all activity of accounts in a clear, accurate and consistent manner.
ACCOUNTS RECEIVABLE-FOLLOW-UP COLLECTIONS
3 Years 9 Months- Managed more than 75-100 high end accounts daily therefore resulting in a company cost savings of more than 50% by meeting and exceeding performance goals
- Resolved payment issues while collecting on outstanding medical bills, enhancing cash flow and reducing aging accounts receivable.
- Corrected and reviewed Collector queue in Meditech billing system for unpaid claims and flagged follow-ups
- Achieved recognition for performance in audits and ensured compliance with Medicaid, Medicare, and state regulations in Missouri and California.
HUMAN RESOURCE ASSOCIATE
3 Years 9 Months- Responded to Tier 1 requests/inquiries from customers via multiple channels primary from phone and HR portals for open enrollment
- Executed key tasks and administrative activities following defined procedures and guidelines.
- Escalated calls for investigation and research to appropriate HR functional teams to facilitate timely resolution
- Utilized the Case Management System to ensure that all details/relevant information are organized and documented appropriately and that cases are classified appropriately
- Supported human resources and delivery support by completing office tasks and facilitating communication with customers and COE, total compensation, and people teams.
Education
DIPLOMA - Medical Billing-Coding
Bachelor's Degree - Education
Computer Network Associate Degree - Information Technology
Skills
Administrative Support
Revenue Cycle Process
Accounts Payable/Receivable
Human Resources
Benefits Administration
Credentialing
Project Planning
Administrative Procedures
Special Event Planning
Record Keeping
Lesson Planning
Training Program Development
Group mediation
Scheduling Coordination
Conflict resolution
Team collaboration
Problem-solving
Instruction interpretation
Service planning
Database management
Interpersonal communication
Student involvement
Relationship management
Classroom administration
Certification
American Academy of Professional Coders-2018, Medical Coding Classes, Expert Rating-Business Analyst Certification-02/16/2019
Personal Information
Title: Teacher/Home room
Timeline
Data Clark/ Registar
Henry County School District
12.2024 - 03.2025Read More
PATIENT FINANCIAL ANALYST SPECIALIST
Beacon Hill Staffing in c/o Kindred Healthcare
09.2019 - 03.2020Read More
APPEALS & CLAIMS REPRESENTATIVE/REVENUE MANAGEMENT REP.
Robert Half in c/o Centene & Anderson Hospital
04.2019 - 10.2020Read More
ADMINISTRATIVE SUPPORT/SUBSTITUTE TEACHER VIRTUAL
Hazelwood School District Kelly Education
09.2018 - 08.2024Read More
MEDICAL BILLING REIMBURSEMENT REP.
St. Charles County Ambulance
09.2017 - 03.2018Read More
LEAD SR. REIMBURSEMENT SPECIALIST-MEDICARE & MEDICAID
CVS Pharmacy (Formerly Coram)
07.2016 - 09.2017Read More
MEDICAL OFFICE MANAGEMENT - BILLING
Legacy Health Systems
06.2014 - 07.2016Read More
ACCOUNTS RECEIVABLE-FOLLOW-UP COLLECTIONS
Conifer Health
02.2010 - 11.2013Read More
HUMAN RESOURCE ASSOCIATE
Beacon Hill Staffing in c/o SSM Health
05.2008 - 02.2012Read More
ITT Technical Institute
Computer Network Associate Degree from Information Technology
Read More
Concordia University
Bachelor's Degree from Education
Read More
Ashworth College
DIPLOMA from Medical Billing-Coding
Read More