Tashiba Hardy
Arlington,TX
Summary
To obtain a position the Reimbursement field where I can utilize my skills and experience to contribute to the success of the organization. Dedicated Reimbursement Specialist with exemplary analyzation and negotiation abilities. Highly skilled in customer service and coverage evaluation. Specializing in medical insurance claims with a well-established knowledge of the general industry.
Overview
20
20
years of professional experience
Work History
Data Integrity Claims/Processor
Assurant Health
01.2004 - 01.2009
- As a Data Integrity Processor, I applied my medical terminology skills, as well as utilize my customer service skills, oral and written skills to support the claims processing function.
Claims Resolution Specialist/Negotiator
Multiplan
01.2011 - 01.2014
- As a Claims Resolution Specialist, I negotiated on behalf of most of the major insurance companies to reduce out of pocket expense for patients for using an out of network provider.
Reimbursement/Medicare Specialist
Walgreens Infusions Services/Option care
01.2014 - 01.2016
- As a Reimbursement, I am responsible for reviewing claims or invoices in a timely and accurate manner ensure they are submitted by the biller correctly
- This includes reviewing and analyzing all medical documentation to ensure proper diagnosis, HCPCS and ICD-9/ICD-10 are being used, as well as calculating the quantity and pricing of any drugs being dispensed.
Intake Quality Control Auditor
BioScrip
06.2016 - 01.2017
- Audited all levels of documents and qualifications needed in order to process claims
- Assisted in managing and working Held-Revenue Reports
- Interacted and obtained any additional documents needed in order to process claims.
Senior Reimbursement Specialist
Option Care
02.2017 - Current
- Streamlined reimbursement processes by implementing efficient tracking systems, reducing time spent on manual tasks.
- Enhanced revenue recovery rates for clients by identifying and resolving underpayments from insurance companies.
- Collaborated with cross-functional teams to develop strategies that improved claims processing accuracy and speed.
- Mentored junior reimbursement specialists, providing guidance on best practices and industry standards for optimal performance.
- Maintained up-to-date knowledge of coding changes, payer policies, and regulatory requirements to ensure compliance in all reimbursement activities.
- Managed high-volume claim submissions efficiently, reducing errors and ensuring timely reimbursements for clients.
- Optimized billing workflows by analyzing trends in payer denials and implementing corrective actions accordingly.
- Developed customized reports that provided valuable insights into reimbursement metrics, assisting clients in making informed financial decisions.
Education
Bachelor of Science - Economics
UNIVERSITY OF WISCONSIN-MILWAUKEE
Milwaukee, WI12.2010
Skills
- Excellent coordination skills, Ambiguous with great work ethic, Great negotiating skills, Confidential Record Management
- Medical Billing
- Insurance Verification
- Payment Posting
- Claims Management
- Team Leadership
- Revenue Cycle Optimization
- Customer Service
- Healthcare Reimbursement
Training
Completed extensive training in healthcare terminology, and customer service delivery.
Timeline
Senior Reimbursement Specialist
Option Care
02.2017 - Current
Intake Quality Control Auditor
BioScrip
06.2016 - 01.2017
Reimbursement/Medicare Specialist
Walgreens Infusions Services/Option care
01.2014 - 01.2016
Claims Resolution Specialist/Negotiator
Multiplan
01.2011 - 01.2014
Data Integrity Claims/Processor
Assurant Health
01.2004 - 01.2009
Bachelor of Science - Economics
UNIVERSITY OF WISCONSIN-MILWAUKEE
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