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Joslyn Sims

@joslynsims1

Denial Specialist at Unity Point, resolving denied medical claims and preparing professional appeal letters.

At Unity Point, I analyzed and resolved denied medical claims across DME, hospital, and professional billing and collections. I examined denial reasons, investigated billing or documentation errors, and prepared appeal letters with supporting documentation.

Previously at Wellsky, I generated Home Infusion and Durable Medical Equipment claims and followed up on patient balances and claim status. At Option Care, I worked in reimbursement, referral coordination, and home infusion billing, including claim submissions and denial follow-up.

Experience

Work history, roles, and key accomplishments

Denial Specialist

Unity Point

Jul 2024 - Oct 2026 (2 years 3 months)

Responsible for analyzing, managing, and resolving denied medical claims from insurance companies. Reviews denial reasons, coordinates with internal departments, submits appeals, and ensures compliance with healthcare regulations to secure reimbursement.

Denial Management Medical Billing Appeals Healthcare Compliance Claims Analysis Documentation

Reimbursement Coordinator

Wellsky

Dec 2022 - Jun 2024 (1 year 6 months)

Generates and collects Home Infusion and Durable Medical Equipment (DME) claims for submissions. Obtains billing information in client's software, generates monthly claims, follows up on patient balances, and obtains claim status via payer calls or online portals.

Medical Billing DME Billing Home Infusion Claim Generation Payer Portals Follow up

Reimbursement Specialist

Option Care

Aug 2021 - Aug 2022 (1 year)

Responsible for timely, accurate submission of invoices to responsible payer for all services and products provided. Evaluates payments received and application to patient account, follows up on denials within 48 hours, and verifies claims received and processing.

Medical Billing Reimbursement Denial Management Payment Posting Claim Verification

Referral Coordinator

Option Care

Feb 2020 - Aug 2021 (1 year 6 months)

Interacts with external service providers and the Option Care Commercial Team to transition new patients onto service. Responsible for collecting, reviewing, and completing applicable care transition documents and setting up new patients on autopay and copay assistance plans.

Patient Coordination Care Transitions Communication Skills Autopay Setup Copay Assistance

Biller - Home Infusion

Option Care

Apr 2018 - Feb 2020 (1 year 10 months)

Submits timely, accurate invoices to payer for products and services provided. Correctly determines quantities and prices for drugs billed and ensures all required documentation is complete and accurate prior to claim submission.

Medical Billing Home Infusion Invoicing Documentation Payer Engagement