# Joslyn Sims

Joslyn Sims is a remote worker on Himalayas, Denial Specialist at Unity Point, based in United States.

Source: https://himalayas.app/@joslynsims1

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

| Detail | Value |
| --- | --- |
| Availability | Looking for a job |
| Location | United States |
| Authorized to work in | United States |
| Salary expectations | 60k+ USD |
| Job categories | Denials Specialist, Reimbursement Coordinator, Reimbursement Specialist, Medical Biller |
| Skills | Medical Claims Denial Management, Claims Appeals, Medical Billing, DME Billing, Hospital Billing, Professional Billing, Medical Collections, Reimbursement, ICD 10 Coding, CPT Coding, HCPCS Coding, Ambulatory Reimbursement, Healthcare Reimbursement, Medical Terminology, Anatomy Physiology |

## About

```text
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

### Denial Specialist

Unity Point. Jul 2024 - Oct 2026

```text
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.
```

Skills: Denial-Management, Medical-Billing, Appeals, Healthcare-Compliance, Claims-Analysis, Documentation

### Reimbursement Coordinator

Wellsky. Dec 2022 - Jun 2024

```text
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.
```

Skills: Medical-Billing, DME-Billing, Home-Infusion, Claim-Generation, Payer-Portals, Follow-up

### Reimbursement Specialist

Option Care. Aug 2021 - Aug 2022

```text
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.
```

Skills: Medical-Billing, Reimbursement, Denial-Management, Payment-Posting, Claim-Verification

### Referral Coordinator

Option Care. Feb 2020 - Aug 2021

```text
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.
```

Skills: Patient-Coordination, Care-Transitions, Communication-Skills, Autopay-Setup, Copay-Assistance

### Biller - Home Infusion

Option Care. Apr 2018 - Feb 2020

```text
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.
```

Skills: Medical-Billing, Home-Infusion, Invoicing, Documentation, Payer-Engagement

## Education

### Northwestern College

Certificate, Health Care Billing and Coding. Grade: 3.00/4.00

```text
Completed a Health Care Billing and Coding Specialist Certificate with a GPA of 3.00/4.00.
```

## Tech stack

- Microsoft Excel
- Microsoft Word
- Microsoft Outlook
- Microsoft PowerPoint
- Epic
- Availity

To contact Joslyn, message them from this profile with a Himalayas employer account: [Hire on Himalayas](https://himalayas.app/hire).

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