SHANITRA GAYLE

Atlanta, GA 770-***-****

ac6i1q@r.postjobfree.com

An accomplished professional with 10+ years of experience in healthcare management and administration. Experienced in the development, implementation and management of facility policies and procedures. A vigorous bellwether with proven interpersonal, communication, and organizational skills. A detail-oriented individual able to acclimate rapidly to incipient settings and agog to take on an incipient challenge. Adept at working independently and a team player, engendering results with high performance standards.

EDUCATION

04/2013

MASTER OF PUBLIC ADMINISTRATION, keller graduate school of management

Specialization: Governmental Management

GPA: 3.79

08/2011

MASTER OF BUSINESS ADMINISTRATION, keller graduate school of management

Specialization: Health Services

GPA: 3.78

02/2010

BACHELOR OF SCIENCE, devry university

Program: Business Administration

GPA: 3.44

SKILLS

- Management - Marketing Strategies

- Policy Implementation & Restructuring - Project Management

- Leadership - Electronic Medical Record Systems

- Policy development and implementation - Microsoft Office Suite

- HIPAA Compliance - Project Management

EXPERIENCE

04/2010 – CURRENT

PRACTICE MANAGER, ent and voice care of atlanta

Meet with staff to ascertain clinical and administrative policies were followed for compliance and better quality of care and understand their frustrations and concerns to ascertain an adequate support system.

Created annual and capital budgets for all locations, monitored expenses and reported variances as needed.

Worked closely with billing to monitor charges and payments and educated physicians and all incoming Residents in billing policies and procedures.

Participate in meetings to ensure practices were HIPPA compliant.

Executed the launch of Balloon Sinuplasty in office procedure within practice, increasing revenue by 17%.

Designed and published patient education materials used in outpatient clinic for improved understanding of surgical procedures, risks and benefits.

Handle documentation, scheduling and cadence of more than 120 patient office visits per week and prioritized over 30 patient and third-party inquiries per day.

Increment accounts receivable, reimbursement amounts, and reduced turnaround time through felicitous documentation and research of current indemnification standards.

Manage major transformation to logistical medical records online, providing communications, training and technical support throughout the process.

Orchestrated an integrated advertising campaign across multiple media channels, growing patient visits by 18%.

Verify provider credentials utilizing on-line resources and note any adverse actions for review by manager.

Provide weekly report of status of the enrollment and privileging process.

Facilitate reappointment process.

Provides support to clients by availing practitioners and mid-level providers with all aspects of the credentialing/privileging process.

Researching and analyzing CMS 1500 claims interpreting reason for denials, referencing policies.

Monitored licensure/certification and reappointment expiration reports to ensure providers were working within hospital compliance.

06/2014– CURRENT

CONSULTANT/PROJECT MANAGER, Audiology at home

Prepare project reports for daily schedule and revenue projection.

Consulted with client to determine needs and priorities.

Detailed knowledge of Medicare, Medicaid, Managed Care, HMO, and PPO insurances ensure billing properties.

Follow-up, collections, cash posting, adjustments, write-offs in addition to reconciliation.

Incremented revenue through loss obviation and cash expedition and denial management methodology.

Medical coding for profit stability and facilitate any coding changes to maximize revenue.

Responsible for evaluating the coding practices of providers evaluating precision; providing recommendations for compliance and coding support

Precise coding and abstracting of medical records data, electronically and manually.

Monitor health information procedures ascertaining high quality standards of documentation, ethical practice, confidentiality, information security, information retention and retrieval.

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