Shan Stokes
Garland, TX *****
ac7e0o@r.postjobfree.com
Work Experience
Business Office Manager
Ridgecrest Healthcare and Rehab - Forney, TX
January 2016 to February 2018
-Bill approx. 100-150 per month claims to Medicare and commercial insurance carriers
-Make deposits, post cash daily, receive private pay payments and post them to appropriate accounts
- A/R responsibilities including following up with insurance carriers and patients in regards to past due accounts and unpaid balances
- Complete the financial portion of the admission packet for incoming residents
- Prepare and submit statements on resident past due balances
- Responsible for balancing during month end using financial reports and reconciling reports against accounting dept. reports
-Prepare financial reports for month end and forward reports to executives in corporate office
-Attend weekly and monthly A/R calls with corporate office
-Post cash receipts and reconcile balances, statements, and A/R reports
-Responsible for entire revenue cycle of claims from billing, collections, and invoicing
-Maintain average of 99%-100%+ for collections of patient, Medicare and managed care accounts
-Financial counselor to families/residents for collection process of due balances
-Process credit card payments
-Helped develop SOPs for billing team
-Created productivity tracking sheets
-Trained employees on processes and company system
-Used Excel for reporting using pivot tables and V look-ups
-Reconciled accounts
-Managed employee time sheets in UltiPro
Team Lead Billing Rep
Forest Park Medical Center - Dallas, TX
July 2015 to December 2015
-Bill all claims electronically (approx. $2,000,000 per day)
-Analyze all pertinent information to ensure claim is received and processed
-Analyze and make decisions on billing procedures for billing department
-Reconcile claims imported from host and exported
-Compile late charge reports and submit corrected claims as needed
-Work with facilities on charge corrections
-Assist with special department projects
-Bill claims using SSI & MediTech
-Compile billing reports using Excel
-Train new employees
-Assist with potential employee interviews
-Helped develop reporting tools for the billing department using the billing software (SSI) & Meditech
-Helped develop policy & procedures for the billing & collection team Billing Analyst
LifeCare Management - Plano, TX
October 2013 to July 2015
-Bill all Medicare claims electronically ($2,000,000-$5,000,000/per day)
-Bill WC claims, auto claims, & LOAs (letters of agreement), electronically and by paper
-Verify patient's eligibility using Passport and other websites
-Contact Medicare to ensure claim is received and in process and to make any necessary corrections to ensure payment
-Make outbound calls to patients to verify insurance information
-Analyze all pertinent information to ensure claim is received and processed
-Analyze and make decisions on rather to pursue patient and/or insurance for payment or adjust balance
-Reconcile claims imported from host and exported
-Compile late charge reports and submit corrected claims as needed
-Work with facilities on charge corrections
-Assist with special department projects
-Review remittance advice forms to verify proper reimbursement and make adjustments as necessary Billing Specialist
Bethany Home Health - Dallas, TX
July 2012 to September 2013
-Responsible for the revenue cycle of all commercial claims and Medicaid using HealthTrust software and Kinnser
-Resolve unpaid claims (commercial insurance carriers & Medicaid) by making outgoing calls to insurance carriers
-Verify patient's insurance benefits with insurance carriers
-Take inbound calls from patients and insurance carriers
-Appeal claims to commercial carriers as well as Medicaid for additional payment (Appeal from
$30,000-$60,000 weekly)
-Assist manager with training new employees on system operations, appeals, billing, collections, etc.
-Run unbilled charges report, determine problems with unbilled charges/correct and bill claims via Zirmed
-Negotiate rates with outside payer sources other than insurance carriers (confirm and sign letters of agreement)
- Assist in credentialing department with getting providers set up with insurance carriers Patient Account Rep
Cancer Center Associates - Dallas, TX
April 2007 to July 2012
-Resolve unpaid claims (commercial insurance carriers & Medicaid) by making outgoing calls to insurance carriers
-Appeal claims to commercial carriers as well as Medicare & Medicaid for additional payment (Appeal from $30,000-$60,000 weekly)
-Assist in training employees on system operations, appeals, billing, collections, etc.
-Run unbilled charges report, determine problems with unbilled charges/correct and bill claims
-Reconcile patient's statements
Medical Claims Collection Representative
Digestive Health Associates - Dallas, TX
March 2001 to April 2007
-Analyze and resolve old age accounts for a total of eight physicians
-Make outgoing calls to insurance companies to verify patient eligibility (commercial insurance carriers, some Medicare & Medicaid)
-Follow up on claim payment with insurance companies by making outgoing calls to insurance carriers
(commercial insurance carriers, some Medicare & Medicaid)
-Adjust patient's accounts i.e. credit balances, incorrect provider discounts
-Appeal claims for additional payment from insurance carriers
-Manage demographics on patient accounts
Education
El Centro Junior College
University of North Texas