Revenue Cycle Leadership
Resume:
SHETINA W. STRAMBLER
Lancaster, TX 75146
*********@*****.***
Objective: Seeking a position in Leadership utilizing the knowledge and experience that may be useful in a growing medical company. As well as a commitment to excellence that will project through good work ethics as well as bringing professionalism and making a positive impact to the team.
Qualification Highlights:
Innovative professional with 17+ years of professional work environment and customer support as well as 3+ year’s management with demonstrated initiative, creativity and success. Proactive, leader/manager with experience in multi-cultural environments.
Expertise in strategic planning, new business start up, market plan execution, customer service, and staff training, supervision and mentoring.
o Quick study with an ability to rapidly achieve organizational integration, easily assimilate job requirements and aggressively employ new methodologies. Energetic and self-motivated team player/builder. At ease in high stress, fast-paced environments with emerging and multiple responsibilities.
o Excellent leadership, management, oral/written communication, interpersonal, intuitive, and analysis skills. Thrive in both independent and collaborative work environments.
Known for developing and executing innovative corporate policies and procedures.
Proven track record of streamlining workflow and creating a team environment to increase productivity.
Clerical skills and experience including credit/collections, Microsoft Office, Power Point presentations, Calyx Point, HMS, SSI, Pbar, MediSoft, Centricity, Access, Oracle Discoverer, SMS, AS400, Great Plains, Nextgen, Medassets, PIMS, Meditech,10-Key, etc,…
Professional Work Experience:
CCS Medical 7/13 – Present
Sr. Rev Cycle IOU Team Lead
Assignment and delegation of workloads and special projects to team members
Assist Director with employee coaching, training and development initiatives including side by side training of individual employees
Handles escalated billing issues and/or concerns
Monitoring and evaluating reimbursement employee productivity and performance
Assist with training new reimbursement employees and conduct ongoing training and skills assessment as necessary
Provide guidance to the team regarding questions related to their daily work
Handle escalated issues maintaining open lines of communication between internal and external customers/depts.
QA audits weekly on each team member providing weekly report to team members discussing trending account errors as training opportunities with team
Weekly leadership meetings recapping and/or addressing work issues/solutions
Ensured that team members are following all Medicare, Medicaid, HIPAA and Private insurance regulations, requirements and guidelines
Sharing the responsibility of maintain the Rev Cycle Productivity report for IOU dept.
Creating innovative ideas to lift the department morale to keep the team motivated
Create and review Policy and Procedures and Job Aides for the dept.
Review and resolve payer and customer issues, patient complaints
Special projects as needed
Methodist Healthcare System/ Wayne Perry & Associate 8/12-3/13 (CONTRACT)
Senior Collector
Responsible for following up on all Government/ Medicaid Managed Care Claims
Making necessary corrections and rebilling
Appealed all denied claims
Worked all Government correspondence
Made all necessary adjustments to accounts
Dallas Medical Center 10/11-8/12
Collector III
Responsible following up with carriers and patients on all Government/ Medicare Manage Care, Commercial, Managed Care Medicaid, Managed Care, Auto & Self Pay accounts.
Secondary and Tertiary Billing.
appealing all denied claims.
Worked Correspondence, Attorneys request and claim research.
worked closely with 3rd party bad debt collections, placing accounts and recalling accounts placed in error.
Updated patient demographics, insurance information, etc…
Back up payment posting payments and adjustments, phone coverage and provided assistance to staff with training questions.
Setup payment plans on self-pay account and took payments over the phone
Stockworth Grp/Odssey Healthcare 9/10-4/11 (CONTRACT)
Claims Analyst
Responsible for accurate and timely resolution for California, Texas, and Ohio Medicaid claims.
Billed claims not found on file and corrected errors and rebilled claims.
appealed all denied claims.
followed up on unpaid claims and account maintenance for sites responsible for.
Forest Park Medical Center 11/09 to 12/09 (CONTRACT)
Claims Analyst
Followed up on past due claims by calling all the insurance carriers.
Reviewed and processed all returned claims correcting any and all errors and rebilled.
appealed all denied claims.
Setting up payment plans for remainder balances for cash patients.
Diversified Healthcare 7/09 to 10/09 (CONTRACT)
Early Out Collector/Medicaid Biller Lead
Assisted team member with any issues and or concerns.
Streamlined workflow to ensure all claims was billed timely.
Spoke with patients making payment arrangements for self-pay patients.
Making Calls to Insurance Carriers verifying benefits and checking status of claims billed.
Billing claims electronically to carriers including TMHP and Medicare, and filing Secondary or Tertiary claims by paper.
Setting up payment plans, applying and posting payments received daily.
Reliant Holdings Ltd 12/08- 7/09
Accounting Specialist
Managing all Floco accounts including all billing, collections, and AR monthly balancing for all Reliant companies
Applying and Posting all sales for FloCo2
Provide Collections for all Reliant companies.
Collect 3000+ past due accounts each month including contacting customers by phone or via email.
Conducted monthly meeting with management on AR issues and month end summary updates.
Run monthly agings.
Run analysis for each customer completing monthly match offs, write off’s and adjustments to clear AR.
Specialty Billing Services 02/07- 11/08
Medical Collections& Billing Supervisor
Reviews, revises, and implemented SOP’s for departments.
Evaluated efficiency and accuracy of departments based on paper flow, claim processing, and collection.
Kept track of Denial Reason Codes monthly to identify internal problems to reduce denial volume.
Sets up monthly or quarterly targets for billers to follow and monitor their performance accordingly.
makes sure confirmation; initial claims, denial follow up, and retro-auth’s are completed in a timely manner.
set up meetings with staffs to identify and resolve billing issues and concerns.
Monitored productivity log to identify performance and problems and makes sure billers work their reports including, High to Low AR, and Denial on a timely manner.
Interviewed and recommended for hiring, and overseen orientation and training for new personnel.
Originated disciplinary warnings, when necessary, and consults with AR Manager and/or HR Dept relative to reprimands and/or discharge of personnel under his / her supervision.
Performed annual reviews for staff, recommends annual rate increase percentage.
Set up monthly meetings with the staff to identify and resolve billing issues and concerns.
Identified billing issues regarding customer service and forward finding to AR Manager and communicate to other departments and monitor improvements as needed.
Involved with the aging and hold revenue report on a monthly basis
Ensured the department minimized distractions to maintain focus on job responsibilities ( ie: personal telephone calls and or discussions ).
Established work priorities and delegation to department personnel and followed up as needed.
Obtained necessary information for billing purposes, reviewed it for completeness and accuracy, and oversees the claims submittal process.
Communicated directly with patients when appropriate, handles any questions or problems that may arise regarding reimbursement.
Communicated and cooperated with other departments, serves as liaison between staff and management.
Reviewed monthly insurances updates, info relayed the changes to management, staff and to IT department for system updates.
Initial write offs and adjustments prior to giving to AR Manager.
Conducted routine evaluations and assisted in the performance of the duties of accounts receivable personnel as listed on their designated job descriptions.
Communicated with AR Manager in regards to the issues or problems in the billing department on a timely manner.
Performed other duties as specified by AR Manager
SDS Processing & Management Services - 08/06- 03/08
General Mgr/Licensed Loan Officer
Manager and business owner overseeing a team of 7.
Delegated workflow to increase productivity and meet deadlines
Design and implement office policies
Establish standards and procedures
Organize office operations and procedures
Supervise office staff
Prepare time sheets
Maintain office equipment
Assign and monitor clerical and secretarial functions
Recruit and select office staff
Orient and train employees
Provide on the job and other training opportunities
Supervise staff
Evaluate staff performance
Coaching and disciplining staff
Ensure protection and security of files and records
Ensure effective transfer o files and records
Transfer and dispose records according to retention schedules and policies
Provide customer service originating new home and commercial loans.
Trinity Industries Inc. - 4/04- 08/06
Credit/Collections Analyst
Provide collections for the Trinity Leasing Dept.
Collect on 300+ past due accounts each month including contacting customers by phone or via email.
Create statements of accounts for each customer that is 1 or more days past due using Oracle.
Create past due spreadsheets with comments.
Conduct monthly meetings providing management with AR month end summary updates.
Run monthly aging.
Run analysis for each customer completing monthly match offs, write off’s and adjustments to clear AR.
Provide remittance instructions to accounting dept for monies received.
Provide payment information for customers requesting the status of an invoice and process payables on as needed basis.
Magellan Behavioral Health - 11/00-06/03
Administrator
Provide Administrative Support for the Vice President of Medical Services and the Vice President of Quality Improvement.
Compile reports.
Create spreadsheets for tracking reports in Excel.
Create and type Word documents such as letters and appeals.
Coordinated onsite and offsite meetings.
Transcribe Committee Meeting Minutes.
Create Power Point Presentations.
Spoke with patients explaining the different types of behavioral health providers and services they provided.
Verification of benefits
Education:
Mansfield Business Dallas, TX
Classes in Business Management
J.F. Kimball High School
Diploma
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