SHEILA ELLISON INFLUENTIAL ANALYTICAL METICULOUS

REIMBURSEMENT SUPERVISOR

Red Oak, Texas 75154 469-***-**** adymzt@r.postjobfree.com Linkedin.com/pub/sheila-ellison-8036b51b0

Motivate Healthcare Staff to Exceed Expectations with Vital Contributions, Ensuring Claims & Patient Statements are Accurate & Revenue is Maximized

PROFESSIONAL SUMMARY

Deliver solution-based recommendations that prevent reimbursement loss.

Mitigate issues, make sound decisions, and meet deadlines in fast-paced environments with shifting priorities and rapid changes.

Interpret and convey complex information to broad-based audience.

KEY QUALIFICATIONS

Health Information Management (HIM) (EHR/EMR) DME Knowledge

Revenue Cycle Management Claims Processes Customer Service Staff Supervision

Charge Entries Insurance Verification ICD 10/CPT Codes Accounts Payable & Receivable

Analysis Results & Reporting Process Improvements

EXPERIENCE

Texas Oncology, Dallas, Texas October 2018–November 2020

Scheduling Supervisor, Presbyterian, Dallas May 2019–November 2020

Oversaw staff of how 15 coordinating scheduling procedures for each physician, lab, and chemotherapy department. Reviewed schedules daily, correcting conflicts as needed. Verified end of day reports aligned with diagnosis and office level completion. Maintained and updated scheduling guidelines. Liaised between physicians, patients, and office staff. Enforced Code of Ethics and Business Standards of US Oncology Compliance Program.

■Obtained all necessary new patient information, including medical records, demographics, and complete insurance information.

■Drove seamless transition and accurate information in collaboration with front office, medical staff, insurance, and billing teams.

■Coached staff conduct investigations and obtain critical additional information.

Revenue Cycle Supervisor, Charles A. Sammons Baylor Cancer Center October 2018–May 2019

Maximized collection of medical services payment and reimbursements from patients, insurance carriers, financial aid, and guarantors overseeing day-to-day revenue cycle operations with support staff of 10. Verified insurance eligibility and processed charges, payments, and claims. Oversaw collections and accounts receivable. Enforced established coding, credentialing, and customer service protocols. Managed denials; initiated appeals. Educated patients as to eligibility.

■Facilitated successful completion of concurrent and retrospective audits with meticulous documentation.

■Reduced delays with ready resolution of claim correspondence from insurance carriers. Tracked and managed deadlines.

■Trained new hires in revenue cycles, analytics, and revenue-cycle management activities.

EXPERIENCE (continued)

Dallas Endoscopy Center/IV Anesthesia Services, Dallas, Texas July 2006–October 2018

Supervisor, Central Billing Office 2016–2018

Drove high level of production and quality with well-communicated expectations for staff of 10. Investigated patient questions and inquiries with reimbursement and billing specialists and billing coordinators as needed. Provided information for performance appraisals. Monitored assigned work queues daily in electronic billing system; resolved errors and edits. Signed off on charge reconciliations. Released corrected claims with accounting staff.

■Secured proper payment for services rendered with comprehensive reviews, correcting claim denials.

■Summarized daily production reports; communicated procedural issues requiring analysis and resolution.

■Developed and motivated committed individuals that achieved high-performance standards and contributed significantly to successful and streamlined organization.

■Prepared team to identify inconsistencies with federal, state, and private payor claims.

■Advised supervisor of performance deficiencies; identify underperforming employees for retraining.

Supervisor 2013–2016

Instituted accountability system, expediting timely account billing with revamped workflow processes and procedures for staff of 15 tasked with preparing, submitting, and collecting on 3rd-party claims. Trained new hires in interpreting EOBs for recoupment, rejections, denials, and delays. Generated reports; alerted billing manager to problematic accounts.

Account Manager 2006–2013

Prepared and submitted claims and invoices to 3rd-party payers in accordance to specific billing requirements.

EDUCATION

Completed undergraduate coursework, Vernon Regional Junior College, Wichita Falls, Texas

TECHNICAL SKILLS

Microsoft Office, G Suite

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