Carriona Sheppard
York ,SC
Summary
Professional Summary
Detail-oriented healthcare administrative and customer service professional with over four years of experience in patient access, reimbursement operations, and revenue cycle support. Skilled in insurance verification, prior authorizations, compliance, auditing, account management, and resolving complex customer inquiries with accuracy and professionalism. Proven ability to thrive in fast-paced, high-volume environments while delivering exceptional patient and customer experiences. Strong background in troubleshooting, problem-solving, and building rapport with diverse populations through effective communication and active listening. Recognized for maintaining regulatory compliance, improving operational efficiency, and supporting organizational goals through attention to detail, data accuracy, and outstanding customer service.
Overview
7
7
years of professional experience
Work History
Patient Access Representative
Conifer Health
06.2023 - Current
- Executed patient registration demographic validation and insurance eligibility verification processes.
- Facilitated prior authorization processes and verified documentation accuracy to enhance revenue cycle efficiency.
- Demonstrated unwavering integrity in all professional interactions and decision-making processes.
- Processed point-of-service payments, including co-pays, deductibles, and outstanding balances.
- Ensured adherence to HIPAA regulations while managing confidential patient information.
- Facilitated collaboration between clinical billing and leadership teams to efficiently resolve account discrepancies.
Reimbursement Manager
CareMetx
01.2021 - 06.2023
- Executed benefits investigations and verified insurance coverage for specialty therapies.
- Streamlined coordination of prior authorization appeals and payer communications to enhance therapy efficiency.
- Orchestrated communication among patients, providers, and insurance companies to streamline access processes.
- Documented case activities meticulously within case management systems to uphold compliance standards.
- Facilitated patient education on financial assistance program coverage options and subsequent steps.
Benefits Verification Specialist
Lash Group
10.2019 - 02.2021
- Performed verification of patient benefits for eligibility and insurance coverage.
- Assisted healthcare providers in collecting necessary documentation for claim submissions.
- Managed patient information effectively through electronic health record systems.
- Reviewed insurance policies to ensure compliance with relevant regulations.
Education
Southeastern College
Charlotte, NC05.2023
Skills
- Customer service
- Insurance verification
- HIPAA compliance
- Patient registration
- Medical terminology
- Problem-solving
- Reliability and dedication
- Administrative and office support
- Caring and empathetic
- Attention to detail
- Friendly and outgoing
- Team leadership
Timeline
Patient Access Representative
Conifer Health
06.2023 - Current
Reimbursement Manager
CareMetx
01.2021 - 06.2023
Benefits Verification Specialist
Lash Group
10.2019 - 02.2021
Southeastern College