*IDX/Centricity system *CPR 70 version *Cerner *OSRx *Meditech *MedSuite *EPIC *Payer portals, including Novitas, Noridian, and Palmetto *Availity
Judith Bell-Shelton
Lancaster
Summary
Experienced Revenue Cycle Manager with expertise in optimizing revenue cycle processes across healthcare organizations. Proven track record in managing and reducing accounts receivables based on streamlining insurance billing, patient collections, and payer appeals to enhance cash flow in a fast-paced environment.
Detail-oriented professional with exceptional communication and project management skills. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
29
29
years of professional experience
Work History
Business Analyst
BlueSky Resources Solutions
03.2025 - Current
- Analyze and interpret patient accounts for Medicare Bad Debt and WS S-10/Uncompensated Care for filing on the Medicare Cost Report
- Work remotely in patient accounting systems (Epic, Cerner, etc.)
- Collaborate with team members on complex issues that arise from the review of patient accounts.
- Work with larger sets of data to analyze anomalies and outlier issues with patient accounts.
- Assist with CMS/MAC audits.
Revenue Cycle Manager
Ventra Health
12.2022 - 02.2025
- Manage all Revenue cycle objectives and metric targets for anesthesia clients to optimize cash flow.
- Ensure all insurance billing and patient statements submitted electronically through the clearinghouse/vendor within 5-7 days of the release date.
- Collaborated with client advocacy reps to meet clients’ business needs each month.
- Assign accounts receivable tasks to offshore partners to ensure timely payment of balances in the 30-, 60-, and 90-day aging categories.
- Managed onsite/hybrid AR staff on payer appeals for the Anesthesia AR for assigned clients. Reduced outstanding balances for AR greater than 90 days by $52 million through appealing claims with the correct modifiers for distinct procedures to initiate payments.
- Managed staff to utilize the appeals through payer portals to overturn denials.
- Work with coding and credentialing departments to maximize payer reimbursement.
- Designed/Created a patient Pre-pay process for discounted estimates for the self-pay patients before surgery.
- Report to Senior leadership all denial trends and resolutions to decrease days in AR and increase cash flow.
- Manages all Bad Debt collection turnover processes to determine what accounts qualify for the Bad Debt vendors’ collection efforts.
- Managed the Print/Mail team and established processes for all work-from-home tasks, ensuring daily mailing of appeals and hard copy claims.
- Completed all assigned clients' month-end close tasks on time, including adjustments, cash posting, and charges, ensuring timely closure each month.
Revenue Cycle Manager
Steward Healthcare
11.2018 - 11.2022
- Managed all aspects of the Revenue Cycle Management for Steward Healthcare Acute care, Behavioral Health, and Psych facilities across the U.S.
- Managed/Created and Designed the Customer Service, Credit Balance, and Support teams to centralize all processes.
- Developed/designed Richardson CBO-Customer Service department for all inbound calls, i.e., Resolving patient disputes, processing patient payments, providing requested Itemized statements and UB04’s, Refund requests, AP invoice payment inquiries and attorney requests.
- Developed/Designed Quality Assurance for Customer Service reps to ensure customer inbound calls are compliant according to PHI and HIPAA guidelines.
- Responsible for the Quarterly Medicare Credit Balance reporting and validations to all CMS intermediaries.
- Reconcile patients’ cash daily and complete Point of Service adjustments by month-end.
- Managed all Support Services functionalities, scanning, indexing of incoming patient/payer correspondence and assured that information routed to correct work queues for the collectors to expedite next steps.
- Created/Designed the Legal- (Attorney requests) department for completion of Subpoenas, Affidavits, Depositions, retrieving the associated billing, and notarizations for completion. Partnered with the MRO (Vendor) to complete attorney requests and it is entirely of the incoming requests.
- Created and managed the bankruptcy process for all South Division bankruptcy notices, utilizing the PACER system to ensure accurate logging and processing of filings in Meditech and with billing/collections vendors.
- Conducted staffing analysis to maintain daily inventory.
- Worked with various departments and Sr. Leadership on system conversion process development (SME) for Meditech, Rev Recover and OnBase applications.
- Collaborated with multiple vendors to ensure timely payment of invoices in alignment with business requirements.
Revenue Cycle Manager
DaVita Rx
05.2017 - 10.2018
- Managed all Revenue Cycle Operations activities for the core/specialty pharmacy business which includes PBM billing, Manual billing.
- Managed AR collections for insurance payer outstanding balances.
- Managed Credit Balance Resolutions for underpayments.
- Managed Cash Applications and Patient collections.
- Created SOPs and job aids to streamline processes.
- Month end processes were reviewed for accuracy.
- Reported all issues/trends through reporting and analytics for resolutions to Senior Leadership.
- Created production/Quality assurance standards for assigned teammates that resulted in accountability and drives Cash flow for all dispensed medications for our DaVita Renal patients.
Medical Collections Manager
Schumacher Clinical Partners
04.2014 - 05.2017
- Oversee and managed all the Commercial/State funded program payers Account Receivables for Emergency Room/Urgent Care services.
- Identified key issues with Managed Care, state funded programs and Indigent programs payers and develop collections strategies to increase cash flow.
- Worked with various Re-pricer and Negotiation companies to maximize reimbursement upon when the payers would short pay for services rendered.
- Designed and implemented the Erisa/AOB processes to collect additional reimbursement from OON payers that paid less than usual/customary of billed charges.
- Developed policies/procedures and implemented plans of action that will maximize the cash flow and minimize the outstanding accounts receivable.
- Managed supervisors to evaluate team performance and meet Metrix goals.
- Identified process flow improvements to streamline collections to eliminate to minimize payer denials going forward.
- Educated staff and other members of the Revenue Cycle team on how to strategize collections techniques.
- Performed weekly evaluations and monitored all collections activities for the Offshore vendors to ensure all accounts that displayed as No Activity/ Denials did not work accordingly.
- Prepare daily, weekly, and monthly financial reporting outlining the issues and next steps/resolutions for the Senior Leadership team.
Reimbursement Supervisor
US Bioservices
03.2005 - 04.2014
- Company Overview: (Amerisource Bergen Company)
- Managed all billing and collection processes for 9 Specialty pharmacy vendors and the laboratory product-Carticel.
- Improved collection processes for PBM, Manufacturer Programs, TPA’s and major medical payors through appealing for accurate reimbursement, negotiations and per contract provisions.
- Ensured all outstanding accounts receivable for the Major-Medical plans are within 90 days of the billing cycle and monitored all PBM payors for timely and accurate reimbursement.
- Supervised payment posting processes, including payments through credit card payments, insurance checks, money orders, EFT’s, and Patient Assistance Programs funding.
- Managed assigned staff performance by way of random Quality Assurance checks for all Medicare patients to ensure that all coding met Medical Policy according to the Medicare guidelines prior to billing.
- Managed Benefits Verification processes prior to dispense for pharmacy orders/products to expedite accurate reimbursement, including retrieving accurate authorizations and Pre-D information.
- Reviewed revenue adjustments according to SOX compliance guidelines for assigned staff.
- Trained all new-hires and assigned staff on creative collection techniques for Government/Managed Care accounts receivables.
- Identified and reported to Senior Management the denial trends by pharmacy/payor and action plans to improve outstanding receivables by month end.
- Reviewed and identified issues for assigned products/payor categories concerning profit margins of drugs dispensed monthly.
- (Amerisource Bergen Company)
Hospital/Physician Consultant
Resulte Universal
02.2004 - 03.2005
Collections Supervisor
UT Southwestern
10.1996 - 09.2003
Education
Bachelor of Science - Business Administration
Texas Woman's University
Denton, TexasHigh School graduate -
David W. Carter
Dallas, TXSkills
- 10-key by touch
- Type 65 wpm
- Lotus 1-2-3
- Power BI
- 3M Physician Coding software
- Wallaby Resident Physician Management system
- Various Billing clearinghouses
- Lockbox processing, including EFT's- 835/837 formats
- Familiar with PLB Segments
- Coding (CPT, ICD-10, HCPCS)
- All Microsoft applications
Accomplishments
- Led teams to meet 90% of KPI's by streamlining business processes and identifying areas for improvement.
Software
Timeline
Business Analyst
BlueSky Resources Solutions
03.2025 - Current
Revenue Cycle Manager
Ventra Health
12.2022 - 02.2025
Revenue Cycle Manager
Steward Healthcare
11.2018 - 11.2022
Revenue Cycle Manager
DaVita Rx
05.2017 - 10.2018
Medical Collections Manager
Schumacher Clinical Partners
04.2014 - 05.2017
Reimbursement Supervisor
US Bioservices
03.2005 - 04.2014
Hospital/Physician Consultant
Resulte Universal
02.2004 - 03.2005
Collections Supervisor
UT Southwestern
10.1996 - 09.2003
Bachelor of Science - Business Administration
Texas Woman's University
High School graduate -
David W. Carter
Career Targets
Accomplishments in collaborating with offshore vendors, managing system conversions, and improving business outcomes through strategic planning and process improvements. Adapt to collaborating with senior leadership to identify denial trends, resolve issues, and implement effective solutions to drive financial performance.
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