LaShonya Hampton
Detroit,MI
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
15
15
years of professional experience
Work History
Provider Engagement Specialist/ Physician Liaison/ Quality Auditor/ Credentialing specialist
Reliance ACO/ Commonwealth Care Alliance ACO
Farmington Hills, MI
10.2017 - 12.2023
- Conducted in person meetings with staff at ACO physician offices monthly and as needed, to train/educate them on ACO protocols and procedures and CMS updates, metrics and requirements
- Secured and maintained provider relationship through consistent and timely personal and professional engagement
- Prepared and maintained quarterly performance reports to present to staff at physician offices during monthly meetings
- Ensured clients issues were addressed and resolved within an efficient and timely manner
- Recommended and participated in the revision/creation of marketing materials.
Office/ Facility Manager
Urgent Care Management
Farmington Hills, MI
03.2009 - 07.2017
- Provided excellent customer service in a medical setting
- Responsible for running front Offices
- Performed patient check-in, Insurance Verification and scheduling of patients
- Performed charge entry, payment posting, and claims management for Urgent Care location
- Created monthly patient and insurance aging reports to identify any open accounts
- Performed medical administrative tasks such as, supply orders, scheduling, licensure, HIPAA and OSHA compliance
- Worked with Medical Director, Facility Managers and Billing Department heads to evaluate systems and processes to ensure effective medical services and revenue collections
- Prepared meeting agendas and organized monthly staff meetings
- Handled all aspects of the medical record department, including: checking to ensure proper documents were complete and filed appropriately
- Responsible for implementing objectives and updating policies/procedures within my Urgent Care location.
Quality Specialist
Reliance ACO/ Commonwealth Care Alliance ACO
Farmington Hills, MI
- Contacted patients to obtain medical information for gap closure reporting for Medicare Quality Improvement program, as required
- Scheduled and conducted on-site reviews and audits to assure Medicare compliance Medical records; electronic and paper
- Monitored Quality Measures within Accountable Care Organization (ACO) physician offices for group practice reporting options and quality improvement
- Searched various EHR for documentation omissions and data errors and provided appropriate offices with reports of findings and improvement suggestions
- Researched, reviewed and analyzed reports to narrow/define scope for on-site review, identifying areas of non-compliance and risk
- Provided and recommended areas to improve quality performance to physician office staff
- Worked with individual offices one on one, when requested, providing customized services
- Worked with other employees and leadership to obtain, share and suggest information to enhance the mission of the organization.
Credentialing Assistant
- Prepared application packets for distribution to providers
- Received completed applications, entered data into credentialing database
- Assigned applicants to appropriate facilities and communicated with appropriate facility manager or representative
- Scanned and emailed completed credential files to appropriate facilities in a timely manner
- Maintained records of all changes to practitioner status and demographics and communicated with appropriate department
- Assisted team in developing helping documentation (reports for credentialing committee, agendas, and other departments, as assigned
- Monitored time-limited documents to assure constant currency within requested time frame
- Notified provider or provider representatives of expiring documents and issues with credentialing
- Performed other position duties as required.
Education
Certificate of Completion - Risk Adjustment Coding
AAPC online
10-2023
Associate of Arts - Healthcare Administration
American Intercontinental University Online
08-2011
Diploma - Medical Administration
National Institute of Technology
01.2001
Skills
- EMR/EHR systems
- Coding/ Billing Software
- Medical Records Auditor
- Customer Service
- Remote work
- Health Plan Contracting and benefits
- Database management
- Data Entry
- Medical Staff
- Insurance Verification
- Provider Engagement
- Problem solving
- Information gathering and analysis
- Attention to Detail
- Time management
- Staff scheduling
- Healthcare Front office
Other Contributions
- Provided management support for multiple clinics
- Provided support and performed regular QA reviews for patient intake, registration and scheduling functions.
- Managed patient reception and services coordination.
- Operated the electronic health records and billing system.
- Managed facility procedures related to insurance and billing; solved patients' queries regarding their insurance inquiries.
- Facilitated the management in resolved general issues related to the patients such as insurance and medical reports.
- Provided the required support and direction for office initiatives and special projects.
- Assisted the HR Director in generating office staff payroll on a bi-weekly basis
- Monitored the equipment used in the Urgent Care Suite, as well as in the entire building to facilitate repairs or replacements as required or needed.
Timeline
Provider Engagement Specialist/ Physician Liaison/ Quality Auditor/ Credentialing specialist
Reliance ACO/ Commonwealth Care Alliance ACO
10.2017 - 12.2023
Office/ Facility Manager
Urgent Care Management
03.2009 - 07.2017
Quality Specialist
Reliance ACO/ Commonwealth Care Alliance ACO
Credentialing Assistant
Certificate of Completion - Risk Adjustment Coding
AAPC online
Associate of Arts - Healthcare Administration
American Intercontinental University Online
Diploma - Medical Administration
National Institute of Technology
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