Lewgelien Shepherd
Marcus Hook,PA
Summary
Detail-oriented and analytical Healthcare Operations & Administration Professional with a demonstrated track record of quality assurance, cross-functional collaboration, and leveraging data-driven decision making to solve ambiguous problems that align to overall business strategies. Energetic Office Manager equipped to support day-to-day operational functions and accomplish business goals. Blends advanced organizational, technical and business expertise to enhance workflows. Focused on attentively assisting office staff and customers and identifying opportunities for improvement.
Overview
15
15
years of professional experience
Work History
OFFICE MANAGER
Heartland Hospice
11.2022 - Current
- Strategy& Execution: Customer service, Patient Care, setting clear goals and objectives, establish timelines and deadlines for projects or tasks, foster collaboration among the team members, allocate resources and manages budget effectively
- Supports company operations by maintaining office systems and supervising staff, organizing office operations and procedures, preparing payroll, controlling correspondence, designing filing systems, reviewing ad approving supply requisitions
- Maintains office efficiency by planning and implementing office systems, layouts, and equipment procurement
- Designs and implements office policies by establishing standards and procedures, measuring results against standards, and making necessary adjustments
- Ensure that all items are invoiced and paid on time
- Completes operational requirements by scheduling and assigning employees and following up on work assignments
- Maintains office staff by coaching, counseling, and disciplining employees, and planning, monitoring, and appraising job performance
- Keeps management informed by reviewing and analyzing special reports; summarizing information; identifying trends.
- Assist in the onboarding process for new hires
- Organize orientation and training of new staff members Participate actively in the planning and execution of company events Coordinate with IT department on all office equipment
HOSPITAL AUTHORIZATION SPECIALIST
NEMOURS ALFRED I DUPONT HOSPITAL
WILMINGTON, DE
12.2019 - 11.2022
- Strategy & Execution: Customer Service, Patient Care, Billing & Claims, Benefits, Insurance, Quality Assurance, Verification, Stakeholder Engagement, Compliance, Physician Correspondence
- Lead for Emergency Room Pediatrics, responsible for utilizing all available resources to verify eligibility, benefit levels, and patient copayment responsibilities, maintaining confidentiality and providing guidance for urgent admissions in a timely manner.
- Partnered and worked In conjunction with insurance provider relations, case managers, and representatives to obtain information and resolve discrepancies related to billing, claims, denials, and technical errors.
- Identify and report trends and prior authorization issues relating to billing and reimbursement.
- Validates eligibility status for income assistive programs, free medical care, and Medicaid eligibility and contact and interview families by phone to obtain necessary information and assist them with insurance issues that may be preventing authorization
- Communicates professionally, effectively, and timely to the physician/ clinical staff regarding authorization status or delays.
- Proactively manages and maintains all outstanding authorization accounts to increase billing of clean claims
- Received 'kudos' and recognition for outstanding work and due diligence.
PATIENT SERVICES COORDINATOR
EYE ASSOCIATES OF BUCKS COUNTY
WILMINGTON, DE
05.2015 - 12.2019
- Strategy & Execution: Patient Services, Daily Operations, Customer Service, Patient Intake, Scheduling, Administrative Services
- Provided administrative front desk support and customer service satisfaction to patients with courtesy, respect, and professionalism
- Supported 4 doctors with scheduling and patient management, assisting with notes and hospitality.
- Identified and collected copayments to meet patient financial obligations, including applicable deductibles
- Resolved issues that could affect care progression by ensuring the flow of information and solving problems.
- Obtained prior authorization for specialty testing for upcoming surgeries
- I.e cataract surgery, utilizing all available resources to verify eligibility, benefit levels, and patient copayment responsibilities
PROVIDER ACCOUNT REPRESENTATIVE
HP ENTERPRISE
NEWARK, DE
06.2014 - 05.2015
- Strategy & Execution: Assurance & Compliance, Claim Eligibility Verification, Denial Resolution, Benefits Services, Quality Assurance
- Ensured efficient and accurate intake, benefit verification, pre-registration, registration and scheduling of patients referred to the network as well as physician follow up and notification.
- Investigated, resolved and communicated provider claim issues and changes
- Served as primary contact for providers and acted as a liaison between the providers and the health plan.
- Interpreted eligibility for Delaware Medicaid members
- Reviewed and processed applications for providers to become enrolled in Delaware Medicaid, adhering to state and federal regulations and guidelines.
CUSTOMER ACCOUNT REPRESENTATIVE
HIGH MARK BLUE CROSS BLUE SHIELD
WILMINGTON, DE
08.2012 - 06.2014
- Strategy & Execution: Patient Care, Customer Service, Billing & Claims, Quality Assurance
- Ensured accuracy In premium copayment collection and reconciliation
- Monitored and maintained assigned accounts and inbound calls
- Issued correspondence to customers to notify of account transfers and to encourage payment of delinquent accounts and final determination.
- Discussed and reviewed in detail the different plans and services offered within Highmark Blue Cross and Blue Shield Delaware
- Complete insurance group requests for medical records, pre-certification, or authorization for medical claim payment.
FRONT DESK CARE REPRESENTATIVE
DELAWARE OPHTHALMOLOGY CONSULTANTS
WILMINGTON, DE
02.2009 - 06.2014
- Strategy & Execution: Patient Services, Admin Operations, Scheduling
- First line of contact for patients scheduling appointments and collected co-pay, surgery prepays and outstanding balances from patients
- Assisted doctors with notes and hospitality, recorded vital screening, and interviewed candidates.
- Answered patients questions concerning upcoming procedures, surgeries, and types of ocular medical conditions
Education
Master of Science Healthcare Administration -
Strayer University
12-2021
Bachelor of Science - Human Resources
Wilmington University
06-2000
Skills
- ERP: EHR/EHR System EPIC
- Productivity: Microsoft Office Suite, Google GSuite /Workspace, HCHB
- Billing: ICD-10 coding HIBS, PSAR, ECS Billing Systems
- Management: Matrix Scheduling System, Nextgen, MMIS application, CMS Application, SRS Chart Manager, kronos, Dayforce
- Performance Improvement and Management
- Employee Retention
- Onboarding
- Payroll Processing
- Teamwork and Collaboration
- Communication ,Decision Making and Organizational skills
Relevant Training
- Management in Healthcare
- Health Service Administration
- Healthcare Operations Management
- Health Service Strategic Marketing
Custom
- SHRM Certification (in progress )
Timeline
OFFICE MANAGER
Heartland Hospice
11.2022 - Current
HOSPITAL AUTHORIZATION SPECIALIST
NEMOURS ALFRED I DUPONT HOSPITAL
12.2019 - 11.2022
PATIENT SERVICES COORDINATOR
EYE ASSOCIATES OF BUCKS COUNTY
05.2015 - 12.2019
PROVIDER ACCOUNT REPRESENTATIVE
HP ENTERPRISE
06.2014 - 05.2015
CUSTOMER ACCOUNT REPRESENTATIVE
HIGH MARK BLUE CROSS BLUE SHIELD
08.2012 - 06.2014
FRONT DESK CARE REPRESENTATIVE
DELAWARE OPHTHALMOLOGY CONSULTANTS
02.2009 - 06.2014
Master of Science Healthcare Administration -
Strayer University
Bachelor of Science - Human Resources
Wilmington University