Summary
Overview
Work History
Education
Skills
Previous Clinical Experience and Skills
References
Timeline
Generic

Mandy Webb

Van Buren,Arkansas

Summary

Dynamic professional with extensive leadership experience and a proven track record in denial management and appeals writing. Adept at transforming workflows through automation and strategic integration to enhance operational efficiency. Skilled in Power BI, SQL and Tableau and evidence-based decision-making, driving impactful results. Seeking to leverage a role in which I can use my expertise in appeals writing and denial analysis to contribute directly to organizational success, bringing a hands-on approach and a commitment to excellence.

Overview

11
11
years of professional experience

Work History

Sr. Manager Clinical Appeals

R1 Rcm
Southfield, MI
08.2017 - 12.2024
  • Managed a team of 50+ employees by providing guidance, setting goals and objectives, delegating tasks, and monitoring performance.
  • Contributed innovative automation strategies that optimized workflows and delivered measurable improvements in outcomes.
  • Played an instrumental role in aligning and integrating two disparate tools, transforming them into a cohesive system that delivers complete data across both platforms, driving improved workflows and decision-making.
  • Reviewed employee performance and provided ongoing feedback and coaching to drive performance improvement.
  • Implemented process improvements to increase operational efficiency and reduce costs.
  • Established effective communication channels between different departments within the organization.
  • Implemented quality control measures to uphold company standards.
  • Reported to executive leadership on performance metrics, challenges, and strategic opportunities.
  • Facilitated team meetings and workshops to align on goals and strategies.
  • Analyzed data to identify trends and develop actionable insights for organizational growth.

Registered Nurse – Clinical Appeals Author

Shared Services Center
Fort Smith, Arkansas
04.2016 - 08.2017
  • Researching and resolving claim discrepancies by performing an in-depth review of medical records and insurance policies.
  • Creating an appeal letter with detailed documentation to support overturning the denial and submitting it to the insurance companies.
  • Tracking frequent denials or trends and providing feedback to other teams with potential process improvements that would result in the resolution of the denials.
  • Verifying insurance coverage and claim status by communicating with various insurance companies.
  • Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
  • Posting payments, including contractual payments, to accounts, as well as posting adjustments when required.
  • Maintained up-to-date knowledge of applicable laws, regulations, policies and procedures related to appeals processing.
  • Checked documentation for appropriate coding, catching errors and communicating with other teams if revisions were needed.
  • Demonstrated ability to work independently as well as collaboratively within a team environment.

Home Health RN Case Manager

LHC Group
Fort Smith, AR
02.2016 - 04.2016
  • Assessed patient conditions during in-home visits, developing personalized care plans.
  • Trained new home health nurses, sharing best practices and clinical expertise.
  • Participated in interdisciplinary team meetings regarding patient care planning and outcomes assessment.
  • Educated patients and families about treatments, medications, and self-care management techniques.
  • Conducted regular follow up visits with patients in order to evaluate progress towards goals set forth in their care plan.

Registered Nurse Supervisor

Area Agency on Aging Home Health & Hospice
Fort Smith, Arkansas
07.2013 - 02.2016
  • Assessed the need for, obtained, and interpreted all patient-specific care orders from both primary and specialty physicians, and updated the plan of care.
  • Processed monthly reports for department performance and end-of-month billing.
  • Demonstrated ability to lead and motivate an outstanding healthcare team as Supervisor/Case Manager.
  • Coordinated Quality Improvement Activities (QIA's) to identify performance areas for improvement.
  • Developed and implemented nursing care plans by reviewing OASIS maintenance and making corrections as needed
  • Ensured all OASIS were coded with correct ICD coding to ensure optimal payment

Education

MBA - Healthcare Management

Western Governors University
Salt Lake City, UT
02-2025

Bachelor of Science - Nursing

Chamberlain College
06-2018

Associate of Applied Science - Nursing

UACCB
Batesville, Arkansas
01.2015

Licensed Practical Nurse - Nursing

Kiamichi Vo-Tech
06-2006

Skills

  • Sound Clinical Decision-Making
  • Leadership Proficiency
  • Denial Management Analysis
  • Experienced with EHR - Soarian, Epic, and Cerner
  • Proficient in ICD-10, CPT, and DRG
  • In-Depth Knowledge of Microsoft Office Suite
  • Proficient in Power BI, SQL, and Tableau
  • Data analytics
  • Strategic Innovation Oversight
  • Reporting Proficiency
  • Evidence-Based Decision Making
  • Investigative Research Skills
  • Strategic Content Creation

Previous Clinical Experience and Skills

  • Prior hands-on nursing with experience in diverse settings, including ICU, Med-Surg, Post-Operative Care, Home Health, and Hospice.
  • Skilled in managing complex cases across a variety of diagnoses, including critical care, post-surgical recovery, chronic disease management, and acute illness.
  • Expertise in delivering high-quality patient care in fast-paced, high-pressure environments such as ICU and Med-Surg units.
  • Strong proficiency in coordinating multidisciplinary care plans, ensuring patient safety and optimal health outcomes.
  • Adept at providing compassionate, patient-centered care in both clinical and home settings, fostering trust and adherence to treatment plans.

References

References available upon request.

Timeline

Sr. Manager Clinical Appeals

R1 Rcm
08.2017 - 12.2024

Registered Nurse – Clinical Appeals Author

Shared Services Center
04.2016 - 08.2017

Home Health RN Case Manager

LHC Group
02.2016 - 04.2016

Registered Nurse Supervisor

Area Agency on Aging Home Health & Hospice
07.2013 - 02.2016

MBA - Healthcare Management

Western Governors University

Bachelor of Science - Nursing

Chamberlain College

Associate of Applied Science - Nursing

UACCB

Licensed Practical Nurse - Nursing

Kiamichi Vo-Tech
Mandy Webb