Michelle Shelley
Non-Profit Administration
Gresham,OR
Summary
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
19
19
years of professional experience
Work History
Clinic Assistant
Legacy Health Mt. Hood Medical Center
2022.02 - Current
- Greeted, checked in patients and collected copays for four different individual departments and schedules
- Performed complex activities in EPIC software such as insurance verification, registration and follow up
- Centralized scheduler for four metro locations
- Entered referrals into EPIC, contacted patients and scheduled appointments
- Completed prior authorizations for specific services
Clinic Service Specialist II
Legacy Health Mt. Hood Medical Center
2021.04 - 2022.02
- Greeted, checked in patients and collected copays and past due balances
- Performed complex activities in EPIC software such as appointment scheduling ,insurance verification, registration and follow up
- Answered multiple line phones with three other dedicated staff, resolved concerns, routed to specific teams and escalated as necessary according to clinic guidelines
Director OCHIN Billing Services
OCHIN
2019.09 - 2021.01
- Established efficient workflow processes, monitored daily productivity and implemented modifications to improve overall effectiveness of personnel and activities to align with organizational goals for revenue cycle management.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
Director Revenue Cycle West Coast
Integra Connect
2019.04 - 2019.09
- Ensured the overall timely and accurate billing of ground ambulance transports for the West Region covering 13 states.
- Produced and analyzed OLAP Cube Revenue Cycle reports outlining financial data to assist management with making strategic plans and operational decisions.
- Insurance verification and follow -up denied or no response claims.
- Compiled data and presented monthly reports to executive leadership team highlighting progress for the region.
Revenue Cycle Manager & HIPAA Compliance Officer
Life Flight Network
2014.01 - 2019.04
- Monitored and guided revenue cycle operations.
- Received and processed medical records requests utilizing EHR.
- Evaluated financial assistance applications and required documentation (letter outlining financial circumstances, tax returns, income verification forms, retirement and bank account statements) against outline specifications to approve or reject and communicated decisions via letter and phone.
- Completed financial reporting and analysis for billing revenue cycle.
- Enrolled providers and Medicaid, Medicare and private insurance plans. Maintained accurate files, records and credentialing documents in information database.
MEDICAL BILLING MANAGER
Planned Parenthood Of Southwestern Oregon
2010.05 - 2014.01
- Orchestrated day-to-day operations of billing department, including medical coding, payment posting, accounts receivables and collections for eight full service clinics.
- Provided NextGen technical support to the organization.
- Improved quality processes for increased efficiency and effectiveness and met goals for Key Performance Indicators.
- Expanded cross-functional organizational capacity by collaborating across departments on priorities, functions and common goals.
- Increased revenue by over 10% by negotiating managed care agreements strategically.
Medical Billing Supervisor
Planned Parenthood Columbia Willamette
2008.08 - 2010.05
- Assisted in day-to-day management of charge entry, payment posting, accounts receivables and collections for 11 clinics across Portland Metro area.
- Trained new employees on multiple medical billing programs and data entry software.
- Devised new methods to make workflows more efficient and brought suggestions to attention of Medical Billing Manager.
- Tracked and analyzed reports to determine needed improvements.
- Evaluated performance and policies against metrics. Coached staff on daily performance and conducted evaluations to constructively address concerns.
- Established relationships with Medicaid, Medicaid Waiver and private insurance providers to resolve billing issues effectively.
Interim Billing Manager
Planned Parenthood Columbia Willamette
2008.02 - 2008.08
- Tasked with interim management during critical period of NextGen PM Go Live
- Managed grossly outstanding AR in legacy system while managing and working through Go Live issues in NextGen EPM system and quickly started meeting Key Performance Indicators for AR management.
- Conducted performance reviews and implemented improvement plans.
Trainer NextGen Implementation
Planned Parenthood Columbia Willamette
2007.08 - 2008.02
- NextGen core team member and implementation trainer for organization with focus on registration, appointment scheduling and charge entry.
Medical Billing Coordinator
Planned Parenthood Columbia Willamette
2006.06 - 2007.08
- Served as liaison between front desk staff, supervisors and managers at 11 Portland Metro clinics and centralized billing department.
- Facilitated monthly meetings with clinic leads to identify, review, and resolve roadblocks leading to bad debt.
- Developed and updated tracking spreadsheets. Responsible for tracking, trending and providing feedback to providers for coding errors or missing data leading to reduced or lost revenue. Primary focus on specific program/grant requirements for proper reimbursement.
Billing Manager
Olsen Memorial Clinic
2005.06 - 2006.07
- Managed day-to-day billing for busy internal medicine practice, including charge capture, payment posting, daily deposits, patient account resolution, appeals, and month end reconciliation.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Assisted other Registration Clerks with front desk duties, answering questions and accurately using reservation system.
Education
MBA - Health Administration
Concordia University
Portland, OR08.2015
Bachelor of Science - Health Care Administration
Concordia University
Portland, OR08.2013
Associate of Science - Business Transfer
Clackamas Community College
Oregon City, OR09.2011
Associate of General Studies - Liberal Arts And General Studies
Clackamas Community College
Oregon City, OR06.2006
Certificate - Medical Office Administrative Assistant
Clackamas Community College
Oregon City, OR06.2006
Certificate - Medical Assistant
Clackamas Community College
Oregon City, OR06.2005
Skills
- Empathetic & Compassionate Customer Service
- Office Support
- Registration Electronic Health Records
- Reporting and Database Management/Analytics
- Regulatory Compliance
- Critical thinking abilities
Accomplishments
National Academy of Ambulance Coding, Certified Ambulance Coder, Certified Privacy Officer, Certified Certification, Ambulance Compliance Officer. Healthcare Finance Management Association ,Certified Revenue Cycle Representative. NextGen Software, EMR & EPM Certified Specialist. American Academy of Professional Coders, Certified Professional Coder. American Medical Assistant Association, Certified Medical Assistant.
Former Certifications
National Academy of Ambulance Coding- Certified Ambulance Coder, Certified Privacy Officer, Certified Certification, Ambulance Compliance Officer
Healthcare Finance Management Association- Certified Revenue Cycle Representative
NextGen Software-EMR & EPM Certified Specialist
American Academy of Professional Coders- Certified Professional Coder
American Medical Assistant Association- Certified Medical Assistant
Timeline
Clinic Assistant
Legacy Health Mt. Hood Medical Center
2022.02 - Current
Clinic Service Specialist II
Legacy Health Mt. Hood Medical Center
2021.04 - 2022.02
Director OCHIN Billing Services
OCHIN
2019.09 - 2021.01
Director Revenue Cycle West Coast
Integra Connect
2019.04 - 2019.09
Revenue Cycle Manager & HIPAA Compliance Officer
Life Flight Network
2014.01 - 2019.04
MEDICAL BILLING MANAGER
Planned Parenthood Of Southwestern Oregon
2010.05 - 2014.01
Medical Billing Supervisor
Planned Parenthood Columbia Willamette
2008.08 - 2010.05
Interim Billing Manager
Planned Parenthood Columbia Willamette
2008.02 - 2008.08
Trainer NextGen Implementation
Planned Parenthood Columbia Willamette
2007.08 - 2008.02
Medical Billing Coordinator
Planned Parenthood Columbia Willamette
2006.06 - 2007.08
Billing Manager
Olsen Memorial Clinic
2005.06 - 2006.07
Bachelor of Science - Health Care Administration
Concordia University
Associate of Science - Business Transfer
Clackamas Community College
Associate of General Studies - Liberal Arts And General Studies
Clackamas Community College
Certificate - Medical Office Administrative Assistant
Clackamas Community College
Certificate - Medical Assistant
Clackamas Community College
MBA - Health Administration
Concordia University
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