Regina Dianne Shack
Greer,SC
Summary
Dynamic AR Follow Up Specialist skilled in payment processing and coding accuracy at Novant Health. Demonstrates a proven track record in resolving insurance denials while enhancing patient billing operations. Strong collaborative leadership and expertise in 3M Code Finder software drive streamlined processes and improved financial outcomes. Aiming to leverage these competencies to further optimize revenue cycle management.
Overview
18
18
years of professional experience
1
1
Certification
Work History
AR Follow Up Specialist
Insight Global-Contract Employee Novant Health
12.2024 - 04.2025
- Review the entered charges for diagnosis and modifier coding errors.
- Review patient chart information to support office levels, and supported diagnosis.
- Verify provider enrollment and CLIA certification with QCOR
- Processed insurance denials and appeals, ensuring timely resolution of accounts, and re-billed or appealed claims within 30-45 days following the initial denial.
- Verify and correct patient identification, and resubmit claims appropriately.
- Identified and reported payer trends or issues to leadership, contributing to the strategic resolution of systemic billing challenges.
- Managed patient billing for non-covered services, secondary, and tertiary insurances, and assisted patients with self-pay balances, maintaining high standards of productivity and quality.
Medical Insurance Specialist
University Surgical Associates
05.2024 - 08.2024
- Verified proper application of diagnostic and modifier codes.
- Verified accuracy of clinical documentation via detailed assessments.
- Effectively handled claim re-billing and appeals in a timely manner of 30-45 days post initial denial.
- Identified payer trends, facilitating strategic resolution of billing challenges.
- Streamlined processes for managing patient financial operations.
- Relocated from Chattanooga to SC.
Patient Access Supervisor
Conifer Health Solutions
09.2022 - 05.2024
- Transitioned resources from CHI to Conifer focusing on hospital RCM unit.
- Supported team by ensuring proper handling of accounts.
- Offers comprehensive daily assistance and guidance to newly hired staff and existing Patient Access team.
- Provides assistance in managing escalated issues, as needed.
- Support preparation of planning proposals for Admitting, Centralized Scheduling, Emergency Department.
- Fosters positive customer service consistently, aiding staff in issue resolution.
- Aligned departmental operations with hospital and corporate regulations by enforcing existing and new policies.
- Moved from CHI to Conifer, which is the hospital side of RCM.
Patient Access Prior Authorization Representative II
Erlanger Health System
09.2007 - 06.2021
- Handled inbound calls from patients and insurance providers.
- Addressed requirements for medical necessity and pre-authorization of MRI, CT scans, PET scans among other radiology tests.
- Utilized PACS for efficient imaging data management.
- Facilitated access to financial aid by assisting with documentation.
- Ensured timely collection of payments for self-pay radiology procedures.
Claims Processor/Coder
Med-Write, Inc.
05.2008 - 09.2012
- Determined correct procedural codes through thorough review of medical documents.
- Coded procedures for the cardiothoracic surgeon located at the Kansas City Heart.
- Managed charge entries for various medical specialties.
- Execute upload of all batches, followed by downloading relevant error reports from clearinghouse.
- Cultivated strong professional relationships with physicians and office personnel.
- Handled server-related support for every billing client.
Education
Medical Billing and Coding Diploma -
01.2024
Medical Office Administration Certificate -
01.2002
High School Diploma -
01.1992
Skills
- Code implementation skills
- Payment processing expertise
- Proficient in 3M Code Finder software
- Epic management
- Identify code solutions
- Proficient in clinical terminology
- Collaborative leadership
- Patient registration expertise
- Precertification documentation expertise
- Inpatient care
- Outpatient procedure coordination
Networking - Linkedin
www.linkedin.com/in/dianne-shack-3a4430205
Certification
- Certified Coding Associate, AHIMA 275713
Timeline
AR Follow Up Specialist - Insight Global-Contract Employee Novant Health
12.2024 - 04.2025
Medical Insurance Specialist - University Surgical Associates
05.2024 - 08.2024
Patient Access Supervisor - Conifer Health Solutions
09.2022 - 05.2024
Claims Processor/Coder - Med-Write, Inc.
05.2008 - 09.2012
Patient Access Prior Authorization Representative II - Erlanger Health System
09.2007 - 06.2021
DeVry University - Medical Billing and Coding Diploma,
Northwest Shoals Community College - Medical Office Administration Certificate,
Phillips High School - High School Diploma,
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