Shamma' Presley

Field LVN

Clinic LVN

Assistant Director of Nursing

Rehab and LTC

• Managed the resolution of complex reimbursement cases, resulting in increased revenue recovery for the organization.
• Reduced errors in billing submissions through regular staff training and implementation of quality control measures.
• Supervised a team of reimbursement specialists, ensuring timely and accurate processing of claims.
• Maintained up-to-date knowledge on industry regulations and compliance requirements, ensuring adherence by all team members.
• Provided ongoing support to team members with challenging case scenarios, fostering professional growth and development within the department.
• Conducted regular audits of reimbursement records to identify areas for improvement and ensure accuracy in reporting data.
• .Cultivated a positive work environment by recognizing team achievements and promoting collaboration among colleagues.

• Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
• Enhanced the overall financial performance of the organization by diligently monitoring outstanding claims and following up on overdue payments.
• Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
• Created documents in accordance with payer guidelines and submitted to appropriate parties.
• Delivered timely information to insurance representatives to resolve common and complex issues.
• Managed multiple priorities effectively under high-pressure deadlines without compromising accuracy or quality of work output.
• Billed and collected for claims submitted on clients' behalf..
• Prevented delays and claim denials by correcting information prior to submission.
• Reduced claim denial rates by thoroughly reviewing documentation before submission to insurance providers.
• Streamlined reimbursement processes by implementing efficient filing and tracking systems.
• Established strong working relationships with insurance providers, fostering open communication channels for smoother claim resolutions.
• Created training materials and led sessions for new hires, ensuring they were equipped with the necessary skills to excel as Reimbursement Specialists.
• Monitored and documented accounts receivable trends and account-specific profitability.