Shana Burris
Wasilla,United States
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Looking to put my education and skills to work by adding value to such wonderful organization.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Billing Supervisor
Alaska Behavioral Health
Anchorage, United States
02.2019 - Current
- Insurance Billing and Coding Specialist; supervises billing, patient, and major/private insurance billing over 2 staff while assisting revenue cycle manage with projects for other staff.
- Monitor all Medicaid Optum behavioral health billing and working with Optum and the state of Alaska with continuous improvement initiatives for better and smoother billing processes and denial management.
- Implemented all the coding for primary care program, Claims to process, scrub and code claims to the CPT, ICD, and HCPCS coding book standards before they go out to insurance or private pay patients, running reports to follow up on account receivable and all client and insurance, research all denials, and review accounts for accuracy and preparation of necessary adjustments, collections, age reports, review accounts, generate refunds, when applicable and research all outstanding balances, send out billing statements, answer patient questions
- Over the years, I've coordinated leave and time off for the billing department employees
- Furthermore, I'm In charge of claims and coding approval reports for other billers and coders
- This includes looking for any coding errors and ensuring all coding is up to date and accurate before being sent out to payers
- As well as making sure the standards are correct, and I participate in the evaluation and validation of all electronic health records to all HIPAA and privacy laws
- I also follow up and make sure other staff members provide the same standards to promote consistency and compliance with all coding rules and regulations
- This includes running reports and analyzing the data and assigning any new clean-up coding projects when needed
- When I first onboarded at Alaska Behavioral Health, I helped with updating the billing department's job descriptions and processes
- This includes being in charge of new training and completing all job standard operating procedures (SOP) manuals, which resulted in improved patient care and incoming company revenues
- Alaska Behavioral Health adopted the LEAN principles
- I joined the PQI (Process Quality Improvement) team
- I am continually looking for new ways to improve processes and keep the company LEAN
- If there are any problems with the processes, I'll look for ways to improve them
- I implement and train the staff on how to do the work and follow up as necessary
- I am also in charge of work birthdays and potlucks
- We do not give out awards; however, we acknowledge employees for their job well done and any new accomplishments at the monthly potlucks and weekly meetings
- I am also on the Employee Action Committee at Alaska Behavioral Health
- We are a team that gets together once a month to help discuss any topics, issues, or events that may be happening within the company
- For example, we will put together the company picnic, holiday party, etc
- As well as if there are any issues in the company, we help implement that; another example, we are in the process of coordinating and either updating our phone system or having a new one put in as the current one is outdated, I have advanced knowledge of the current 2021 ICD, CPT, and HCPCS
- I put together training events to ensure other billing staff is educated and kept up to date
- I also follow up and make sure that they keep up with the regulatory guidelines, and current coding conventions are being followed
- I restructured the whole new employee orientation on the billing and coding section for onboarding all new employees
- I track payments and coding trends and report them at monthly meetings
- All coding and billing information to report
- I've implemented new coding changes and tracked all telehealth coding and evaluation and management coding when it was first implemented into our new primary care programs
- This included building and assigning new coding to primary care procedures to the current standards of the ICD, CPT, and HCPCS manuals
- I also tackle any general coding trends and denials that come about with insurance companies
- Accounted for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications
- Researched and analyzed data needs for reimbursement
- Analyzed medical records and identifies documentation deficiencies
- Served as resource and subject matter expert to other coding staff
- Reviewed and verified documentation supports diagnoses, procedures, and treatment results
- Identified diagnostic and procedural information
- Audited clinical documentation and coded data to validate documentation that supports services rendered for reimbursement and reporting purposes
- I track payments and coding trends and report them at monthly meetings
- All coding and billing information to report
- I've implemented new coding changes and tracked all telehealth coding and evaluation and management coding when it was first implemented into our new primary care programs
- This included building and assigning new coding to primary care procedures to the current standards of the ICD, CPT, and HCPCS manuals
- I also tackle any general coding trends and denials that come about with insurance companies.
Insurance Billing Specialist
LaTouche Pediatrics, LLC
Anchorage, United States
01.2018 - 02.2019
- Followed up on all insurance claim denials
- Oversaw all insurance denial management
- This was not limited to collecting and analyzing data of denials and coding pricing
- This includes but is not limited to calling insurance companies, using their websites, and getting claims paid
- Needing knowledge in coding and payments
- Additionally, making sure adjustments are correct as well as knowing correct CPT codes and ICD diagnosis coding
- Filing corrected claims and appeals when necessary
- Calling patients and making sure their coordination of benefits is up to date
- As well as following up with any denials in a timely manner
- Running reports and following up with any claim rejections
- Also answering patients billing and coding questions, calls, and emails.
Medical Billing Specialist
Anchorage Medical & Surgical Clinic
Anchorage, United States
02.2015 - 01.2018
- Handled all billing, patient, and major/private insurance billing
- Processed EOB's for billings noted previously and apply payments to accounts, claims to process, scrub and code claims before they go out to insurance or private pay patients, research all denials and review accounts for accuracy and preparation of necessary adjustments, collections, age reports, review accounts, generate refunds, when applicable and research all outstanding balances, send out billing statements, answer patient questions, fill in for the reception, answer multi-phone line phones and patient scheduling.
Medical Billing Specialist
Alaska Urology
Anchorage, United States
10.2013 - 01.2015
- Handled all billing for private pay patients and all major insurance company billing, and the end of the month checks and balance reports, and ensured proper and timely balancing, demographics, process EOB's, claims, collections, age reporting, review account receivable, provider and group enrollment with private insurance and coordination with an administrator, generate refunds (private and insurance) when applicable and research all outstanding balances, answer patient questions and answer multi-line phones
- We saw both inpatient and outpatient clients
- We coded outpatient and inpatient when patients were being seen on call from our providers in the hospital
- This includes making sure all inpatient and outpatient coding and modifiers are to regulations and standards.
Education
Masters in Healthcare Administration -
Southern New Hampshire University
07-2023
Bachelor's degree - Business Administration and Management
Southern New Hampshire University
06.2021
Associate's degree -
Anthem College
05.2008
Skills
- Medical Billing
- Healthcare Claim Coding
- Revenue Cycle Management
- HIPAA Compliance
- Organizational Skills
- Problem-Solving
- Communication
- Team Management
Affiliations
AAPC - Member
Job Related Training
- Certified Professional Coder
- Certified Nursing Assistant
References
- Ashley Evensone, Alaska Behavioral Health, Revenue Cycle Manager 907-887-9720
- Angi Titus, LaTouche Pediatrics, Billing Administrator, 907-644-9526
- Jenifer Walker, Alaska Urology, Lead Medical Biller, 907-550-6608
- Mischellean Smith, Quality Service Manager, 907-891-0376
Certification
- AAPC Coding Certificaion
Timeline
Billing Supervisor
Alaska Behavioral Health
02.2019 - Current
Insurance Billing Specialist
LaTouche Pediatrics, LLC
01.2018 - 02.2019
Medical Billing Specialist
Anchorage Medical & Surgical Clinic
02.2015 - 01.2018
Medical Billing Specialist
Alaska Urology
10.2013 - 01.2015
Masters in Healthcare Administration -
Southern New Hampshire University
Bachelor's degree - Business Administration and Management
Southern New Hampshire University
Associate's degree -
Anthem College
- AAPC Coding Certificaion
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