Summary
Overview
Work History
Education
Skills
Certification
References
Timeline
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Shane Gomes

New Bedford,MA

Summary

Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Surgical Booking Specialist

South Coast Health Systems
Fairhaven, MA
10.2023 - Current

• Scheduling ambulatory surgical procedures for operating rooms according to predetermined time schedules. Complete daily surgical schedules, including special equipment and medication requirements, incorporating timely procedure scheduling including radiology and non-surgical use of operating room facilities. Communicating with surgical staff, and admissions personnel to obtain patient information, coordinate and confirm schedules and identify any additional needs.

• Printing and distributing schedules to designated areas of the program.

• Identifying and communicating critical information, such as surgeon and physician availability, and special supply and equipment requests.

• Monitoring Epic for insurance authorization for the procedures.

Authorization Specialist

Southcoast Hospitals Group
08.2022 - 10.2023
  • Educated patients on eligibility and affordability options by offering insightful information.
  • Reviewed applications for different aid programs and determined which qualification criteria for individuals.
  • Interviewed applicants and explained scope of different available benefits.
  • Assessed information gleaned from interviews, educational and medical records, consultation with other professionals and diagnostic evaluations to identify clients' abilities, needs and eligibility for services.
  • Secured patient information and confidential medical records in compliance with HIPPA privacy standards to protect patients privacy.

Appeals and Denials Coordinator

South Coast Health Systems
Fairhaven, MA
10.2016 - 06.2022
  • Maintain relationships with internal business partners and provider Relations Managers regarding denials trends
  • Determine staff education based on denial studies
  • Analyzing and process apples to increase intake revenue
  • Maintain spread sheets and functions within Excel, Microsoft office, MS Teams and EPIC
  • Collaborate with the Educate Dept and project Manager to execute initiatives to reduce denials
  • Provide functional or technical supervision of employees

Education

Associate of Arts - Biblical Studies

International School Of Ministry
San Bernardino, CA
06-2010

Skills

  • Works well under pressure and within timelines
  • Pays attention to details and completion of tasks
  • Able to work efficiently and independently
  • initiative taking and extremely dependable
  • Able to multi task and adapt to change
  • Excellent communications skills
  • Strong knowledge of Medicaid and Medicare programs
  • Third Party Billing
  • Insurance Verification
  • Goal-Oriented
  • Strong Organization
  • Document Preparation
  • File Management

Certification

  • Ordained Reverend - Associate Pastor, Ebenezer Baptist Church

References

References available upon request.

Timeline

Surgical Booking Specialist

South Coast Health Systems
10.2023 - Current

Authorization Specialist

Southcoast Hospitals Group
08.2022 - 10.2023

Appeals and Denials Coordinator

South Coast Health Systems
10.2016 - 06.2022

Associate of Arts - Biblical Studies

International School Of Ministry
Shane Gomes