Shanel Paige
Baltimore,MD
Summary
Accomplished Accounts Receivable and Medical Billing Professional with extensive experience supporting commercial, government, and managed care payers. Recognized subject matter expert in BCBS. Extensive knowledge in Medicare and Medicaid billing. Proven record of revenue recovery, operational efficiency, and regulatory compliance. Analytical, detail-oriented, and customer-focused leader skilled in complex claim investigations, denial resolution, and team leadership within high-volume healthcare environments. and well diverse.
Overview
14
14
years of professional experience
Work History
Patient Account Representative III
University of Maryland Orthopedic Associates
Baltimore, MD
05.2018 - 10.2025
- Reconciled posted and edited payments against Elecltronic Remittance Advice (ERA) and Explaination of Benefits (EOB) to ensure accuracy and compliance.
- Manually posted payments, contractual adjustments, and rejections from EOB's.
- Performed comprehensive A/R follow-up on rejected and denied claims to secure reimbursement.
- Researched and resolved patient account discrepancies in alignment with payer and organizational policies.
- Monitored and followed up on open invoices by insurance classification.
- Resolved BAR and e-commerce edits within departmental benchmarks.
- Maintained strict HIPAA compliance while delivering high-quality customer service.
- Served as lead support and trainer for junior level employees.
Call Center Manager
CONDUENT
Baltimore, Maryland
03.2017 - 09.2017
- Directed daily call center operations, overseeing call volume, service levels, ASA, and customer satisfaction metrics.
- Ensured adherence to client service level agreements (SLAs) and performance standards.
- Led full-cycle employee management including recruitment, onboarding, coaching, performance management, and disciplinary actions.
- Developed staffing schedules and facilitated team meetings to align performance with business goals.
- Promoted a culture of accountability, service excellence, and operational efficiency.
- Strengthened partnerships with Small and Diverse Business partners and contingent suppliers
Supervisor
MOBILEX USA
Sparks, Maryland
12.2011 - 03.2017
- Supervised and coached a team of 15 accounts receivable representatives.
- Scheduled, prioritized, and delegated daily assignments to ensure productivity and timely completion.
- Conducted performance evaluations, coaching sessions, and disciplinary actions as needed.
- Maintained accurate documentation for attendance, leave, and employee performance.
- Reviewed and enforced policies impacting patients with commercial insurance, Medicare, and Medicaid.
- Approved account adjustments and ensured timely, policy-compliant customer responses.
- Created Standard Operating Procedures (SOP) for BCBS.
Education
Some College (No Degree) - Nursing
CCBC Essex
Essex, MDSome College (No Degree) - General Studies
Morgan State University
Baltimore, MDSkills
- Accounts Receivable & Revenue Cycle Management
- Medical Billing & Claims Processing
- Insurance Verification & Payer Relations
- Commercial & Government Payers (Medicare, Medicaid, BCBS)
- Appeals, Denials & Underpayment Resolution
- EOB & ERA Reconciliation
- ICD-9 / ICD-10 / CPT Coding
- Medical Terminology & HIPAA Compliance
- Investigative Analysis & Quality Review
- Workflow Optimization & Process Improvement
- Team Leadership, Training & Coaching
- Scheduling & Workforce Management
- Customer Service & Professional Communication
- IDX, GE Centricity, EPIC
- Microsoft Suite
Additional Information
- Medical Claims Experience Processing medical reimbursements denied commercial, government, and managed care . medical records EOB’s, audit and denial letters low payments and various denials; Payer Disputes departmental policies. Preparing payer appeals for denied claims time management skills to manage accounts. Maintain a high level of integrity and confidentiality / patient privacy (HIPAA). reimbursement environment is always confidential. customer service.
Additional Accomplishments
- Extensive experience managing medical records, audits, EOBs, denial letters, and payment disputes
- Proven ability to manage high-volume workloads with strong time management and accuracy
- Maintained the highest standards of confidentiality and data integrity in compliance with HIPAA
- Customer-focused professional with strong knowledge of payer dispute processes and reimbursement policies
Key Accomplishments
- Recovered significant denied and underpaid revenue through detailed claim investigation, appeals preparation, and follow-up with commercial and government payers.
- Identified and corrected recurring billing and posting errors, contributing to improved payment accuracy and reduced rework.
- Recognized as a go-to subject matter expert for complex BCBS claims and escalated account issues.
- Successfully resolved high-risk, aged A/R accounts by applying investigative review and payer policy knowledge.
- Improved workflow efficiency by prioritizing insurance classes and streamlining follow-up processes.
- Consistently met or exceeded productivity and quality benchmarks in high-volume environments.
- Led, trained, and mentored teams, contributing to improved staff performance and retention.
- Maintained 100% compliance with HIPAA and payer regulations while handling sensitive patient and financial data.
- Demonstrated exceptional customer service by resolving complex inquiries professionally and accurately.
Accomplishments
- Achieved 99% accuracy with audit findings and reduced erroneous billing denials by 50%.
- Collaborated with certified Coders to improved ICD-10 and CPT coding by 10%.
Timeline
Patient Account Representative III
University of Maryland Orthopedic Associates
05.2018 - 10.2025
Call Center Manager
CONDUENT
03.2017 - 09.2017
Supervisor
MOBILEX USA
12.2011 - 03.2017
Some College (No Degree) - Nursing
CCBC Essex
Some College (No Degree) - General Studies
Morgan State University