Shanel Tolbert
Willis,TX
Summary
Certified Professional Coder and Accounts Receivable management efficient in handling all aspects of medical billing, including coding, charge entry, claim submission, invoicing and payment posting. Dedicated and driven team player offering 20 years of hands-on experience working in the medical field. Proven success building relationships and maintaining optimal billing efficiency. Excellent organizational and problem-solving skills with superior client service acumen.
Overview
20
20
years of professional experience
Work History
Accounts Receivable Manager/ CPC
Texas Medical Management Services
Jersey Village, Texas (Remote)
10.2019 - Current
- Process and submit invoices, and credit memos to clients.
- Investigate and resolve issues to maintain billing accuracy.
- Verify and enter patient and insurance information into database.
- Research and resolve rejections and EOB denials.
- Enforce and optimize billing protocols to streamline operations and minimize aging balances.
- Utilize daily audit information to update aging reports.
- Resolve account variances and reconcile bank statement histories and record information in database.
- Calculate discounts, negotiations, credits, and adjustments.
- Manage all payments processing, invoicing, and collection tasks.
- Review physician documentation to ensure coding team appropriately applies CPT, HCPCS, and ICD 10-CM Coding.
- Review and resolve all daily coding related issues based on coding guidelines.
- Submit claims to appropriate insurance carriers via clearinghouse.
Senior Certified Professional Coder
1960 Family Practice
Houston, Texas
06.2001 - 10.2018
- Reviewed clinical data from medical records to assign the appropriate CPT, HCPCS, and ICD 9 and ICD 10-CM Coding.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Accurately assigned procedural and diagnosis codes using software and official print copy of coding books.
- Reviewed accounts to confirm patient and insurance information was accurate and updated database as needed.
- Responded to coding questions from other internal departments and insurance carriers regarding processing and payment of medical claims.
- Collaborated with billing team to confirm additional diagnosis codes available for LCD/NCD coverage as needed.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Thoroughly reviewed remittance codes from EOBS to ensure proper payment and adjustments.
- Maintained high accuracy rate on daily production reviews.
Education
Certified Professional Coder
American Academy of Professional Coders
Houston, Texas08.2019
Texas All-Lines Adjuster
The Adjuster School
Katy, Texas12.2018
Certificate of High School Equivalency
Texas Education Agency
Austin, Texas03.2000
Skills
- Customer Service
- ICD-10, CPT, HCPCS Coding
- Data Entry and Verification
- Claims Processing
- Invoicing Proficiency
- Payment Posting
- Collections
- Billing Dispute Resolution
- Verbal and Written Communication
- Active Listening
- Critical Thinking
- Time Management
Timeline
Accounts Receivable Manager/ CPC
Texas Medical Management Services
10.2019 - Current
Senior Certified Professional Coder
1960 Family Practice
06.2001 - 10.2018
Certified Professional Coder
American Academy of Professional Coders
Texas All-Lines Adjuster
The Adjuster School
Certificate of High School Equivalency
Texas Education Agency
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