Shanna Harris
Virginia Beach
Summary
Professional insurance specialist with deep knowledge of underwriting, claims management, and policy analysis. Strong focus on team collaboration and delivering measurable results. Known for flexibility, reliability, and adapting to changing needs. Skilled in risk assessment, client relations, and regulatory compliance.
Overview
2026
2026
years of professional experience
1
1
Certification
Work History
Sr. Insurance Specialist
Virginia Oncology Associates
01.2014 - Current
- Monitors delinquent accounts and performs collection duties
- Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, resubmits claim to the payer
- Reviews payment postings for accuracy and to ensure account balances are current. Works with co-workers to resolve payment and billing errors.
- Contacts patients to secure past due balances, verify patient demographics and insurance providers, updates information in systems, and documents conversations. Answers patient's payment, billing, and insurance questions and resolves complaints
- Contacts third-party payers to resolve payer issues, expedite claim processing, and maximize medical claim reimbursement
- Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations.
- Recommends accounts for collection or write-off
- Verifies existing patients have necessary referral and/or authorization documentation prior to the examination date
- Utilizes electronic medical records (EMR) to extract relevant clinical documentation, ensuring all required medical information is obtained and properly documented to support appeal submissions
- Prepares and submits detailed, compliant medical appeals to insurance carriers, working to overturn denials and maximize reimbursement. Maintains a high level of accuracy and attention to detail while adhering to HIPAA regulations and payer-specific guidelines.
- Reviews and analyzes denied insurance claims to identify accurate principal and secondary diagnoses using ICD-10 and CPT coding systems in accordance with national coding standards.
Patient Access Services / Registrar II (part-time)
Chesapeake Regional Medical Center
2016 - 2024
- Interview and accurately collect patient information and demographics for various hospital services; meet patient access scorecard standards by meeting accuracy rate as defined in annual goals and ensuring accuracy in medical record selection
- Use knowledge to verify, review, and coordinates benefits on behalf of patients; meet Patient Access Scorecard expectations for insurance verification rate
- Manage registrations for patients for various hospital services; meet patient access scorecard standards by registering patients in less than 10 minutes and maintaining a wait time of less than 10 minutes, when applicable
- Manage payments at point-of-service, conduct cash receipting, and post payments; point-of-service collection expectations are on the patient access scorecard
- Assist with training of new staff as well as share departmental knowledge and provide assistive training with teammates
- Manage scanning for the patient medical record as required
Billing Specialist
Urology of Virginia
01.2013 - 01.2014
- Reviewed and analyzed account overpayments to determine appropriate insurance refund actions in compliance with payer guidelines and internal policies.
- Responded to patient inquiries regarding account balances, billing statements, and insurance claims; resolved concerns with professionalism and accuracy.
- Verified and updated patient demographic and insurance information in electronic medical records (EMR) systems to ensure claim accuracy and timely reimbursement.
- Contacted insurance carriers to investigate and discuss denial trends, escalating recurring issues to appropriate departments for resolution.
- Verified patient insurance eligibility and coverage details via insurance portals or direct payer contact to ensure accurate billing and minimize claim denials.
Patient Account Representative (Billing/Follow-Up Unit)
Sentara Medical Group
01.2006 - 01.2013
- Contacted insurance companies to investigate and discuss claim denial patterns; collaborated with payers to resolve recurring issues and reduce future denials.
- Reviewed and analyzed account overpayments to determine appropriate insurance refund actions in compliance with payer policies and internal guidelines.
- Utilized insurance carrier websites and portals (e.g., Availity, payer-specific systems) to verify patient eligibility, check claim status, and ensure coverage accuracy.
- Entered and updated patient insurance and demographic information in the system to ensure clean claim submission and accurate billing.
- Accurately entered charges into the IDX billing system and balanced daily batches to maintain financial accuracy and integrity.
Patient Account Representative (Payment Posting Unit)
Sentara Medical Group
01.2006 - 01.2013
- Managed all aspects of payment processing and account reconciliation for a high-volume patient billing cycle, accurately entering and posting payments and adjustments into the IDX billing system.
- Calculated complex contractual write-offs and various adjustment amounts by meticulously interpreting payer agreements and detailed reimbursement policies.
- Reconciled daily payment batches to the original remittance advice or deposit logs, ensuring 100% accuracy and strict financial accountability within IDX.
- Applied logical reasoning to carry out instructions delivered verbally, in writing, or via diagrams, following standard operating procedures.
Medical Account Specialist (part-time)
National Healthcare Management LLC
01.2005 - 01.2007
- Contacted patients to discuss medical account balances, billing concerns, and insurance-related inquiries, ensuring timely and professional communication.
- Entered patient charges into Groupcast, including demographic updates and applicable adjustments, while maintaining accuracy and compliance with billing standards.
- Verified, updated, and added patient health insurance information to ensure accurate claims processing and timely reimbursement.
- Balanced charge entries against original batch totals to ensure financial accuracy and system integrity within Groupcast.
- Performed insurance adjustments and write-offs by accurately calculating contractual allowances and percentage-based reductions in accordance with payer agreements.
- Met and exceeded productivity benchmarks while maintaining high standards of accuracy and attention to detail in all data entry and account management tasks.
Network Auditor
ValueOptions
01.1999 - 01.2006
- Reviewed provider records to assess the accuracy and performance of Network Management Specialists, ensuring adherence to internal quality standards and compliance guidelines.
- Analyzed and reported quality review results to identify performance trends, discrepancies, and process gaps; recommended corrective actions to supervisory personnel.
- Provided analytical support by utilizing continuous quality improvement (CQI) tools to identify opportunities for operational and process enhancements.
- Maintained strict confidentiality of provider information and quality review scores in compliance with HIPAA and organizational privacy policies.
Data Integrity Specialist
ValueOptions
01.1999 - 01.2006
- Identified and corrected data integrity issues resulting from multiple system migrations, ensuring accuracy and consistency across platforms.
- Resolved complex data conflicts by identifying and merging duplicate entries for vendors, providers, facilities, groups, and TINs/EINs to maintain a single, accurate source of truth.
- Corrected provider assignment errors involving inappropriate Payment Organization Group (PORG) codes, fee schedules, contract codes, and network rows, ensuring accurate payment processing and contract compliance.
Education
Tidewater Community College
Skills
- Training and mentoring
- Compliance monitoring
- Claims management
- Policy administration
Certification
Certified Professional Coder (CPC)
Timeline
Sr. Insurance Specialist
Virginia Oncology Associates
01.2014 - Current
Billing Specialist
Urology of Virginia
01.2013 - 01.2014
Patient Account Representative (Billing/Follow-Up Unit)
Sentara Medical Group
01.2006 - 01.2013
Patient Account Representative (Payment Posting Unit)
Sentara Medical Group
01.2006 - 01.2013
Medical Account Specialist (part-time)
National Healthcare Management LLC
01.2005 - 01.2007
Network Auditor
ValueOptions
01.1999 - 01.2006
Data Integrity Specialist
ValueOptions
01.1999 - 01.2006
Patient Access Services / Registrar II (part-time)
Chesapeake Regional Medical Center
2016 - 2024
Tidewater Community College
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