SHANNON BOULTON
Deptford,NJ
Summary
Detail-oriented medical billing professional with extensive experience in healthcare administration. Proven track record in managing medical claims, resolving denials, and coordinating patient communications to enhance satisfaction and recovery rates. Expertise in HIPAA compliance, insurance verification, and precise documentation.
Overview
14
14
years of professional experience
Work History
OFFICE ADMINISTRATOR
Komfort & Kare Orthotics & Prosthetics
Magnolia, NJ
08.2022 - 04.2026
- Coordinated scheduling, product ordering, inventory management, and administrative workflows within a high-volume DME/orthotics environment.
- Coordinated prior authorizations, pre-certifications, and eligibility with insurance carriers, ensuring accurate submission of required documentation to expedite patient access to necessary products.
- Verified patient insurance eligibility and benefits to determine coverage for custom orthotics, orthopedic braces, and other DME products.
- Communicated directly with patients regarding insurance benefits, coverage requirements, authorization status, appointments, and medical equipment.
- Collaborated with licensed orthotists and clinical staff to enhance patient care coordination and streamline processing of authorized products and services.
- Resolved insurance and patient-related issues with persistence and attention to detail, delivering strong customer service to enhance patient satisfaction.
BILLING MANAGER & WORKFLOW COORDINATOR
Style Family Medicine Associates, PA
Voorhees, NJ
02.2015 - 08.2022
- Managed medical claim submission and billing, ensuring claims were filed accurately and on time.
- Researched claim denials, identified reimbursement issues, and submitted appeals to state, federal, and third-party payers, enhancing claim recovery.
- Communicated directly with insurance companies to resolve claim discrepancies, clarified payer requirements, and facilitated reimbursement.
- Assisted patients with insurance inquiries and payment collection, ensuring clarity and satisfaction in billing processes.
- Coordinated sensitive patient demographic, medical, and financial information, upholding HIPAA compliance and accuracy standards.
BILLING SPECIALIST & DATA COORDINATOR
DM Medical Billings
Berlin, NJ
07.2012 - 02.2015
- Supported medical billing and administrative operations through detailed data entry, documentation review, claim appeals, leveraging medical terminology for accurate processing.
- Audited patient information and records to identify discrepancies, enhancing accuracy of billing documentation and supporting timely claims resolution.
- Processed and maintained sensitive patient demographic and medical billing information, ensuring data integrity and compliance with regulations.
Education
Liberal Arts Associate Degree -
Camden County College
Blackwood, NJHigh School Diploma -
Clearview Regional High School
Mullica Hill, NJSkills
- Authorization management
- Benefits verification
- Claims processing
- Denial resolution
- Payer communication
- Reimbursement follow-up
- Billing support
- Patient communication
- Scheduling and coordination
- EHR management
- Data entry accuracy
- HIPAA compliance
- Microsoft Office proficiency
- Medical coding
- Office Administration
- Portal navigation
Timeline
OFFICE ADMINISTRATOR
Komfort & Kare Orthotics & Prosthetics
08.2022 - 04.2026
BILLING MANAGER & WORKFLOW COORDINATOR
Style Family Medicine Associates, PA
02.2015 - 08.2022
BILLING SPECIALIST & DATA COORDINATOR
DM Medical Billings
07.2012 - 02.2015
Liberal Arts Associate Degree -
Camden County College
High School Diploma -
Clearview Regional High School