Shannon McCandless
Colorado Springs,CO
Summary
I am a doctoral student pursuing a Doctor of Health Science degree, specializing in Hereditary Pancreatitis with Exocrine Pancreatic Insufficiency. With extensive experience in Revenue Cycle and medical operations management, I have demonstrated expertise in starting and efficiently operating a pain management ASC from inception to production. In addition, I have in-depth knowledge and experience in accounting, billing, and coding supervision. My proficiency in securing authorizations, setting financial arrangements, and creating training manuals has been crucial to my success. My strong communication skills allow me to manage interactions effectively with clients, vendors, attorneys, insurance companies, and employees. My comprehensive understanding of Healthcare Financial Management and Revenue Cycle Management regulations, including state and federal billing practices and credentialing processes, has enabled me to proficiently coordinate provider credentialing with payers and facilities and credentialing ASCs with payers and state regulations.
Overview
10
10
years of professional experience
Work History
Revenue Cycle Manager
GuideHouse Managed Services
01.2024 - Current
- I lead a revenue cycle management team of over 30 associates, focusing on performance monitoring, staff development, and collaboration to maintain compliance and operational efficiency
- By analyzing KPIs, refining SOPs, and addressing escalated issues, I drive strategic initiatives, enhance patient experience, and provide actionable insights to improve overall operations
- I attain for my team to move $2 Million in AR weekly to keep unbilled down
- Provided staff training on revenue cycle management best practices, increasing productivity across the department.
- Completed financial reporting and analysis for billing revenue cycle.
Accounts Receivable Reconciliation Manager
NEXT Oncology
01.2023 - 01.2024
- Resolved discrepancies and streamlined billing processes, effectively managing receivables from sponsors and CROs, reducing turnaround time from several weeks to a few days
- Expertise in billing protocols and regulatory compliance enhanced customer satisfaction and operational efficiency
- Reduced discrepancies in financial data by conducting thorough investigations and resolving issues promptly.
- Oversaw data entry and contract management, collaborated with specialists to maintain data integrity and compliance
- Adaptability and cross-functional support contributed to exacting standards in fiscal management, driving organizational success and long-term objectives
- Collaborated with cross-functional teams to develop innovative solutions for improving the overall reconciliation process.
Operations Manager
Innovative Practice Strategies
01.2019 - 01.2023
- Increased the activation rate by 18% by ensuring seamless onboarding, provider credentialing, and compliance with CAQH, payor, and state regulations
- Managed billing and coding activities, including insurance verifications, charge entry, claims processing, and revenue cycle management
- Addressed aging claims and supported financial reconciliations
- Proficient in multiple EMR systems
- Specialized in billing for anesthesia, pain management, orthopedics, gastroenterology, and OBGYN procedures across various settings
- Focused on regulatory compliance and operational efficiency, delivering accurate financial outcomes and upholding industry standards
Operations Manager
Florida Women's Care
01.2016 - 01.2019
- I specialized in optimizing revenue cycle processes through meticulous account audits to identify discrepancies and prevent underpayments or claim rejections
- Reduced AR by 35% within the first 60 days
- I managed accounts receivable, secured insurance benefits and authorizations, and provided financial counseling to ensure timely payments and a healthy revenue cycle
- Proficient in coding and billing for diverse services, I led strategic appeals for denied claims and oversaw provider credentialing and CAQH updates, maintaining compliance with HIPAA and industry standards
Chief Operating Officer
Restore Medical Partners
01.2015 - 01.2016
- Oversaw the establishment and management of a new medical office and surgical suite
- Led pre-launch planning, insurance credentialing, and network enrollment
- Spearheaded recruitment and training of medical and administrative staff
- Optimized EMR usage and developed marketing strategies to drive patient engagement and vendor relationships
- Ensured compliance with regulatory standards and secured permits
- Maintained equipment and created operational documentation such as policies and employee manuals
- Demonstrated expertise in strategic planning, staff management, and operational excellence, contributing to the facility's growth and success
Education
Ph.D. - Hereditary Pancreatitis With Exocrine Pancreatic Insufficiency
Keiser University
West Palm Beach, FL01.2027
MBA-Health Administration -
Keiser University
Sarasota, FL01.2024
BS - Interdisciplinary Studies
Keiser University
Sarasota, FL01.2021
Accomplishments
- Reduced receivables by 20% through streamlined billing processes at NEXT Oncology.
- Led revenue cycle team maintaining 95% operational efficiency in North & Central regions.
Timeline
Revenue Cycle Manager
GuideHouse Managed Services
01.2024 - Current
Accounts Receivable Reconciliation Manager
NEXT Oncology
01.2023 - 01.2024
Operations Manager
Innovative Practice Strategies
01.2019 - 01.2023
Operations Manager
Florida Women's Care
01.2016 - 01.2019
Chief Operating Officer
Restore Medical Partners
01.2015 - 01.2016
MBA-Health Administration -
Keiser University
BS - Interdisciplinary Studies
Keiser University
Ph.D. - Hereditary Pancreatitis With Exocrine Pancreatic Insufficiency
Keiser University
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