Shannon McCandless
Pittsfield,MA
Summary
Experienced revenue cycle executive with a proven track record of optimizing financial operations and enhancing revenue streams. Recognized for strong team collaboration and a results-driven approach, consistently delivering adaptable solutions to evolving challenges. Possesses key skills in healthcare finance, process improvement, leadership, and compliance.
Overview
22
22
years of professional experience
Work History
Director of Revenue Cycle Optimization & Contracts
Berkshire Health Systems
03.2025 - 08.2025
- Built forecasting model to accurately project revenue and guide strategy.
- Led sales training on product, negotiation, and account growth to increase revenue.
- Negotiated contracts and maintained state compliance across operational areas.
- Implemented performance metrics to drive accountability and continuous improvement.
- Partnered with providers and service line leaders to improve clinical documentation accuracy and compliance with ICD-10 and HCC standards, reducing denials and increasing reimbursement.
Revenue Cycle Director- Central Region - Contract
GuideHouse Managed Services
01.2024 - 03.2025
- Ensured accurate revenue reporting through routine reconciliation of general ledger accounts.
- Achieved sub-3-day claim turnaround via 6-week billing analysis.
- Performed regular audits to uncover inefficiencies and enhance revenue cycle performance.
- Improved processes to ensure accurate charge capture and coding compliance.
Director, AR Reconciliation - Contract
NEXT Oncology
01.2023 - 01.2024
- Reduced accounts receivable by 20% through clinical documentation audits and process redesign.
- Partnered with clinicians to strengthen documentation completeness, ensuring ICD-10 and clinical trial compliance.
- Led billing discrepancy resolution, cutting receivables turnaround from weeks to days.
- Proactively ensured regulatory compliance
- Provided strategic cross-functional leadership to uphold fiscal discipline.
- Drove collaborative innovation to optimize reconciliation and enhance operational efficiency.
Revenue Cycle Director
Innovative Practice Strategies
01.2019 - 01.2023
- Increased activation rate 18% via streamlined onboarding, credentialing, and compliance with CAQH, payers, and state regulations.
- Managed billing, coding, insurance verification, charge entry, claims, and full revenue cycle operations.
- Maintained data accuracy through consistent reconciliation of general ledger accounts.
Revenue Cycle Director
Florida Women's Care
01.2016 - 01.2019
- Reduced AR 35% in 60 days; ensured billing within 3 days.
- Led coding, billing, strategic appeals, and maintained CAQH/provider compliance.
- Cut denials through charge capture audits and clinical documentation feedback.
- Ensured high compliance with HIPAA and regulatory standards.
Chief Operating Officer - Contract Consultant
Restore Medical Partners
01.2015 - 01.2016
- Oversaw launch and management of 2 medical offices with surgical suites.
- Led pre-launch planning, insurance credentialing, and network enrollment.
- Recruited and trained 50 medical and administrative staff.
- Ensured regulatory compliance and secured necessary permits.
- Managed equipment and developed operational policies and manuals.
- Designed forecasting models to project divisional revenue and guide ambulatory/post-acute strategy.
- Trained clinical and administrative teams on documentation accuracy and compliance, resulting in improved coding alignment and decreased claim denials.
Education
Doctor of Health Sciences - Hereditary Pancreatitis With Exocrine Pancreatic Insufficiency
Keiser University
Palm Beach, FL04-2027
MBA-Health Administration -
Keiser University
Sarasota, FL12-2024
Bachelor of Science - Interdisciplinary Studies
Keiser University
Sarasota, FL08-2021
Skills
- Ambulatory & Post-Acute Revenue Optimization
- Charge Capture Accuracy & Reconciliation
- Clinical Documentation Improvement (CDI)
- ICD-10-CM, HCC, MS-DRG, APR-DRG
- Strategic Pricing & Payer Contract Negotiation
- Revenue Forecasting & Profitability Analysis
- Regulatory Compliance (HIPAA, CMS, State)
- Liaison between Corporate & Divisional Teams
Accomplishments
- Enhanced financial performance by reducing accounts receivable 20% at NEXT Oncology through improved charge capture accuracy and documentation audits.
- Optimized revenue cycle operations to 95% efficiency across North & Central regions by implementing division-wide process improvements and accountability metrics.
- Improved patient access and engagement by 30% at Restore Medical through streamlined front-end processes and payer credentialing initiatives.
- Achieved 99% compliance in the East Region by leading a clinical documentation and SOP overhaul, ensuring adherence to ICD-10 and payer requirements.
- Accelerated billing turnaround to three days post-service through process redesign and reconciliation of charge capture with clinical and billing systems.
- Generated $3M in financial gains within six weeks at BHS, DBA Integritus by restructuring pricing models, renegotiating payer contracts, and strengthening revenue forecasting.
Affiliations
- Colorado Springs Women in Business
- Crisis Volunteer - Mercy's Gate
- American Association of Healthcare Administrative Management
- National Pancreas Foundation - Colorado Chapter
- National Pancreas Foundation - Boston Chapter
- Women in Business - MA
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Director of Revenue Cycle Optimization & Contracts
Berkshire Health Systems
03.2025 - 08.2025
Revenue Cycle Director- Central Region - Contract
GuideHouse Managed Services
01.2024 - 03.2025
Director, AR Reconciliation - Contract
NEXT Oncology
01.2023 - 01.2024
Revenue Cycle Director
Innovative Practice Strategies
01.2019 - 01.2023
Revenue Cycle Director
Florida Women's Care
01.2016 - 01.2019
Chief Operating Officer - Contract Consultant
Restore Medical Partners
01.2015 - 01.2016
Doctor of Health Sciences - Hereditary Pancreatitis With Exocrine Pancreatic Insufficiency
Keiser University
MBA-Health Administration -
Keiser University
Bachelor of Science - Interdisciplinary Studies
Keiser University
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