Shannon Nicholson

• Optimizes appointment management for enhanced clinic efficiency.
• Maintains and revises medical histories for accuracy.
• Protects patient privacy through strict adherence to confidentiality protocols.
• Supports medical billing and coding processes.
• Addresses patient inquiries and concerns, resolving issues in a timely and empathetic manner.
• Works closely with departmental staff members in order to ensure proper coordination of care across multiple departments.
• Researched clinical criteria and determined eligibility for requested services based on plan provisions.
• Monitored changes in insurance policies and guidelines to ensure compliance with prior authorization processes.
• Reviewed prior authorization requests to ensure accuracy and completeness of required information.

• Collaborated with senior management to outline department goals and objectives.
• Analyzed regional staffing levels to assess workforce efficiency.
• Effectively managed customer grievances promptly.
• Implemented effective strategies to enhance employee performance.
• Identified strengths and growth areas of team members to enhance performance.
• Trained and guided new office managers to achieve operational efficiency.
• Selected qualified personnel to enhance the team's workforce.
• Handled human resource concerns and established plans to handle issues consistently and efficiently.
• Created and maintained relationships with key customers in the region.

• Performed general bookkeeping duties such as reconciling bank statements and creating journal entries.
• Maintained impeccable office organization to support efficiency, professionalism and performance objectives.
• Interpreted and communicated work procedures and company policies to staff.
• Responded to customer inquiries via phone or email in a professional manner.
• Assigned work and monitored performance of project personnel.
• Maintained confidential records relating to personnel matters.
• Maintained filing system for records, correspondence and other documents.
• Trained new staff on prior authorization procedures and company policies.
• Coordinated resolutions for issues and appealed denied authorizations.
• Provided guidance to providers regarding the prior authorization process.

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• Coordinated communications between departments to ensure timely completion of projects.
• Optimized staff orientation to maintain workforce stability.
• Facilitated continuous workflow by leading and coordinating administrative personnel.
• Devised streamlined processes, optimizing operational productivity.
• Handled client queries and grievances promptly with a high level of professionalism.
• Facilitated sessions to inform team about changes and new requirements in policies.
• Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
• Provided support and guidance to colleagues to maintain a collaborative work environment.
• Developed filing systems to maintain confidential records of personnel information and business activities in accordance with company policies.
• Answered incoming telephone calls from internal and external customers promptly and professionally; transferred calls appropriately; responded to inquiries in a timely manner.
• Handled confidential information with discretion and integrity.
• Reviewed claims submitted without valid pre-authorization codes and took corrective action when necessary.
• Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
• Assisted healthcare providers with appeals for denied authorizations, including gathering additional information and documentation.