Shannon Sheridan
Ronan,MT
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Seasoned in navigating complex regulatory environments, with a strong background in ensuring compliance across diverse sectors. Possess deep understanding of housing certification & compliance. Known for effective communication and analytical abilities, facilitating proactive solutions to compliance challenges. Demonstrated impact through streamlining compliance processes, enhancing operational efficiency, and fostering robust internal controls.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Certification Specialist
Salish Kootenai Housing Authority
Pablo, MT, MT
10.2005 - Current
- Monitored customer records for changes that might affect their eligibility for certain certifications.
- Responded promptly to inquiries from customers regarding the status of their applications or certificates.
- Investigated discrepancies between customer-provided information and official records.
- Assisted with troubleshooting customer issues related to certification status or application submission.
- Evaluated applications and associated documentation to determine eligibility.
- Issued clear warnings to violators, outlining infractions, penalties and remediation steps.
- Prepared reports summarizing the status of ongoing certification efforts.
- Received inquiries and advised on regulations related to programs.
- Maintained detailed database of compliance data, activities and actions taken.
- Collaborated with team members to identify potential areas for improvement in the certification process.
- Reviewed records in cases of potential liability and determined compliance actions.
- Reviewed and evaluated certification applications for accuracy and completeness.
Claims Processsor
CS&KT Tribal Health & Human Services
Saint Ignatius, MT
01.2001 - 09.2005
- Verified claim data correctness in preparation for processing.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Maintained confidentiality of policyholder information in compliance with HIPAA regulations.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Corresponded with providers regarding any missing or incomplete documentation needed for successful adjudication of claims.
- Assisted customers via telephone inquiries related to their specific claim status or general questions about the company's services.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Utilized claims processing software to streamline workflow and increase efficiency.
- Performed additional duties as requested by management team.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
- Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
- Managed escalated customer complaints pertaining to denied or delayed payments in a timely manner.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Responded to external audits by providing requested claims documentation and explanations.
- Applied knowledge of coding systems such as CPT-4 and HCPCS codes for proper reimbursement.
- Participated in audits of claims files to ensure adherence to company policies.
In-Home Nanny
Joyce Labelle & Richard Barton
Andover, MA
02.1998 - 11.2000
- Implemented daily routines to foster a structured and nurturing environment.
- Supported children with special needs, adapting activities to meet individual requirements.
- Followed routines to foster stability and structure in children's lives during parental absences.
- Cooked nutritious meals to promote healthy diet and nutrition.
- Transported children to and from school, appointments, and recreational activities.
- Engaged in outdoor recreational activities with the children such as trips to the park or beach.
- Engaged with children on individual basis to build positive, trusting relationships.
- Taught basic hygiene habits such as hand washing and brushing teeth.
- Provided comfort when needed through hugs or words of encouragement.
- Developed creative and educational games to stimulate cognitive and emotional growth.
- Traveled with family to help with vacation activities and childcare.
Education
High School Diploma -
Arlee High School
Arlee05-1994
Skills
- Certification management
- Certification renewals
- Continuing education
- Train fellow co-workers
- Review policies regularly to ensure up to date for compliance
- Penalty enforcement
- Document review
- Team leadership
- Compliance monitoring
- Data privacy
- Privacy and confidentiality
- Audit documentation
- Multitasking capacity
Certification
- Low Income Tax Credit Compliance Certified
- Certified Occupancy Specialist
- regularly attend compliance trainings to ensure up to date on IRS compliance and State Compliance for the Low Income Tax Credit Program & NAHASDA programs
Timeline
Certification Specialist
Salish Kootenai Housing Authority
10.2005 - Current
Claims Processsor
CS&KT Tribal Health & Human Services
01.2001 - 09.2005
In-Home Nanny
Joyce Labelle & Richard Barton
02.1998 - 11.2000
- Low Income Tax Credit Compliance Certified
- Certified Occupancy Specialist
- regularly attend compliance trainings to ensure up to date on IRS compliance and State Compliance for the Low Income Tax Credit Program & NAHASDA programs
High School Diploma -
Arlee High School
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