Shantel West
Kansas City,MO
Summary
Friendly Patient Advocate trained in all areas in Revenue Cycle Management while meeting SOPs, Software and Compliance requirements and expectations. Detail-oriented, hardworking and reliable. Successful working with hospital, social service entities and insurance companies to achieve positive all-around outcomes.
Overview
21
21
years of professional experience
Work History
Patient Navigator
United Health Group, Optum
Overland Park, KS
02.2020 - 06.2020
- Educated patients on insurance and healthcare plans.
- Utilized knowledge of available resources to help patients select appropriate courses and obtain relevant support.
- Assisted patients in understanding individual rights and responsibilities in regards to care, coverage and payment.
- Worked effectively with staff from all departments to coordinate resolutions.
- Collected and reviewed patient information to assess eligibility for special programs.
- Helped patients file appeals to insurance denials and worked with insurance companies to resolve disputes.
- Managed over 50 Cases daily
- Authorizations
- Infusion Therapy
- Specialty Pharmacy
- Case Holder
- Appeals
- Welcome Calls
- Utilization Review Work Flow
- Collections
- Escalations
- Copay Assistance
Client Billing
Children's Mercy Hospitals And Clinics
Kansas City, MO
10.2018 - 06.2019
- Executed billing tasks and recorded information in company databases.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Produced large volumes of client invoices.
- Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered.
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Followed up with appropriate parties to obtain prompt payments.
- Kept all patient information secure and confidential.
- Developed rapport with clients and vendors to cultivate loyalty and satisfaction.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Worked 60 Client Accounts daily
- Claim Submission
- Authorizations
- Follow-up
- High Dollar Claim Review
- Appeals
- Reports
- Collections
- SME
- Cash Posting
- Credit Balances
- Escalations
Senior Patient Account Rep III
Cerner
Kansas City, MO
03.2018 - 10.2018
- Prepared reports detailing billing actions, flags and other key information.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Monitored flags and resolved urgent items with accuracy and efficiency.
- Posted payments and processed refunds.
- Electronically submitted bills according to compliance guidelines.
- Clearinghouse Submissions
- Kronos-Time Keeping for PARS
- Denial Management
- Cash Posting
- Appeals
- Collections
- Credits
- Follow-up
- Trends
- Actively listened to customers' requests, confirming full understanding before addressing concerns
Unit Coordinator
Providence Medical Center
Kansas City, KS
06.2013 - 09.2015
- Coordinated non-clinical and ancillary services of assigned patient care units.
- Identified and facilitated resolution of unit operational problems independently, collaborating with manager to resolve complex problems.
- Prioritized safe care for patients, staff and visitors.
- Collected and analyzed data related to customer service, patient charges and supply utilization.
- Input complete and accurate patient record and identity of physician of record on computer and patient chart to facilitate appropriate routing of patient information to correct physician.
- Assisted in ordering and serving patient meals, transporting patients and performing indirect patient care duties at competent level and according to needs of patient population served.
- Scheduled patient testing, delivered specimens to lab, received STAT lab results and posted in patient record for access by physicians.
- Labor & Delivery Charges
- Admission and Discharges
- Birth Records
- Secured Unit
- Emergency Codes
Unit Coordinator
The University Of Kansas Medical Center
Kansas City, KS
04.2012 - 03.2013
- Coordinated non-clinical and ancillary services of assigned patient care units.
- Identified and facilitated resolution of unit operational problems independently, collaborating with manager to resolve complex problems.
- Prioritized safe care for patients, staff and visitors.
- Collected and analyzed data related to customer service, patient charges and supply utilization.
- Input complete and accurate patient record and identity of physician of record on computer and patient chart to facilitate appropriate routing of patient information to correct physician.
- Assisted in ordering and serving patient meals, transporting patients and performing indirect patient care duties at competent level and according to needs of patient population served.
- Scheduled patient testing, delivered specimens to lab, received STAT lab results and posted in patient record for access by physicians.
- EEG/Telemetry Monitoring
- Admission and Discharges
- Birth Records
- Secured Unit
- Emergency Codes
- Coordinated non-clinical and ancillary services of assigned patient care units
Senior Account Representative-Cash Posting
The University Of Kansas Cancer Center
Kansas City, KS
04.2011 - 04.2012
- Posted Client/Insurance payments.
- EFT/Lockbox Posting
- Posting Hospital/Physician and Specialty Clinic monies.
- Adjustments
- EOBs
- SME/Lead
- Detailed Oriented
- 100% Accuracy Goal
- Deadlines
- Reports
- Documented relevant demographic and order details
- Identified and qualified accounts to assess revenue potential
- Trained and coached sales team members servicing accounts
Radiation/Infusion Scheduler
The University Of Kansas Cancer Center
Kansas City, MO
11.2010 - 04.2011
- Insurance Verification
- Authorizations
- Account Receivables
- Surgery/Procedural Scheduling
- Coding
- Encounters
- EMR
- Carried out day-day-day duties accurately and efficiently
- Developed and maintained courteous and effective working relationships
- Resolved conflicts and negotiated mutually beneficial agreements between parties
- Maintained excellent attendance record, consistently arriving to work on time
Lead Biller
PropartnersMD Healthcare
Overland Park, KS
04.2005 - 02.2006
- Monitored outstanding invoices and performed collections duties.
- Responded to customer concerns and questions on daily basis.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Claim Submissions
- Denials Managements
- Account Receivables
- Cash Posting
- Insurance Verification
- Authorizations
- Deposits
- Deadlines
- Reports
- Generated financial statements and reports detailing accounts receivable status
- Promoted consistent accuracy of billing information by reconciling accounts monthly
- Trained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance
- Used data entry skills to accurately document and input statements
Lead Customer Service Rep
Dickson & Diveley Orthopedics
Leawood, KS
07.2003 - 04.2005
- Procedural Scheduling
- Copays
- Deposits
- Account Receivable
- Cash Posting
- Insurance Verification
- Authorizations
- Travel
- Boosted team spirit and performance by communicating clear service expectations and quality goals to each team member
- Investigated and resolved customer inquiries and complaints quickly
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates
Supervisor
Regional MRI
Overland Park, Kansas
02.1999 - 07.2003
- Lead Biller
- Rejections
- EOBs
- Appeals
- Denials
- Claim Submissions
- Cash Posting
- Authorizations
- Reports
- Time Keeping
- Pay Checks
- Maintained compliance with company policies, objectives and communication goals
- Provided supportive link between external customers and internal operations
- Handled customer complaints, resolved issues and adjusted policies to meet changing needs
Education
Associate of Science - Medical Management
National American University - Rapid City
Rapid City, SD08.2016
High School Diploma -
Liberty Senior High School
Liberty, MO05.1998
Skills
- Helpful and Service-Oriented
- Documenting and Recording Information
- Denials/Appeals SME
- Knowledge of Community Services and Programs
- Registration and Scheduling
- Administrative and Office Support
- Claims Handling and Coverage Verification
- Medical Terminology
- SME Collector
- Billing Issue Resolution and Support
- Revenue Cycle Management
- Insurance Authorizations
Timeline
Patient Navigator
United Health Group, Optum
02.2020 - 06.2020
Client Billing
Children's Mercy Hospitals And Clinics
10.2018 - 06.2019
Senior Patient Account Rep III
Cerner
03.2018 - 10.2018
Unit Coordinator
Providence Medical Center
06.2013 - 09.2015
Unit Coordinator
The University Of Kansas Medical Center
04.2012 - 03.2013
Senior Account Representative-Cash Posting
The University Of Kansas Cancer Center
04.2011 - 04.2012
Radiation/Infusion Scheduler
The University Of Kansas Cancer Center
11.2010 - 04.2011
Lead Biller
PropartnersMD Healthcare
04.2005 - 02.2006
Lead Customer Service Rep
Dickson & Diveley Orthopedics
07.2003 - 04.2005
Supervisor
Regional MRI
02.1999 - 07.2003
Associate of Science - Medical Management
National American University - Rapid City
High School Diploma -
Liberty Senior High School
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