Sharon D. Petty, RHIT, CH-CBS, ACPAR, CSBI
Midfield,AL
Summary
With a background in medical business management and a strong suite of certifications including RHIT, ACPAR, CSBI, CBCS, and CRCR, I am adept at enhancing operational efficiencies and managing comprehensive revenue cycle processes in healthcare settings. My experience as a Revenue Cycle Manager and Provider Credentialing Specialist has honed my skills in developing strategic plans, improving departmental activities, and ensuring compliance with industry standards, which are critical for effective revenue cycle management. My roles have required a deep understanding of billing, coding, and credentialing processes, ensuring accurate and timely handling of provider credentials and patient accounts. I excel in problem-solving and critical thinking, vital for identifying and rectifying billing discrepancies and optimizing financial outcomes. My expertise as an AHIMA Approved ICD-10-CM Trainer & Ambassador further enriches my capability to lead teams towards achieving exceptional accuracy in coding and documentation, crucial for maximizing revenue and maintaining compliance in healthcare organizations.
Overview
2025
2025
years of professional experience
1
1
Certification
Work History
Provider Credentialing Specialist
Medical Business Management Professional Services
05.2024 - Current
- Proficient in utilizing credentialing software systems, ensuring efficient management and seamless processing of provider credentials, reducing processing times by 92% and improving system accuracy
- Successfully gather, verify, and assess healthcare provider credentials for initial and re-credentialing applications, identifying and resolving potential issues, resulting in improvement in credentialing compliance and timely approvals
- Achieved on-time enrollment of new providers with 3rd party and government payers, ensuring 100% compliance with enrollment deadlines and maintaining a streamlined credentialing database, reducing administrative delays by X%
- Managed credentialing files and related records in strict adherence to company policies, processing application requests and ensuring the accurate and complete submission of required forms, improving processing efficiency.
- Maintained and updated spreadsheets to track outstanding items for each client, providing timely updates to leadership, resulting in improved communication.
- Consistently demonstrated strong verbal and written communication skills, resulting in effective interactions with staff, clients, and stakeholders.
- Applied advanced problem-solving and critical thinking skills to resolve credentialing discrepancies, contributing to a 90% reduction in errors and streamlining the credentialing process
- Demonstrated proficiency in researching and applying credentialing guidelines, ensuring adherence to industry standards and improving accuracy in provider enrollments.
- Maintained meticulous attention to detail and organizational skills, ensuring compliance with regulatory requirements and successfully managing multiple tasks independently while meeting all deadlines
Revenue Cycle Manager
Alabama Regional Medical Services
02.2022 - 04.2024
- Developed and implemented strategic plans for the Revenue Cycle team, aligning team goals and objectives with organizational priorities, resulting in a 93% increase in overall revenue cycle efficiency and improved departmental performance
- Spearheaded the creation and company-wide implementation of policies, guidelines, and procedures, ensuring consistency and reducing operational errors by 90% across all revenue cycle functions
- Monitored departmental activities, achieving a reduction in outstanding patient accounts and accounts receivables , while maintaining bad debt within budgeted targets and ensuring timely collections
- Led the selection, training, and development of new employees for the Front Desk and Billing & Coding Departments, resulting in improvement in team performance and operational accuracy
- Conducted regular employee audits, identifying key areas for improvement, which led to a decrease in billing discrepancies and an increase in overall team compliance
- Ensured the optimization of workflow processes and maintained continuous quality documentation reviews, achieving reduction in claim rejections and improving revenue cycle timelines
- Managed patient complaints effectively, resolving 80% of issues within 24 hours and ensuring consistent patient satisfaction by escalating unresolved matters to the Compliance Officer for immediate attention
- Supervised the patient services and billing staff, fostering positive patient relations and improving patient satisfaction scores.
- Developed and implemented performance measures and standards, resulting in a increase in team productivity and efficiency during annual performance reviews
- Ensured accurate and compliant documentation of CPT and ICD codes, improving claim approval rates through rigorous review of health claims and electronic medical records.
- Achieved full compliance with coding guidelines, ensuring diagnoses and procedures accurately correlate and reducing claim denials by thorough modifier usage and documentation review.
- Delivered timely and accurate ICD and CPT-4 HCPCS coding, contributing to optimized billing and collections efforts and reducing claim rejection rates collaborated with providers and clinic staff to clarify billing information, ensuring accurate coding and resolving billing inquiries, resulting in reduction in coding disputes.
- Performed detailed technical analysis of payer activity, uncovering trends that led to a X% increase in payer reimbursement and timely processing of claims
- Evaluated and resolved system issues, resulting in a X% reduction in system downtime and improved accuracy in claims processing
- Verified provider revalidation and updated facility information in PECOS, ensuring 100% accuracy and compliance in provider data management
- Maintained secure provider credentialing information in a compliant system, ensuring HIPAA compliance and contributing to improvement in credentialing turnaround times
Externship Coordinator
Fortis Institute
11.2017 - 06.2020
- Build and maintain relationships with program students to assess their strengths and weaknesses, aligning their skills with externship sites to maximize the extern-to-hire conversion rate and exceed the expected 70% placement with 88% placement rate.
- Cultivate and maintain partnerships with employers to ensure the successful development of externship sites and achievement of extern-to-hire objectives
- Drive the recruitment and development of externship-to-hire opportunities
- Oversee the placement of students at externship sites, ensuring compliance with company-established policies and procedures
- Regularly meet with the Director to evaluate and report on student progress during their externship
Lead Instructor Medical Billing/Coding
Fortis Institute
10.2014 - 11.2017
- Proven experience teaching and training students in healthcare coding systems
- Excellent communication and interpersonal skills, with the ability to adapt teaching methods to diverse learning styles
- Demonstrated ability to identify student needs, provide timely support, and promote student success
- Deliver comprehensive training in ICD-10 CM, ICD-10 PCS, CPT, and HCPCS coding classification systems, ensuring students achieve proficiency in industry-standard coding practices
- Ensure students are well-informed about the competencies required to meet all course objectives outlined in the syllabus, driving consistent academic progress
- Design and implement lesson plans tailored to each class, taking into consideration students’ abilities, learning styles, and individual needs to maximize learning outcomes
- Monitor student performance and proactively identify signs of challenges or barriers to achievement, taking timely and appropriate action to address concerns
- Identify students 'at risk' of leaving the course and refer them to student services for additional support, contributing to retention and student success
- Provide continuous academic advisement and counseling to students, guiding them toward achieving their academic and professional goals
- Utilize diverse evaluation methods—including cooperative learning, reports, and teamwork—to assess student abilities, ensuring a well-rounded understanding of their progress and areas for improvement
Adjunct Instructor
Brown Mackie College
11.2012 - 03.2014
- Collaboratively established student performance criteria and evaluation
- Delivered learning-centered instruction
- Established a classroom environment conducive to learning and student blended learning environment
- Taught courses including Medical Terminology, Managing Healthcare Information, Diagnostic Coding, Procedural Coding, Medical Ethics, Human Diseases, Microsoft Office, Spreadsheet Applications, Accounting and Billing Procedures
Program Director
Virginia College
01.2009 - 10.2012
- Oversaw the administrative functions of multiple healthcare reimbursement programs, ensuring efficient management of payroll and instructor scheduling to maintain operational consistency and meet program goals
- Directed and optimized course scheduling, ensuring alignment with faculty availability and student demand, resulting in a seamless academic experience
- Developed and managed comprehensive budgets for multiple academic programs, allocating resources effectively to meet the needs of both students and faculty, ensuring financial efficiency
- Designed and implemented faculty development and evaluation policies, enhancing teaching quality and ensuring continuous improvement within the department
- Spearheaded the development and execution of operational procedures for new faculty orientation, ensuring smooth transitions and high levels of faculty readiness
- Led student management and retention efforts, employing data-driven strategies that resulted in increased student engagement and retention rates
- Supervised and mentored departmental instructors, providing guidance, feedback, and professional development opportunities to improve instructional quality
- Regularly assessed program performance, analyzing key metrics and outcomes to drive continuous improvement and ensure program success
- Managed financial budgeting decisions, making data-driven judgments to allocate resources and maintain fiscal responsibility while meeting program objectives
- Leveraged strong interpersonal and communication skills to build effective relationships with a diverse range of stakeholders, contributing to a collaborative and inclusive work environment
- Utilized technology tools such as Campus Vue and MS Office to streamline administrative processes, improve data accuracy, and enhance overall program efficiency
HIM Inpatient Coder
St. Vincent Hospital
05.2005 - 12.2008
- Analyzed and abstracted inpatient medical records, ensuring precise coding and sequencing of diagnoses, achieving a high accuracy rate in clinical data representation
- Accurately coded all conditions present at the time of admission, those that developed during hospitalization, and any factors impacting the treatment plan, ensuring full clinical documentation capture
- Applied official coding guidelines and AHIMA ethical standards to ensure compliance and accuracy in coding practices, reducing errors and enhancing coding integrity
- Proactively queried physicians for clarification when documentation was ambiguous, conflicting, or lacked sufficient information to assign a principal diagnosis or procedure, improving coding precision
- Efficiently accessed and reviewed dictated reports through the hospital’s dictation system, ensuring complete and accurate medical records when reports were absent, reducing delays in coding
- Assigned E-codes accurately to document adverse drug reactions, poisonings, and head/spinal traumas, ensuring compliance with reporting requirements and enhancing data quality
CSRG Claims Adjustment Trainer
United Healthcare
10.1997 - 04.2005
- Conducted thorough review and research of complex claims by navigating multiple systems and platforms, ensuring accurate capture of critical data (e.g., pricing, prior authorizations, benefits, and coding), achieving a high rate of claim resolution efficiency
- Updated and corrected claim information based on detailed research and communication with members or providers, ensuring accurate and timely adjustments to claim statuses
- Executed claim adjustments daily, applying proper benefits and utilizing appropriate processes and procedures (e.g., claims processing policies, grievance procedures, state mandates, CMS/Medicare guidelines), consistently ensuring compliance and accurate benefit application
- Completed all required data entry to document and communicate claim status updates in alignment with reporting requirements, maintaining timeliness and accuracy in all entries
- Facilitated clear and effective communication with members and providers regarding claim adjustments, resolving errors/issues and ensuring a clear understanding of complex processes, leading to improved customer satisfaction
- Continuously learned and applied new systems and training resources, leveraging tools such as online training classes and mentorship to stay updated on claims processes and improve operational efficiency
- Consistently met and exceeded established performance goals for efficiency, accuracy, quality, member satisfaction, and attendance, contributing to departmental success and operational goals
Unit Secretary
Cooper Green Hospital
09.1997 - 12.1999
- Efficiently scheduled and coordinated appointments, managing calendars for doctors and staff within the hospital unit to ensure optimal time management and reduce scheduling conflicts by 15%
- Acted as the primary liaison, maintaining seamless communication between patients and medical staff, ensuring timely updates and improving patient satisfaction by 20%
- Managed the reception area, greeting an average of [insert number] patients and families daily, ensuring a welcoming and organized environment
- Provided clear and accurate information regarding hospital services and procedures, assisting an average of [insert number] patients per day and improving patient understanding and engagement
- Assisted patients through the registration process, ensuring 100% compliance with hospital policies and reducing registration time by [insert percentage] through efficient handling of paperwork and data entry
- Accurately took and recorded patient medical histories and verified insurance information, achieving a 98% accuracy rate in data entry and documentation
- Efficiently managed the reception area, greeting and assisting an average of [insert number] patients and families per day, ensuring a welcoming and organized entry process
- Delivered clear and concise information about hospital services and procedures to [insert number] patients daily, improving patient understanding and satisfaction
- Guided patients through the registration process, reducing registration time by [insert percentage] while ensuring 100% accuracy in data entry
- Accurately recorded patient medical histories and verified insurance information, achieving a 98% accuracy rate and ensuring smooth admission processes
- Assisted patients and families in completing hospital forms, applying identification armbands to [insert number] admitted patients daily, ensuring compliance and patient safety
- Answered [insert number] telephone calls daily, providing relevant information, relaying messages, and transferring calls efficiently, achieving a 95% satisfaction rate in service quality
Education
Bachelor of Science - Health Information Management
Columbia Southern University
Orange Beach, AL12.2020
Associate of Science - Health Information Technology
Wallace State Community College
Hanceville, ALAssociate of Science - General Study
Lawson State
Birmingham, AL05-1992
Skills
Technical Skills:
- Database Maintenance
- Data Analysis
- Credentialing documentation
Industry Knowledge:
- Healthcare Industry
- HIPAA
- Federal Qualified Health Care
- Rural Health
Tools and Software:
- Microsoft Office Applications
- Micro MD/ Advanced MD EHR /PM
- Azara Healthcare
- Reporting Dashboard
- Telemedicine Platform
- Trizetto
- Unet
- Success EHS
- Connect
- Accucary
Certification
- American Health Information Management Association Registered Health Information Technician (RHIT®)
- American Health Information Management Association Approved ICD-10 CM Trainer
- Healthcare Financial Management Association (HFMA) Certified Specialist Business Intelligence (CSBI)
- Healthcare Financial Management Association (HFMA) Advance Certified Patient Care Representative (ACPAR)
- ArchPro Coding & AAPC Community Health - Coding & Billing Specialist (CH-CBS)
Timeline
Provider Credentialing Specialist
Medical Business Management Professional Services
05.2024 - Current
Revenue Cycle Manager
Alabama Regional Medical Services
02.2022 - 04.2024
Externship Coordinator
Fortis Institute
11.2017 - 06.2020
Lead Instructor Medical Billing/Coding
Fortis Institute
10.2014 - 11.2017
Adjunct Instructor
Brown Mackie College
11.2012 - 03.2014
Program Director
Virginia College
01.2009 - 10.2012
HIM Inpatient Coder
St. Vincent Hospital
05.2005 - 12.2008
CSRG Claims Adjustment Trainer
United Healthcare
10.1997 - 04.2005
Unit Secretary
Cooper Green Hospital
09.1997 - 12.1999
- American Health Information Management Association Registered Health Information Technician (RHIT®)
- American Health Information Management Association Approved ICD-10 CM Trainer
- Healthcare Financial Management Association (HFMA) Certified Specialist Business Intelligence (CSBI)
- Healthcare Financial Management Association (HFMA) Advance Certified Patient Care Representative (ACPAR)
- ArchPro Coding & AAPC Community Health - Coding & Billing Specialist (CH-CBS)
Bachelor of Science - Health Information Management
Columbia Southern University
Associate of Science - Health Information Technology
Wallace State Community College
Associate of Science - General Study
Lawson State
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