Summary
Overview
Work History
Education
Skills
Locations
Timeline
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SHAWN MYERS

Gainesville,FL

Summary

Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with several years of hands-on experience claiming refunds, reviewing claims, and maintaining billing reports. Accommodating and helpful team player proficient in job-related billing software.

Overview

12
12
years of professional experience

Work History

Follow up (Contract Ends Mid November 2024)

Health-Tech (Remote)
04.2024 - Current
  • Handled patient and other correspondences, including detailed reports to meet organizational expectations
  • Conducted research on overdue billing by contacting patients, local affiliates and insurance carriers
  • Advised finance staff and providers regarding changes to procedural and billing codes from Medicare, Medicaid and private insurance carriers
  • Resolved accounts quickly and accurately to obtain maximum reimbursement
  • Verified coverage with insurers, filed required forms and submitted paperwork to obtain timely payments

Medical Billing Level 2 Team Lead

Trinity Health (Remote)
Gainesville
11.2022 - 04.2024
  • Started with a Temp agency (GHR) and I was on assignment with Trinity Healthcare and the temp assignment last 6 months then I was hired on fulltime with Trinity health
  • HB and PB billing In Epic, I Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules
  • Precisely completed appropriate paperwork and system entry regarding claims
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays
  • Contacted insurance providers to verify insurance information and obtain billing authorization
  • Posted charges, payments and adjustments

MEDICARE MEDICAL BILLER

Haven Hospice (Hybrid)
Gainesville, USA
11.2021 - 11.2022
  • Completed and submitted appeals for denied claims
  • Coordinated communications between patients, billing personnel and insurance carriers
  • Posted charges, payments and adjustments
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays
  • Posted and adjusted payments from insurance companies
  • Reviewed and verified benefits and eligibility with speed and precision
  • Collaborated closely with other departments to resolve claims issues
  • Entered procedure codes, diagnosis codes and patient information into Ability, MyUnity, DDE
  • Contacted insurance providers to verify insurance information and obtain billing authorization
  • Precisely completed appropriate paperwork and system entry regarding claims

Medical Billing Manager

Gainesville Prosthetics (Hybrid)
Gainesville, USA
01.2021 - 07.2021
  • Verify CPTs were correct before billing
  • Apply payments
  • Monitor and train front desk
  • Office Duties
  • The Owner was talking about going all self pay since it was a small 2 provider DME clinic and I left the job due to my father had colon cancer and I took time to help him and my mother for 5 months
  • He is 100% now and doing great

Financial Counselor

Florida Cancer Specialists
08.2020 - 01.2021
  • Responsible for monitoring and collecting the financial responsibilities of our patients
  • The Financial Counselor Float must keep patients' insurance benefits up to date in Onco EMR and Centricity and view the patients' services for diagnosis and insurance coverage appropriateness
  • Also performs the daily tasks of Managed Care and Financial Counselor
  • This position must travel to any office/clinic within their 'region' and when not covering for another Financial Counselor as the float will be assigned various Financial Counselor work to assist others
  • Obtain Authorizations from the patient's insurance company

MEDICAL BILLING SPECIALIST

The Cardiac and Vascular Institute
Ocala
10.2018 - 08.2020
  • Work HB and PB as well as Acute Hospital A/R and collections
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes
  • Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house
  • Posted and adjusted payments from insurance companies
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements
  • Performed full-cycle medical billing in a fast-paced medical billing company
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies
  • Reviewed and verified benefits and eligibility with speed and precision
  • Completed appeals and filed and submitted claims
  • Submitted refund requests for claims paid in error
  • Identified errors and re-filed denied or rejected claims in a timely manner
  • Kept detailed and accurate documentation of payments, charges and write-ups of cardiovascular procedures
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials

BILLING SPECIALIST

CITRUS CARDIOLOGY
03.2018 - 10.2018
  • Collect all the information necessary to prepare insurance claims and bill patients
  • Enter patient demographic and insurance information into the medical claim software
  • Enter patient encounter information
  • Review accounts for possible assignments and prepares information for the collections agency
  • Fill in the claim form accurately by contacting the patients, company, or the health institution, for a single mistake might delay the whole process

CARE TEAM COORDINATOR

Kindred at Home
09.2017 - 03.2018
  • Developed and implemented strategies to ensure all care team members had the necessary resources to accomplish their duties.
  • Provided guidance on complex clinical issues and assisted in resolving conflicts between team members.
  • Maintained accurate records of case reviews and follow-up actions taken by the care team.

4 Different Departments

University of Florida Health
Jacksonville, USA
06.2012 - 09.2017

UF Jacksonville Physicians:

Batcher:

  • Maintained accurate records of all batches produced, including batch numbers and quantities.
  • Assisted in the development of new processes and procedures for batching operations.

UF Health Shands Gaineville:

H.I.M tech:

  • Reviewed medical records for completeness, accuracy and compliance with regulatory standards.
  • Maintained patient confidentiality in accordance with HIPAA regulations.
  • Assisted in the preparation of documents for filing and scanning into electronic health record systems.

Verification specialist:

  • Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
  • Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
  • Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.

Eye clinic check out:

  • Developed and maintained scheduling procedures to ensure timely completion of projects.
  • Schedule appointments for patients.
  • Collect co-pay

Education

HIGH SCHOOL DIPLOMA -

Mandarin High School

NO DEGREE - CRIMINAL JUSTICE

Florida State College

Skills

  • Revenue Cycle
  • Epic
  • Ecw
  • Meditech
  • Trac
  • Team Lead
  • Billing Management
  • Appeals
  • Follow Up
  • Collections
  • HB Billing
  • PB Billing

Locations

  • Gainesville, FL
  • Ocala
  • Palatka
  • Jacksonville, FL

Timeline

Follow up (Contract Ends Mid November 2024)

Health-Tech (Remote)
04.2024 - Current

Medical Billing Level 2 Team Lead

Trinity Health (Remote)
11.2022 - 04.2024

MEDICARE MEDICAL BILLER

Haven Hospice (Hybrid)
11.2021 - 11.2022

Medical Billing Manager

Gainesville Prosthetics (Hybrid)
01.2021 - 07.2021

Financial Counselor

Florida Cancer Specialists
08.2020 - 01.2021

MEDICAL BILLING SPECIALIST

The Cardiac and Vascular Institute
10.2018 - 08.2020

BILLING SPECIALIST

CITRUS CARDIOLOGY
03.2018 - 10.2018

CARE TEAM COORDINATOR

Kindred at Home
09.2017 - 03.2018

4 Different Departments

University of Florida Health
06.2012 - 09.2017

HIGH SCHOOL DIPLOMA -

Mandarin High School

NO DEGREE - CRIMINAL JUSTICE

Florida State College
SHAWN MYERS