SHAWN MYERS

• Lead the account follow-up team to process and submit medical claims with 99% precision using advanced billing software and patient accounting systems.
• Manage the appeals process for denied claims, resulting in a 15% increase in successful reimbursements from commercial insurance companies.
• Reviewed patient records and documentation standards for accuracy, minimizing claim denials and supporting optimized revenue cycle flow.
• Mentored junior staff on commercial collections techniques and revenue cycle protocols, enhancing team performance and financial recovery.
• Monitored claim status to resolve outstanding balances, reducing payment timelines through meticulous coding review.

• Processed and compiled complex healthcare data for billing, utilizing specialized patient accounting systems to enhance revenue cycle efficiency.
• Monitored government regulations and healthcare reimbursement policies, ensuring compliance with documentation standards for commercial collections.
• Organized and prioritized incoming billing inquiries from patients and providers to facilitate professional account follow-up and resolve disputes.
• Maintained accurate data entry practices, reducing administrative errors by 10% across all commercial insurance claims.

• Utilized Epic to reconcile clinical notes and health information, maintaining strict HIPAA documentation standards and revenue integrity.
• Verified insurance information and obtained billing authorizations to streamline claims submission and minimize front-end denials.
• Organized claims paperwork entry for HB and PB billing, ensuring accuracy and efficiency in the revenue cycle.
• Identified and re-filed rejected claims to prevent payment delays and enhance commercial collections outcomes.

• Maximized revenue collection by submitting detailed appeals for denied claims to Medicare and commercial payers.
• Managed medical claim processing to ensure compliance with insurance regulations and support process improvements.
• Coordinated patient-insurance carrier communications to resolve outstanding balances efficiently.
• Processed charges, payments, and adjustments to maintain financial integrity.

• Led initiatives to streamline end-to-end billing cycle, enhancing documentation standards for improved accuracy and efficiency.
• Organized and monitored staff training on patient data entry and insurance verification protocols, improving overall revenue cycle outcomes.
• Reviewed CPT codes for accuracy before claims submission to reduce front-end denials by 12% and improve revenue flow.
• Processed and applied patient payments into accounting systems, ensuring accurate financial records and timely resolution of accounts.

Processed medical claims batches, ensuring timely billing and reimbursement.

Collaborated with medical coders to achieve accurate billing and reimbursement for healthcare services.

H.I.M Specialist:

Managed healthcare data, maintaining accurate and secure patient records to support informed decision-making.

Verification Rep:

Verified patient insurance information prior to appointments, procedures, or hospital admissions. Confirmed coverage details including plan type, effective dates, deductibles, co-insurance, prior authorization requirements, and out-of-pocket maximums.

• Processed patient demographic data into medical claim software, ensuring accuracy for revenue integrity.
• Reviewed medical records to extract data critical for revenue cycle management and compliance with documentation standards.
• Organized patient information, preparing accurate insurance claims for commercial collections and ensuring timely submission.

• Maintained high-volume data entry records for batch production and inventory tracking with 100% accuracy.
• Assisted in the development of process improvement initiatives for batching operations to increase workflow efficiency.