Summary
Overview
Work History
Education
Skills
Timeline
Generic

Shaye Garrett

Hanford,CA

Summary

Strong team player that thrives off of tackling any job that comes my way. Detail-oriented with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Reviews and updates production processes to increase consistency, minimize waste and capitalize on latest technological developments. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

20
20
years of professional experience

Work History

Senior Billing Follow up Associate

Adventist Health
02.2023 - Current
  • Monitors encounters to identify and rectify contract payment discrepancies.
  • Identifies and researches billing variances
  • Works effectively with medical payers such as managed care and commercial insurances to obtain timely and accurate payments.
  • Uses data entry skills to accurately document encounters.
  • Follows up with appropriate parties to obtain prompt payments.

Data Quality Coordinator

Kaweah Health
07.2015 - 02.2023
  • Assisted with quality control audits.
  • Provided regular updates to team leadership on quality metrics
  • Developed monthly, end-of-quarter and other statistical reports for leadership team and quality improvement programs.
  • Established and tracked quality department goals and objectives.
  • Reports all Quality Measures to CMS and TJC
  • Quality Net Administrator
  • Review medical records and abstracts Surgical and Stroke measures for quality compliance

Medical Billing Associate

Adventist Health
08.2013 - 07.2015
  • Primary and secondary billing of current claims
  • Review followup reports and resolved outstanding claims
  • Communicated with insurance providers to resolve denied claims and resubmit for payment.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Trained new employees on multiple medical billing programs and data entry software.
  • Liaised between patients, insurance companies and billing office.
  • Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.

Medical Billing Office Manager

Corcoran District Hospital
10.2009 - 02.2013
  • Reviewed billing problems, researched issues and resolved concerns.
  • Worked with customers to develop payment plans and bring accounts current.
  • Conducted performance reviews and implemented improvement plans.
  • Trained and mentored staff on procedures, compliance requirements and collections techniques.
  • Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
  • Prepared cash flow projections.
  • Established and checked coding procedures, monitored reports and updated internal files.
  • Billed out medical claims for all financial classes when backup was needed
  • Supported financial director with special projects and additional job duties

Medical Billing Associate

Corcoran District Hospital
02.2005 - 10.2009
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Posted and adjusted payments from insurance companies.
  • Located errors and promptly refiled rejected claims.
  • Precisely evaluated and verified benefits and eligibility.
  • Identified and resolved patient billing and payment issues.
  • Billed out and Follow up for Hospital, Clinic and Prison Claims for all financial classes

Education

Certificate - Lean Six Sigma Yellow Belt

Council For Six Sigma Certification
Certificate Number: FF7gy3VMOH
02.2022

Certificate - Medical Coding

Visalia Adult School
Visalia, CA
06.2021

High School Diploma -

Hanford High School
Hanford, CA
06.1990

Skills

  • Process Documentation
  • Continuous Quality Improvement (CQI)
  • Document Quality
  • Quality Improvement Activities
  • Data Collection Processes
  • Stakeholder Communications
  • Quality Performance Measures
  • High Dollar claim Follow up
  • High Production Employee
  • MS Office
  • Verbal Communication
  • Relationship Building
  • Supervision and leadership
  • Problem-Solving
  • Dependable and Responsible

Timeline

Senior Billing Follow up Associate

Adventist Health
02.2023 - Current

Data Quality Coordinator

Kaweah Health
07.2015 - 02.2023

Medical Billing Associate

Adventist Health
08.2013 - 07.2015

Medical Billing Office Manager

Corcoran District Hospital
10.2009 - 02.2013

Medical Billing Associate

Corcoran District Hospital
02.2005 - 10.2009

Certificate - Lean Six Sigma Yellow Belt

Council For Six Sigma Certification

Certificate - Medical Coding

Visalia Adult School

High School Diploma -

Hanford High School

Similar Profiles

CREATE PROFILE
Shaye Garrett