Sheena Hodges
100 Vanderford Ln, Smyrna,TN
Summary
Friendly, positive, hard worker, who is ambitious and motivated to succeed in any environment, with extensive experience in customer service. Work well with others, with the ability to take on tasks singularly, if needed. Seeking an opportunity to develop and grow within the medical data industry.
Overview
11
11
years of professional experience
Work History
Rules Associate
R1RCM
Atlanta, GA
03.2023 - Current
- Utilized 835 data to analyze line item denials, identifying prevalent trends and frequently occurring denial causes.
- Identified opportunities to improve processes related to patient accounting activities.
- Utilized research of payer policies and CMS guidelines to develop strategies for denial reversal and rule creation based on industry best practices.
- Developed rules and associated logic in SSMS to suggest the most efficient action for overturning denials based on categorized denial reasons, improving time efficiency.
- Created reports, presentations, and other documentation for stakeholders.
- Analyzed large datasets using statistical methods and software programs.
- Documented procedures for performing tasks such as data collection and manipulation.
- Participated in regular meetings with management to assess and address issues and identify and implement improvements.
- Performed quality assurance to assess data and validate results.
Care Support Specialist, III
Aspire Health
Nashville, TN
01.2018 - Current
- Contacting patients to coordinate in home, telephonic and virtual health care professional visits
- Responsible for escalating patients' health care concerns to clinical team via inbound and outbound calls
- Developing and fostering positive relationships with healthcare professionals and colleagues to ensure a helpful and cohesive experience for patients
- Maintained accurate records and documented client data, including verified insurance information, in company databases.
- Built and maintained strong relationships with patients by successfully resolving issues and responding promptly to phone inquiries.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
Customer Service Representative
American HomePatient
Nashville, TN
06.2013 - 01.2018
- Contacting and building relationships with physician's offices, while
collecting billing documentation for Medicare patient's in need of
oxygen and CPAP supplies - Responsible for making and receiving calls from patients regarding
medical supply needs, and resolving any questions or concerns, while
following all HIPAA guidelines for patient information protection - Receiving and processing setup documentation, and submitting clean,
billable orders to quality assurance - Informed customers about billing procedures, processed payments and provided payment option setup assistance.
- Consulted with customers to resolve service and billing issues.
- Responsible for staying abreast of and following all Medicare
regulations for billing and reimbursement
Medical Billing and Coding Extern
The Pain Management Group
Antioch, TN
03.2013 - 06.2013
- Process and post payments to insurance, in addition to Medicare
reimbursements/recoupments - Ensure patient's demographic and account information is correct
- Entering data and following company procedures for coding practices
- Experienced working with the Voters Intergy database
Education
Bachelor of Science - Data Analytics
Western Governor's University
Salt Lake City, UT10-2025
Medical Billing And Coding
National College of Business And Technology
Nashville, TN06.2013
Associate of Applied Science - Human Services
Kaplan University
07.2011
Skills
- Creative problem solver
- Quick and eager learner
- Analytical and Methodical
- Medical terminology
- Strong client relations
- CPT coding/ICD 9 and ICD 10
- Tracking and Documentation
- Research and analysis
- Database entry
- Attention to Detail
- SSMS SQL Server
- Excel
Timeline
Rules Associate
R1RCM
03.2023 - Current
Care Support Specialist, III
Aspire Health
01.2018 - Current
Customer Service Representative
American HomePatient
06.2013 - 01.2018
Medical Billing and Coding Extern
The Pain Management Group
03.2013 - 06.2013
Bachelor of Science - Data Analytics
Western Governor's University
Medical Billing And Coding
National College of Business And Technology
Associate of Applied Science - Human Services
Kaplan University
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