SHEKIA LEE
NEW YORK
Summary
Achieved improved billing accuracy through effective data entry and financial analysis. Delivered timely revenue reconciliation that enhanced overall financial reporting. Developed customized reporting solutions that significantly reduced billing errors and streamlined manual entry processes.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Medical Billing & Data Analyst
Samaritan Daytop Village
12.2023 - Current
- Reviewing and extracting appropriate CPT, ICD-10CM, and/or HCPCS based on documentation, payer remittance responses RARC & CARC codes, and regulatory edit.
- Collaborate with RCM, program staff, and IT to develop and refine data collection instruments and improve data systems and processes.
- Work with program stakeholders to develop specific and measurable program metrics for operational and performance management. Process and prepare data for analysis and reporting; data check; document data management procedures monitor data quality, identify issues, and work with stakeholders to resolve.
- Prepare routine reports and presentations of program performance with data graphs/service trends; communicate (oral Clearly and written) results of analyses to program staff/leadership and other non-technical audiences.
- Created visual reports summarizing patient outcomes and billing efficacy.
- Respond quickly and accurately to ad hoc data requests for internal and external users
- Work with leadership and program stakeholders on the interpretation and limitations of data analysis results and provide actionable recommendations.
Program/Flyer Creator
Self-Employed
11.2005 - Current
- Create Flyers and Programs for Business and events- Home Business.
Billing Data & Healthcare Analyst
The Bridge INC
07.2023 - 12.2023
- Generate bills for Community Oriented Recovery and Empowerment (CORE). Review healthcare invoices, ensuring accuracy and compliance with regulatory requirements and insurance policies for Article 31, PROS, OASAS, ACT
- Analyze healthcare financial data, including claims, reimbursements, and patient accounts to identify issues and payer trends.
- Prepare and present regular financial and healthcare performance reports to insurance agencies.
- Monitor and manage insurance claims errors, ensuring proper coding and timely reimbursement. Resolve billing discrepancies and denied claims.
- Assist in healthcare program management by tracking patient outcomes, ensuring compliance with program guidelines and regulations.
- Ensure the integrity of healthcare data by maintaining accurate and secure electronic health records (EHR) and healthcare billing databases.
- Supervise Credentialing Coordinator Monitor, report, and assist in the credentialing of providers and payers.
- Right hand to AVP of Billing creating AD HOC Reports as needed.
Billing and Reporting Analyst
The Bridge INC
07.2021 - 06.2023
- Generate and review invoices for accuracy, ensuring they adhere to company policies and client agreements.
- Analyze financial data to identify trends, anomalies, and opportunities for cost savings or revenue optimization.
- Prepare and present regular financial reports to management, to assist in decision-making and strategic planning.
- Maintain effective communication with Clinicians regarding billing inquiries, discrepancies, and providing assistance in resolving issues.
- Ensure compliance with company policies in all billing and reporting activities.
- Identify and implement process improvements to enhance billing efficiency, accuracy, and timeliness.
- Perform regular account reconciliations to verify the accuracy of billing and payments.
- Assist in financial forecasting and budgeting processes to support the organization's financial goals.
- Maintain and update billing and financial databases with the latest information and changes.
- Work closely with cross-functional teams, such as accounting and programs to address billing and reporting needs.
- Process, post, and track all payment not received Electronically.
- Complete AD HOC Reports and other assignments deemed necessary by AVP of Billing
Health Home Billing Analyst
The Bridge INC
01.2017 - 06.2021
- Conduct thorough research of claim status to identify issues and takes corrective measures to obtain payment and ensure accuracy of future claim submission of over 700 individuals.
- Keep meticulous track of claims and payments submitted threw BTQ and RELEVANT
- Reconciling the accounts receivable and providing monthly Reports to the Controller for GL Posting.
- Works in coordination with programs to obtain information needed for clean claim submission and additional follow up documentation as needed.
- Conducts analysis of denials and partial payments to determine trends that may need to be addressed either in revenue cycle management, operationally, or with the payer.
- Resolves denial and payment issues with resubmission of claims and processing of appeals.
- Communicates effectively and frequently with supervisor regarding accounts.
- Generate and distribute regular reports, dashboards, and presentations to share key healthcare performance metrics with healthcare providers, administrators, and Finance.
- Utilize health information systems and software to input, retrieve, and analyze patient and healthcare data.
- Monitor and maintain the integrity of healthcare data by identifying and rectifying data discrepancies and inaccuracies.
- Complete AD HOC Reports and other assignments deemed necessary.
Accounts Receivable Specialist
Services for the UnderServed (S:US)/Palladia Inc
08.2015 - 01.2017
- Manage the financial accounts of approximately 375 Congregate Care Level 2 clients in AWARDS who are receiving various forms of public and federal assistance, and/or working clients currently residing within the agency’s residential treatment facilities.
- Create and send invoices for SSI Self pay and Employed consumers on a monthly basis.
- Collect payment based on invoices, update consumers account and submit payments to Finance to be deposited.
- Receive review and process various requests on a daily basis and maintain accurate files for said request.
- Prepare journal entries and cash receipts for incoming EFT from HRA
- Review accounts and submit request for back payment.
- Reviews and return unused/unentitled funds to HRA, SSI, and SSP
- Provide weekly Schedule to Comptroller for SSI funds.
- Provided report on SSI funds received for month-end close.
- Provide account breakdowns per request on a daily basis.
- Compile consumer samples to facilitate audit proceedings.
Billing Specialist
Palladia Inc
11.2010 - 07.2015
- Receive, review, process and prepare and submit incoming consumers HRA Application.
- Coordinate HRA appointment with the Client liaison
- Receive and process HRA re-certification Request.
- Create and maintain accurate and up to date folders for all over 300 consumers.
- Review and Process consumers weekly/biweekly Stipend
- Prepare and provide a monthly Schedule to Comptroller for SSI amounts for Stipends.
- Return unused funds to HRA on a weekly basis.
- Receive, analyze, review and manually enter monthly allotment from HRA for over 250 consumers monthly in AWARDS.
- Provide director and COO with monthly HRA outstanding arrears Report.
- Compile Client Samples to facilitate Audit Proceedings
- Back-up Medicaid biller for Outpatient program
Admin. Assistant
Arbor WeCare
07.2008 - 09.2008
- Responsible for sitting at front desk to meet and greet Clients, make sure clients sign in
- Inform Case Managers for Clients have arrived for scheduled appointments.
- Typing, Filing, Answer Phones, Prepare Outreach letters and other general office duties.
Education
Certified billing and coding specialists (CBCS) - undefined
National Healthcareer Association
03.2027
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Post University
06.2026
Certified professional biller (CPB) - undefined
American Academy of Professional Coders
12.2025
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Independence High School
06.2008
Skills
- STARS
- EPACES
- NGS Connex
- ALBIA MIP
- RTP BILLING SYSTEM
- Relevant RMA
- MAPP
- Payer Portals (Healthfirst, Carelon, Fidelis ETC)
- Innovation
- Foothold Technology
- Yardi
- Accumedic
- NextGen
- BTQ Financial Health Home Portal
- Microsoft Excel Intermediate/ Advanced (Pivot Tables, Chart, Slicers)
- Adobe
- Financial data modeling and reporting
- Fast Learner
- Tableau
Certification
CPBCS - Certified Professional Billing and Coding Specialist
Timeline
Medical Billing & Data Analyst
Samaritan Daytop Village
12.2023 - Current
Billing Data & Healthcare Analyst
The Bridge INC
07.2023 - 12.2023
Billing and Reporting Analyst
The Bridge INC
07.2021 - 06.2023
Health Home Billing Analyst
The Bridge INC
01.2017 - 06.2021
Accounts Receivable Specialist
Services for the UnderServed (S:US)/Palladia Inc
08.2015 - 01.2017
Billing Specialist
Palladia Inc
11.2010 - 07.2015
Admin. Assistant
Arbor WeCare
07.2008 - 09.2008
Program/Flyer Creator
Self-Employed
11.2005 - Current
Certified billing and coding specialists (CBCS) - undefined
National Healthcareer Association
undefined
Post University
Certified professional biller (CPB) - undefined
American Academy of Professional Coders
undefined
Independence High School