Shelby Davidson
Oklahoma City
Summary
Knowledgeable about preparing invoices, processing payments and pursuing past-due balances. Well-versed in accurately coding different types of bills for clear recordkeeping and tracking. Team-oriented, dependable and performance-driven.
Overview
10
10
years of professional experience
Work History
Credentialing/Contracting Specialist
Oklahoma Spine Surgery Center
06.2023 - Current
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Conducted primary source verifications such as background checks and board certifications.
- Safeguarded confidential provider information by adhering to strict data privacy regulations and company policies.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Received and evaluated applications to look for missing and inaccurate information.
- Liaised with healthcare providers to address and resolve any credentialing issues promptly, maintaining strong professional relationships.
Billing/Credentialing Specialist
Oklahoma Pain Management
11.2022 - Current
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Collected payments and applied to patient accounts.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Posted payments and collections on regular basis.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Filed and updated patient information and medical records.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Liaised between patients, insurance companies, and billing office.
Loss Mitigation Evaluator
MidFirst Bank
08.2021 - 11.2022
- Assessed clients' financial data to determine loan suitability.
- Analyzed credit, income, compliance, title documents, and appraisals during underwriting process.
- Reviewed applications for mortgage assistance and worked with lenders to find eligible assistance programs
- Collaborated with and facilitated communications between borrowers and lenders to obtain ideal refinanced loans.
Billing Specialist/Insurance Follow-up/Outpatient Coder
Eastern Oklahoma Medical Center
01.2019 - 08.2021
- Worked various denied, and unpaid insurance claims, submitted for prior authorizations.
- Resourcefully used various coding books, procedure manuals, and on-line encoders to code outpatient claims in skilled nursing facilities.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Manually submitted Medicare and Medicaid claims.
Medical Scribe
ScribeAmerica
05.2018 - 01.2019
- Accompanied physicians through day in fast-paced, stressful environments.
- Demonstrated confidentiality in dealing with sensitive information or records to comply with HIPAA guidelines and regulations.
- Charted patient encounters by recording information such as diagnosis, treatments, and prescriptions.
- Documented complete information about examinations, treatment plans, lab results, and other details directly into charts.
Cashier
Walmart
05.2015 - 05.2018
- Helped customers complete purchases, locate items, and join reward programs.
- Greeted customers and responded to requests for information.
- Handled customer complaints and concerns and escalated to direct supervisor for quick resolution.
- Maintained organized and orderly front end and removed carts, baskets, and debris.
- Operated register system to process new purchases, item returns, and merchandise exchanges.
Education
Master of Science - Health Information Management
Southwestern Oklahoma State University
Weatherford, OK12-2024
Bachelor of Applied Science - Interdisciplinary Studies
Liberty University-Online
Lynchburg, VA07.2021
Associate of Applied Arts - Professional Studies
Southern Arkansas University Tech
Camden, AR05.2018
High School Diploma - General Education
Howe High School
Howe, OK05.2015
Skills
- Benefits Verifications
- Medicare and Medicaid Processes
- HIPAA Compliance
- Medical Claims Submission
- Billing Codes
- CMS-1500 Billing Forms
- Medical Coding Knowledge
- ICD-10 Coding
- Insurance Claims
- Client Inquiries
- Verbal and Written Communication
- Credentialing and Contracting
Timeline
Credentialing/Contracting Specialist
Oklahoma Spine Surgery Center
06.2023 - Current
Billing/Credentialing Specialist
Oklahoma Pain Management
11.2022 - Current
Loss Mitigation Evaluator
MidFirst Bank
08.2021 - 11.2022
Billing Specialist/Insurance Follow-up/Outpatient Coder
Eastern Oklahoma Medical Center
01.2019 - 08.2021
Medical Scribe
ScribeAmerica
05.2018 - 01.2019
Cashier
Walmart
05.2015 - 05.2018
Master of Science - Health Information Management
Southwestern Oklahoma State University
Bachelor of Applied Science - Interdisciplinary Studies
Liberty University-Online
Associate of Applied Arts - Professional Studies
Southern Arkansas University Tech
High School Diploma - General Education
Howe High School
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