Shelby Talkington
Roseville,MI
Work Preference
Summary
Results-driven professional specializing in insurance verification, authorization, billing, and collection management, with a proven track record of enhancing team performance and optimizing workflow. Expertise in developing SOPs and implementing AI technology to streamline processes, resulting in reduced denials while minimizing write-offs. Committed professional who fosters collaboration across departments to enhance operational efficiencies.
Work History
Insurance Verification & Authorization Manager
Residential Home Health & Hospice
Remote, MI
2018 - 2025
- Managed a team of 24 insurance verification and authorization specialists for home health and hospice. This included hiring, training, mentoring, conducting one-on-ones, performance reviews, and setting productivity goals based.
- Worked with in-house programmers and a third-party vendor to develop, test, and implement AI technology to verify insurance weekly for all patients, as well as automate authorization for specific key payers.
- Collaborated with clinical operations and the revenue cycle to ensure patients' charts were verified, and care was authorized in a timely manner. This included working with the Director and VP of Revenue Cycle to analyze write-offs and identify the root cause. Identified, educated, and advised staff on write-off root causes to ensure compliance and error reduction.
- Managed workflow for insurance verification and authorization. This included educated staff on proper documentation submissions to reduce denials, tracking denials, and working with the team to ensure appeals were filed timely.
- Developed and maintained SOPs to ensure staff members had training material for guidance.
AR & Billing Manager
Trinity Health Senior Communities
Livonia, MI
2013 - 2018
- Managed a team of 14 billers, collectors, and cash posting team members who oversaw accounts receivable in 7 states for 34 owned and managed skilled nursing facilities, continuing care retirement communities, and villages. This included hiring, training, mentoring, conducting one-on-ones, performance reviews, and setting productivity goals.
- Managed employee schedules, time off, approved payroll in Kronos, and onboarded new employees through Workday.
- Implemented a clearinghouse and bank conversion with scanners to maximize efficiencies and have cash in the bank more quickly.
- Reviewed contracts, ensured EMR was loaded properly, and worked with payers and the EMR team to resolve discrepancies with contracts and EMR.
- Billed Medicare, managed Medicare, and commercial insurances, as well as collected outstanding AR.
- Developed and maintained SOPs for billing, collections, and cash posting.
- Processed AP invoices, resident refunds, and worked with accounting to reconcile cash receipts to the bank statement.
Regional Manager of Business Office Operations
Trinity Health Senior Communities
Livonia, MI
2011 - 2013
- Directed eight skilled nursing facilities' business office operations, including overseeing private pay collections, resident trust reconciliation, and working with the business office managers on Medicaid applications.
- Provided support and training for new business office managers and admission staff members.
- Developed policies and procedures for month-end close.
- Completed month-end close when business office managers were on PTO.
- Met with residents and family members regarding their statements or Medicaid applications to resolve any outstanding issues in a timely manner.
- Managed facility census by balancing census, entering payer changes and leaves of absence into EMR system.
Accounts Receivable / Credit & Collection Manager
Durr Ecoclean
Plymouth, MI
2008 - 2011
- Implemented procedures for monitoring credit limits, overdue accounts, and collections efforts.
- Collaborated with the sales team to evaluate credit risks and policies.
- Trained new staff on credit management and collection processes.
- Processed credit applications and established credit limits, including analyzed financial statements, reviewed terms and conditions, and approved/denied orders.
- Processed billing, cash receipts, made collection calls, and forecasted cash.
- Reduced DSO from 164 days to 42 days.
- Recorded fixed assets and reconciled them to the general ledger. Prepared and entered month-end journal entries.
Education
Associate in Business Administration - Business Administration
Oakland County Community College
Waterford, MI01-2009
Skills
- Change maker
- Leadership
- Staff management and development
- Teamwork and collaboration
- Time management
- Adaptability and flexibility
- Communication
- EMR - HCHB, PointClickCare, Healthmedx Vision, MatrixCare
- Clearinghouse - Availity, Waystar
- Business software - Office, Teams, RingCentral, Salesforce
Timeline
Insurance Verification & Authorization Manager
Residential Home Health & Hospice
2018 - 2025
AR & Billing Manager
Trinity Health Senior Communities
2013 - 2018
Regional Manager of Business Office Operations
Trinity Health Senior Communities
2011 - 2013
Accounts Receivable / Credit & Collection Manager
Durr Ecoclean
2008 - 2011
Associate in Business Administration - Business Administration
Oakland County Community College
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