Shelly Alexander
Concord,NC
Summary
Knowledgeable Accounts Receivable Specialist with a proven track record in managing patient billing and resolving account discrepancies. Demonstrated expertise in patient account management and collection strategies.
Overview
8
8
years of professional experience
Work History
Supervisor
OrthoCarolina
11.2022 - Current
- Supervises Accounts Receivable and Utilization Review Team
- Monitors productivity, and conducts monthly quality audits for team members
- Conducts performance reviews
- Runs daily reports to measure KPI to ensure department goals are met
- Educates all staff members on proper policies and protocols
- Trains new staff members
- Remains update on pricing methods, coding principles, governmental regulations, and billing protocols and documentation guidelines
- Analyzes denial reasons provided by payers. Collaborates with management to identify, trend and address root causes of denials.
- Researches and analyzes payer trends
- Monitors work queues for missing/unposted payments
- Maintains professional relationships with Physicians and staff
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
Accounts Receivable Rep II (Team Lead)
Ensemble Health Partners
11.2017 - 11.2022
- Resolved high dollar claim denials for the AR and Special projects team
- Reviewed aged accounts to secure appropriate and timely reimbursement for multiple hospitals and insurance carriers
- Analyzed denial reasons and collaborated with management to identify, trend and address root causes of denials.
- Acted as first point of contact for new and current staff members
- Implemented and developed onboarding programs for new staff members
- Created all SOP’s, Tips Sheets, and Reference Guides for departments/clients
- Led and coordinated training for new staff to ensure they are equipped with the necessary skills and knowledge to complete their specific job
- Led weekly account review sessions to address questions and assist with claim issues
- Collaborated with leadership to ensure orientation and training program were up to date
- Provided customized education to staff members based on their specific need and area of improvement
- Performed monthly Quality Assurance Audits
- Utilized Billing software (e-premise, Relay Assurance, SSI) to submit updated/corrected UB-04 and 1500 claims
- Drafted and submitted technical and clinical appeals
- Maintained a thorough understanding of federal and state regulations, as well as payer specific requirements
- Assisted Supervisor with other duties
Education
Associates of Applied Science - Medical Office Administration
Gaston College
Dallas. NC01.2017
Skills
- Microsoft Office
- Epic
- Epremis
- HMS
- Meditech
- Cerner
- SSI
- FinThrive
- Navinet
- Government
- Commercial
- Medicare/Medicaid Traditional and HMO
- Workers Compensation
Timeline
Supervisor
OrthoCarolina
11.2022 - Current
Accounts Receivable Rep II (Team Lead)
Ensemble Health Partners
11.2017 - 11.2022
Associates of Applied Science - Medical Office Administration
Gaston College
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