Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Shena C. Atchison

Seattle,United States

Summary

Seasoned professional in conflict resolution, known for high productivity and efficient task completion. Skilled in negotiation, active listening, and communication, ensuring fair outcomes in complex situations. Excel at empathy, patience, and problem-solving to navigate through disputes and foster mutual understanding.

Overview

30
30
years of professional experience

Work History

Managing Owner

Global A/R Systems
Seattle, Washington
01.2020 - 12.2025
  • Developed, maintained and monitored all billing procedures for multiple professional providers.
  • Followed up on all receivable balances.
  • Monitored write-offs with the objective of minimizing these losses.
  • Prepared monthly billing reports for my contracted professional providers.
  • Secured the credentialing of eligible staff for insurance networks.
  • Supervised all billing staff to ensure accuracy, efficiency, and timeliness of claims.
  • Ensured that payment received for all services were allocated properly.
  • Actively pursued all non-payments identifying the cause and providing a corrective solution.
  • Prepared and delivered all reports as directed.
  • Audited entire workforce to assure quality customer service.

Quality Assurance Performance Facilitator (Contractor)

Agero Roadside Assistance
Seattle, US
01.2017 - 12.2019
  • Providing quality audit services for the program, including the review of call recordings, emails, and/or other contacts, as applicable, in order to identify compliance with the requirements set out in the agreements with call center companies using the Arise platform.
  • Preparing documentation to reflect the audit results.
  • Attending calibration sessions.
  • Providing support services to agents servicing the Agero Program.
  • Holding information sessions for the agents servicing the program.
  • Educated disputants on laws, regulations and procedures applying to cases and potential legal roadblocks for proposed solutions.
  • Supported learners by providing additional guidance where necessary.
  • Developed and implemented training programs to increase participant knowledge and understanding of relevant topics.
  • Resolved conflicts between participants using effective communication skills.
  • Provided timely follow-up after each session with participants, stakeholders, and other parties involved.
  • Delivered conclusions on mediation cases.
  • Analyzed data from surveys and assessments to identify trends or patterns among participants.
  • Monitored progress throughout the course ensuring objectives were being achieved.

Family Account Specialist

Seattle Children's Hospital
Seattle, Washington
01.2014 - 12.2016
  • Investigated billing problems and assisted with the collection process under the direction of the Revenue Cycle Supervisor.
  • I was responsible for answering all billing/cashier questions regarding customer accounts. Researched data entry errors with the appropriate staff to ensure accurate coding/billing. Researched eligibility, demographics, patient charts for pertinent information.
  • Performed credit balance maintenance as it applied to specific accounts.
  • Reviewed and Updated accounts according to COB guidelines.
  • Reviewed and performed Follow up on accounts to assure timely accounts receivable management.
  • Maintained High Dollar accounts with balances over $25,000.00.
  • Handled appeal of payor denials when applicable.
  • Answered all patient questions pertaining to their insurance.
  • Kept the Revenue Supervisor up to date on any changes necessary to improve the department.
  • Reviewed all billing, CPT and ICD-9 coding, to ensure all possible revenue was recorded for accuracy on a daily basis.
  • Met one-on-one with the Billing supervisor on a monthly basis to review statistics and the progress of their insurance carriers. Met as a group on a monthly basis to discuss overall concerns, discussing changes, etc.
  • Promoted good customer/patient service by ensuring that customer/patient questions or concerns were researched and resolved in a timely and courteous manner.
  • Provided feedback for billing policies and procedures.
  • Helped maintain the accounts receivable database in the computer system and review the data input for completeness and accuracy. This includes updating account information and transferring charges to the correct agency and carrier.
  • Obtained appropriate information as needed. Used the support capabilities of the computer system to obtain appropriate information and work product.
  • Made adjustments to patient and customer accounts according to written policies and procedures.
  • Prepared patient account refunds, as it reflected on the collection accounts.

Medical A/R and Collection Specialist

Endeavor Medical Systems
Houston, TX
01.2010 - 01.2014
  • Before relocating to Seattle, WA, I was the dedicated Revenue Cycle Specialist for Highland Park Emergency Center and Omega Emergency Physicians. My responsibilities included:
  • Reviewed final billed initial claims for accuracy and completeness before submitting for payment.
  • Obtained necessary patient records required as attachments to claims.
  • Calculates Tier, Outlier, DRG and/or other Fee Schedule based reimbursement.
  • Submits electronic and/or hardcopy claims with any attachments as per the contract timely filing.
  • Documented all account activity in the hospital system notes and the database.
  • Within appropriate time frames, contacted the health plan by phone or website to determine status of claim.
  • Documented all follow-up actions in the hospital account notes and database and sets up account for additional review based on client expectations for follow-up of unresolved accounts.
  • Researched all account information on paid or partially paid claims and analyzes the status of the payment related to the expected payment calculation and itemization provided by the remittance advice.
  • Determined if payment was appropriate according to contract specifications and analyzed any denied, disallowed or non-covered claims and determines if non-payment is based on medical or technical reasons.
  • Resolved any technical issues when warranted with health plans via phone or website.
  • Prepares requests for account balance adjustments in accordance with client specific procedures.
  • Prepared claims for clinical audit processing in the case of authorization, coding, level of care and/or length of stay denials.
  • Processed overpayment transactions in accordance with client specific procedures and Followed guidelines for prioritization, timely filing deadlines, hospital and database documentation.

Full Service Quality Assurance Analyst

Carefirst Blue Cross Blue Shield of Maryland
01.1996 - 12.2009
  • Monitoring and evaluating calls within the company among customer service representatives to ensure that standards of quality are being met with our service for customers and potential customers.
  • Draft quality assurance policies and procedures.
  • Interpret and implement quality assurance standards -evaluate adequacy of quality assurance standards.
  • Devise sampling procedures and directions for recording and reporting quality data.
  • Review the implementation and efficiency of quality and inspection systems.
  • Document quality assurance activities.
  • Investigate customer complaints and non-conformance issues.
  • Collect and compile statistical quality data.
  • Analyze data to identify areas for improvement in the quality system.
  • Develop, recommend and monitor corrective and preventive actions.
  • Prepare reports to communicate outcomes of quality activities.
  • Identify training needs and organize training interventions to meet quality standards.
  • Responsible for documenting call quality.

Education

Bachelor of Science Degree - Business Administration

Towson State University
Towson, Maryland
05.1983

High School Diploma - Business College Preparatory Program

Western Senior High School
Baltimore, Maryland
05.1979

Skills

  • Customer service and support
  • Data analysis
  • Training development
  • Audit reporting
  • Performance evaluation
  • Team collaboration
  • Quality assurance and improvement
  • Billing and collections
  • Revenue cycle management
  • Effective communication
  • Feedback delivery
  • Assertiveness
  • Business planning
  • Negotiation
  • Multitasking

References

  • Edith Sunderland, Supervisor, Blue Cross Blue Shield of Maryland, 410-581-3000
  • Kim Lewis, Supervisor, Seattle Children's Hospital, kim.lewis@seattlechilderns.com
  • Everett Brown, Information Security Engineer, Bartell Drugs, Inc., (Former Employee @ Global A/R Systems)

Timeline

Managing Owner

Global A/R Systems
01.2020 - 12.2025

Quality Assurance Performance Facilitator (Contractor)

Agero Roadside Assistance
01.2017 - 12.2019

Family Account Specialist

Seattle Children's Hospital
01.2014 - 12.2016

Medical A/R and Collection Specialist

Endeavor Medical Systems
01.2010 - 01.2014

Full Service Quality Assurance Analyst

Carefirst Blue Cross Blue Shield of Maryland
01.1996 - 12.2009

Bachelor of Science Degree - Business Administration

Towson State University

High School Diploma - Business College Preparatory Program

Western Senior High School

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