Sherice Odems
Summary
Quality-driven clinical supervisor driven to maximize care quality and efficiency of service for patients. First-rate planner, problem-solver and conflict-manager. Ready to leverage several years of experience to take on challenge new position with room for growth and advancement.
Overview
19
19
years of professional experience
Work History
Clinical Operation Supervisor
Children’s National Medical Center
10.2015 - Current
- Implement the department's goals through efficient management of day-to-day operations of the health center; troubleshoot operational issues and develop action plans to resolve
- Collaborate with health center management team on significant operational issues/barriers; assist manager and/or management team in the development, implementation, and evaluation of services, programs, policies, and procedures, and performance standards to achieve departmental goals.
- Attend meetings as required and participate in committees as requested.
- Review registration and eligibility denials, and provide feedback to staff to maintain denials below 10%.
- Participate in performance improvement initiatives, as identified by the management team.
- Supervise, train, and mentor the administrative and MA team.
- Assist with phone calls and respond to patient requests.
- Process patients through the check-in/out workflow.
- Verify insurance eligibility and benefits by utilizing integrated real-time eligibility tool, payer websites, and telephone calls to payers; document payer verification responses in designated fields within the registration pathway; compare the primary care physician (PCP) information indicated by the insurance verification response to the location of the primary care office visit, if applicable; contact the patient/family and provide guidance for resolution of PCP discrepancies or mismatches
- Organizing daily workflows.
Medical Billing Manager
Annapolis Surgery Center
02.2006 - 03.2017
- Complete set up of revenue cycle management for professional and institutional billing.
- Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures.
- Prepared and analyzed weekly and monthly financial reports.
- Bank Reconciliation.
- Extensive knowledge of prior authorization, charge capture, CPT/ICD-10 coding, and denial management.
- Extensive knowledge of CPT, HCPCS, and ICD-10 coding reimbursement guidelines.
- Accurately assign ICD-10 and/or CPT code per medical records for Physical Medicine, Orthopedic, General Surgery, Ophthalmology, Podiatry, and Plastic Surgery, and Ambulatory Surgery Center.
- Plans and conducts investigations of claims to confirm coverage and to determine eligibility.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
Education
Master’s Degree - Social Work
Walden University, Online University
09.2024
Master’s Degree - Business Administration
Strayer University of Maryland
01.2020
Medical Assistant Diploma -
National Education Center
01.1995
Skills
- Demonstrated ability to communicate clearly and concisely with customers to understand needs and provide appropriate solutions
- Utilized active listening techniques to comprehend customer concerns, resulting in a reduction in escalation to managers
- Medical Billing & Coding: CPT, ICD-10, HCPCS, HIPAA Compliance, Medical Terminology, EHR Systems, Insurance Claims Processing
- Software & Tools: Cerner, Medisoft, NextGen, MS Office Suite (Excel, Word)
- Finance & Administration: Accounts Receivable Management, Data Entry, Billing Reconciliation, Payment Posting, Collections Processing
- Knowledge of Medicaid/Medicare reimbursement and policies
Timeline
Clinical Operation Supervisor
Children’s National Medical Center
10.2015 - Current
Medical Billing Manager
Annapolis Surgery Center
02.2006 - 03.2017
Master’s Degree - Social Work
Walden University, Online University
Master’s Degree - Business Administration
Strayer University of Maryland
Medical Assistant Diploma -
National Education Center