SHONTA LOWE
Apopka,FL
Summary
Results-driven Accounts Receivable Specialist with over 10 years of experience in reducing open balances through proactive customer follow-up and strategic planning. Adept at leveraging strong analytical skills and relationship-building capabilities to communicate effectively and drive financial outcomes. Known for a stellar work ethic and a proven track record of delivering exceptional results.
Overview
17
17
years of professional experience
Work History
AR Management Account Resolution Specialist II
Wellstar MCG Health
Augusta , GA
2022.09 - Current
- Enhance the resolution process for open insurance claims by obtaining and reviewing information from various sources in a prompt and precise manner.
- Collaborate with other departments on escalated cases involving complex issues.
- Facilitate compliance with third-party payer guidelines by implementing measures such as claim resubmissions, denial appeals, and timely submission of necessary documents for swift claim resolution.
- Conduct research on payer trends/issues, collate relevant data, and communicate findings effectively to management.
- Optimize cash flow by implementing efficient resolution tactics, resulting in a reduction of accounts receivable for aged claims.
- Collaborate with management on various special projects, including claim analysis, and the implementation of process improvements.
- Provide comprehensive training on claims procedures and system navigation to improve the onboarding experience for new hires.
- Maintain high levels of accuracy in payment and residual balances, while also demonstrating promptness in processing and following up on appeals.
- Cooperate with both internal and external teams, enhancing efficiency in claim resolution through effective communication.
Senior Reimbursement Analyst
Nix Healthcare
San Antonio , TX
2016.04 - 2019.12
- Oversaw all contracts in the contract management system while conducting regular audits of insurance claims to identify discrepancies in payments and billing errors.
- Maximized adherence to accuracy standards while managing reimbursement methodologies for managed care and government contracts.
- Demonstrated critical thinking ability by analyzing, identifying, and resolving reimbursement issues while effectively communicating the resulting financial impact to leadership.
- Oversaw account balance appropriateness by assisting with the resolution of reimbursement issues through application of plan contract and state regulations.
- Aided with revenue analysis and explanations, proactively resolving discrepancies by month's end.
- Collaborated with other departments within the organization on projects related to reimbursement initiatives.
Accounts Receivables Specialist
IHeartMedia
San Antonio , TX
2015.06 - 2016.03
- Oversaw collections for a diverse portfolio of business customers, managing accounts receivable balances from $8 million to $18 million
- Engaged with account executives, agencies, and designated contacts to resolve past due balances.
- Facilitated negotiation of mutually acceptable payment arrangements and ensured adherence to these agreements in a timely manner.
- Accurately recorded and tracked customer account interactions to maintain comprehensive system records
- Achieved prompt resolution of disputed balances and discrepancies through follow-up actions and reconciliation
- Distributed necessary customer documents such as statements, invoices, and aging reports
- Ensured prompt action was taken on delinquent accounts to minimize loss
- Efficiently managed the process of following up on, collecting, and allocating payments.
- Managed the prompt processing of adjustments, charge-offs, and refunds as necessary.
- Consistently achieved decreased A/R collections on a quarterly basis.
Insurance Reimbursement Specialist
Florida Hospital
Maitland , FL
2011.03 - 2015.03
- Performed reimbursement functions with emphasis on collections, through complete and accurate billing.
- Handled aged claims to determine and rectify any instances of improper payments, billing errors, and discrepancies for successful resolution.
- Secured prompt payment through meticulous review and resubmission of corrected or rejected claims containing fixes to issues like incorrect ICD-9 coding, HCPCS coding discrepancies, absence of modifiers, incomplete medical records, and essential supporting documents.
- Played an active role in preparing, reviewing, and analyzing reports that identified coding errors and payer trends.
- Maintained documentation of billing, follow-up, and collection steps for resolving assigned accounts.
- Demonstrated a consistent track record of exceeding productivity targets.
Emergency Department Charge Lead
Florida Hospital
Orlando , FL
2008.01 - 2011.03
- Achieved successful collaboration with nursing staff and different departments, resulting in enhanced workflow and improved patient experience in the emergency department.
- Led a team of 15+ employees on both the second and third shifts, providing guidance in their training and professional growth.
- Obtained necessary data from patients and/or guarantors such as demographics, clinical particulars, billing history, and insurance details.
- Ensured compliance with specified time frames by accurately verifying insurance coverage and benefits while facilitating required notifications and authorizations.
- Performed quality audits and looked for opportunities for process improvement.
- Identified and processed various types of required payments, such as co-payments, co-insurance, and deductibles.
- Implemented coaching classes to maximize collection opportunities for team members.
- Actively contributed to continuous improvement efforts by suggesting innovative ideas and participating in problem-solving initiatives.
- Achieved remarkable goal by efficiently managing tasks and exhibiting a strong dedication to work.
Education
Associate of Science - Computer Information Technology
Valencia College
Orlando, FL05.2022
Skills
- Proficient in managing and maintaining accounts receivable processes, including billing, collections, and reconciliation.
- Excellent communication skills for interacting with clients and team members, both verbally and in writing.
- Experienced in using ERP systems (SAP), and Microsoft Office Suite (Excel, Word, Outlook,PowerPoint).
- Capable of establishing and maintaining positive relationships with clients to facilitate smooth financial transactions.
- Strong ability to analyze accounts, identify trends, and implement strategies for reducing accounts receivable.
- Proficient in managing and maintaining accounts receivable processes, including billing, collections, and reconciliation.
- Effective in contacting customers and representatives via phone and email to resolve payment issues and negotiate arrangements.
- Competent in investigating and resolving discrepancies and disputed balances.
- Accurate in documenting account actions and maintaining thorough system records.
- Skilled in managing multiple accounts efficiently, prioritizing tasks, and following up on pending actions.
- Strong ability to analyze accounts, identify trends, and implement strategies for reducing accounts receivable.
- Experienced in processing payments, adjustments, charge-offs, and refunds accurately and promptly.
Timeline
AR Management Account Resolution Specialist II
Wellstar MCG Health
2022.09 - Current
Senior Reimbursement Analyst
Nix Healthcare
2016.04 - 2019.12
Accounts Receivables Specialist
IHeartMedia
2015.06 - 2016.03
Insurance Reimbursement Specialist
Florida Hospital
2011.03 - 2015.03
Emergency Department Charge Lead
Florida Hospital
2008.01 - 2011.03
Associate of Science - Computer Information Technology
Valencia College
Similar Profiles
Kristin CasteelKristin Casteel
BSN Charge Nurse at Wellstar MCG HealthBSN Charge Nurse at Wellstar MCG Health
1LT Gregory Forrest Ayers RN BSN CEN CCRN TCRN1LT Gregory Forrest Ayers RN BSN CEN CCRN TCRN
Registered Nurse, Medical ICU at WellStar MCG HealthRegistered Nurse, Medical ICU at WellStar MCG Health
Cheronda GrahamCheronda Graham
Patient Care Technician at Wellstar MCG HealthPatient Care Technician at Wellstar MCG Health