Shundra Riddick
Summary
Dedicated medical billing/reimbursement specialist in the area of insurance verification, claims submission, denials, appeals, medical records submission, payment posting, account reconciliation, patient accounts, and revenue cycle management. Proven success in working claims efficiently and timely.
Overview
15
15
years of professional experience
Work History
Reimbursement Specialist
Neurotech/Theragen
03.2023 - Current
- Claims management, AR, work denied claims, dispute denied claims by reconsideration/appeal, patient collections, claims resubmission, contact insurance companies via online portals/phone regarding claim status/denial, request medical records, timely claims submission, and assist patients with account questions/balance.
EBO Billing Analyst
Healthcare Resource Group
08.2021 - 03.2023
- Assist clients in resolving claims, work /correct denied claims, utilize insurance online portals /contact insurance companies regarding denied claims, post all insurance and patient payments, follow up on claims denied denials, create/submit COMM Log to client to instruct them on what needs to be done to get claim paid, correct /adjust account or to correct/resend a claim.
Medical Billing Specialist
Premier Cardiovascular Center
10.2019 - 10.2021
- Review medical records to ensure billing criteria is met, Create and file all claims, verify eligibility, post payments, bill/code all hospital charges ,bill/code all office visits and testing, work aged accounts, prepare and mail all patient statements, set up patient payment plans, train front desk on the basics of insurance, eligibility, copay, coinsurance,, deductibles, request prior authorizations for testing, reconcile patient accounts, call insurance companies on denied claims, insurance appeals, assist patient with questions regarding insurance benefits and account balance.
Medical Billing Specialist
Carolina Behavioral Care
05.2018 - 10.2019
- Submitted BCBS and Magellan medical claims for behavioral health, verified patient’s insurance benefits, work aged accounts, claim denials, appeals, payment reconciliations, and assist patients with account questions.
Medical Biller
Fernecreek Cardiology
01.2017 - 05.2018
- Create and code claims for hospital inpatient and outpatient cardiac consults and procedures for a medical group of 7 physicians, verified patient insurance, maintain patient accounts, reconcile patient accounts, insurance disputes, communicated with insurance companies to resolve denied claims, and worked AR accounts.
Office Manager
Sandhills Womancare, PA
04.2012 - 01.2017
- Trained staff for front desk and billing position, interviewed potential employees, implemented office policies/procedures, managed the office’s daily workflow in productivity, patient load, and patient care. Promoted team building, ensured staff adhered to all polices/procedures of the office while providing a positive environment for patients and staff.
Insurance Coordinator / Medical Biller
Sandhills Womancare, PA
04.2010 - 01.2012
- Insurance verifications, front desk management (scheduling patients, posting payments), submitted authorization requests to Tricare, scheduled surgeries, obtained prior authorization for procedures and surgeries along with benefit information, generated/reviewed patient statements, batched all insurance claims, maintained pending insurance claims to meet timely filing guidelines, worked denied claims and AR.
Education
Bachelor of Science - Healthcare Management
Skills
- Appeals handling
- HCPCS coding
- HIPAA compliance
- ICD-10 coding
- Claims processing
- Microsoft office
- Insurance verification
- Denial management
- Medical billing
- Problem-solving
- Time management
- Adaptability and flexibility
Timeline
Reimbursement Specialist
Neurotech/Theragen
03.2023 - Current
EBO Billing Analyst
Healthcare Resource Group
08.2021 - 03.2023
Medical Billing Specialist
Premier Cardiovascular Center
10.2019 - 10.2021
Medical Billing Specialist
Carolina Behavioral Care
05.2018 - 10.2019
Medical Biller
Fernecreek Cardiology
01.2017 - 05.2018
Office Manager
Sandhills Womancare, PA
04.2012 - 01.2017
Insurance Coordinator / Medical Biller
Sandhills Womancare, PA
04.2010 - 01.2012
Bachelor of Science - Healthcare Management
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