Summary
Overview
Work History
Education
Skills
Timeline
Generic
Shyla Robinson

Shyla Robinson

Byram,MS

Summary

Highly skilled and quality focused Medical Claims and Coding Specialist that demonstrates strong ambition and advanced analytical thinking. Offers a keen eye for auditing medical accounts and the meticulous verification of medical details/diagnoses. Well versed in ICD-10, CPT, HCPCS and DRG procedures with the proficient ability to accurately assign codes to complex patient encounters. Skilled expertise in benefits and claims adjusting with strong ability to adapt to new software/technology applications. Immaculate interpersonal and communication skills with demonstrated success of efficient prioritization, successful claims management, and loss minimization. Proven experience working as a leader as well as in a team environment to devise, evaluate, and implement continuous process improvements. Offers an incomparable work ethic with outstanding reputation for integrity and positive rapport.

Overview

14
14
years of professional experience

Work History

Founder/Volunteer

RWCO Non-profit Organization
12.2018 - Current
  • Fundraising planning
  • Securing financial support
  • Event planning/provide food, clothing and job readiness for the community.

REGISTRAR

St. Dominic Hospital Part-time
02.2011 - 10.2016
  • Accurately verified insurance coverage to attain authorization for charges
  • Collected and duly processed various payments including deductibles and patient co-pays
  • Effectively utilized medical terminology, CPT codes and ICD-9 codes
  • Consistently ensured positive interactions with patients, family members, medical staff, third party representatives and hospital personnel.

BENEFITS ADJUSTER III

APL
10.2016 - Current
  • Keenly analyze policies/contracts and review applications to determine proper policy coverage and benefit eligibility
  • Review and research medical bills/records to authorize and make accurate payments within coverage limits
  • Consistently provide excellent customer service
  • Firmly adhere to best claim practices and specific state laws to properly process claims
  • Operate in partnership with liability, underwriting and special investigations in the acquisition and preservation of undesirable risks
  • Effectively communicate and disperse correspondence to policyholders, claimants, attorneys and healthcare providers.

BENEFITS COORDINATOR

Baptist Hospital (Part-time)
05.2010 - 10.2016
  • Meticulously reviewed claim submissions to confirm submission of required documents
  • Completed medical code verification, eligibility, authorizations, and account benefit plans
  • Adhered to established policies and procedures to pay, pend for additional information, or deny claims
  • Utilized electronic health record system to effectively perform chart audits and accurate data entry
  • Effectively followed processes and worked diligently to meet or exceed Key Performance Indicators (KPI).

Education

Bachelor Of Administrative Studies - Healthcare Administration/Public Health

Jackson State University
Jackson, MS
05.2018

Associate Of Business Administration - Data Management Technology/Data Processing

Hinds Community College
Raymond, MS
12.2015

Skills

  • Skilled Expertise in CPT, ICD-10-CM, and HCPCS
  • Medical billing and Coding
  • Customer service
  • Problem-solving
  • Communication
  • Data entry
  • Attention to detail
  • Research
  • Organizational skills
  • Time and Task management
  • Written and verbal communication
  • The ability to work independently
  • Comfort with technology, and specific knowledge of remote communication tools like Zoom, Skype, Dropbox, Google Suite, KPI, Teams, Microsoft Office, Epic and etc

Timeline

Founder/Volunteer

RWCO Non-profit Organization
12.2018 - Current

BENEFITS ADJUSTER III

APL
10.2016 - Current

REGISTRAR

St. Dominic Hospital Part-time
02.2011 - 10.2016

BENEFITS COORDINATOR

Baptist Hospital (Part-time)
05.2010 - 10.2016

Bachelor Of Administrative Studies - Healthcare Administration/Public Health

Jackson State University

Associate Of Business Administration - Data Management Technology/Data Processing

Hinds Community College
Shyla Robinson