Stacie Shirley
Tyler
Summary
Dedicated and detail-oriented Business Analyst, excelling in claims trend analysis and processing. Proven track record of mentoring teams and achieving 100% quality and financial standards. Skilled in Microsoft Excel and fostering strong interpersonal communication, delivering actionable insights to enhance operational efficiency and drive financial success. Self-motivated with strong analytical and problem-solving skills.
Overview
9
9
years of professional experience
Work History
Business Analyst I
Centene, Superior Health Services
10.2024 - Current
- Analyzing Medicare and Medicaid CheckRun data to determine claims errors.
- Preparing and analyzing daily reports using Excel to support business needs.
- Instructing and guiding claims analysts in the claims shop on how to process Duals Medicaid claims.
- Reviewing claims on the Vendor Audit report. This involves research into the rules and regulations per the TMHP website and other various sources to determine recoupment.
- Carefully following SOP guidelines for instruction. Creating and submitting various bots for completion. Analyzing SOP for inaccuracies and ways to improve.
- Analyzed data to identify root causes of problems and recommend corrective actions.
- Identified patterns and trends in large data sets and provided actionable insights.
Claims Analyst II, Team Lead Assist
Centene Corporation
07.2022 - 10.2024
- Maintained strict confidentiality with all personal data as per company guidelines.
- Interacted with employees, which helped cultivate positive working relationships.
- Analyzing, processing, paying, and denying a variety of medical claims.
- Directed and coordinated efforts to increase financial payment.
- Exceeding all standards to maintain 100% on quality and 100% of expected number of claims while in production.
- Teaching and mentoring inexperienced Claims Analysts
- Running and presenting reports to leadership
- Assisting the team lead in various tasks including the assignment of work to Claims Analysts.
Accounts Receivable and Payable Assistant
Rose City Pump, LLC.
03.2019 - 10.2022
- Answered incoming phone calls to process requests, transfer calls, or relay messages to appropriate personnel.
- Assisted manager in all aspects of business operations.
- Greeted guests in with friendliness and professionalism.
- Worked closely with management to provide effective assistance for specific aspects of business operations.
- Processed accounts payable invoices, verified accuracy, and ensured timely payments to vendors.
- Managed accounts receivable billing, posted payments, and followed up on outstanding balances.
- Reconciled vendor statements and customer accounts to maintain accurate financial data
Bar and Restaurant Manager
IceHouse, LLC
03.2017 - 03.2019
- Correctly calculated inventory and ordered appropriate supplies.
- Reconciled cash and credit card transactions to maintain accurate records.
- Effectively managed payroll and timekeeping, and paperwork for new hires and terminations.
- Quickly identified problem situations and skillfully resolved incidents to satisfaction of involved parties.
- Oversaw daily bar and restaurant operations, ensuring smooth service and high customer satisfaction
- Hired, trained, and supervised staff, creating a positive team environment and improving overall performance.
- Ensured compliance with health, safety, and alcohol service regulations.
- Resolved high conflict customer issues promptly and professionally.
Education
Medical Billing And Coding
Everett Community College
High School Diploma -
Chapel Hill High School
Skills
- Claims trend analysis
- Claims review
- Accounting spreadsheets
- Skilled in Microsoft Excel
- Interpersonal communication
- Claims processing
- Data research
- AR/AP
- Customer relations
Accomplishments
- Achieved Employee of the Month through effectively implementing a training program which increased both payment and financial quality. Payment quality increased from 53% to 98%. Financial quality increased from 98.15% to 99.05%.
Timeline
Business Analyst I
Centene, Superior Health Services
10.2024 - Current
Claims Analyst II, Team Lead Assist
Centene Corporation
07.2022 - 10.2024
Accounts Receivable and Payable Assistant
Rose City Pump, LLC.
03.2019 - 10.2022
Bar and Restaurant Manager
IceHouse, LLC
03.2017 - 03.2019
Medical Billing And Coding
Everett Community College
High School Diploma -
Chapel Hill High School