Symone Shelby
Houston,TX
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
13
13
years of professional experience
Work History
Business Office Manager Assistant
The Concierge
03.2023 - Current
- Update report, manage and process all billing functions including Medicare, Medicaid, private pay and insurance.
- Assist with financial aspects of residents admissions and discharges.Maintain resident trust fund account in accordance to federal and state guidelines
- Resolved financial discrepancies and customer billing issues, ensure timely and accurate submissions of claims and follow-ups
- Monitor accounts receivable and implements collection process.
Clinical Support Coordinator
Ascension Care Management
01.2020 - 03.2022
- Engage with patients over phone, chat, or email to answer questions, address concerns, and provide information about medical procedures, appointments, or general healthcare inquiries.
- Schedule and manage patient appointments, coordinate follow-up visits, and handle cancellations or rescheduling requests in collaboration with clinical staff.
- Confirm patient insurance coverage, eligibility, and co-payment requirements, and inform patients of any potential out-of-pocket costs.
- Guide patients through pre-appointment preparation steps, providing instructions on paperwork, required documentation, or necessary preparations for procedures.
- Remote
Scheduling Coordinator
PFS GROUP
06.2018 - 01.2020
- Coordinate and schedule patient appointments, ensuring that times align with provider availability and patient preferences, and confirming appointment details with both parties.
- Verify patient insurance eligibility, coverage, and copay requirements before scheduling appointments to ensure coverage of services.
- Communicate with clinical staff via Epic in basket to relay urgently patient concerns along with confirming schedule.
- Engage with patients through live chat, phone calls, and email to answer questions, provide information, and handle any concerns about appointments, insurance, or healthcare services.
- Remote
Medical Claims Specialist
Continuum Global Solutions
03.2015 - 06.2018
- Verified patient eligibility for medical claims and determined benefit coverage.
- Submitted and tracked medical claims to insurance companies via electronic or paper methods.
- Processed appeals on rejected or partially paid claims, including filing additional paperwork as needed.
- Addressing customer inquiries, complaints, and feedback in a professional and courteous manner. Assisting customers with understanding their Explanation of Benefits (EOB) statements.
- Verifying claims information and ensuring completeness and accuracy.
- Coordinating with healthcare providers and insurance companies to resolve claims issue.
- Remote
Insurance Verification Specialist
Dr.Raza Pasha
02.2013 - 03.2015
- Conducted thorough benefit verifications for patients by liaising with insurance providers and analyzing insurance policies to determine coverage details, including medication and treatment options.
- Collaborated closely with healthcare providers and insurance companies to obtain prior authorizations for prescribed medications, streamlining the approval process and minimizing delays in patient care.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Acted as an advocate for patients, ensuring they were informed about their insurance coverage, co-pays, and out-of-pocket expenses.
Education
Associate of Science - undefined
San Jacinto College South
Houston, TXHigh School Diploma - undefined
J.Frank Dobie High School
Houston, TXSkills
- Healthcare administration
- Patient services management
- Patient confidentiality
- Remote Operations
- Inbound/Outbound Calling
- Data Entry
- HIPAA
- Customer Service
- Claims Investigation
- Insurance claims processing
- Prior authorization
- Call escalation
- EOB Analysis
- Benefit explanation
- Patient outreach
- Clinical data collection
- Scheduling
- Intake documentation
- Epic
Timeline
Business Office Manager Assistant
The Concierge
03.2023 - Current
Clinical Support Coordinator
Ascension Care Management
01.2020 - 03.2022
Scheduling Coordinator
PFS GROUP
06.2018 - 01.2020
Medical Claims Specialist
Continuum Global Solutions
03.2015 - 06.2018
Insurance Verification Specialist
Dr.Raza Pasha
02.2013 - 03.2015
Associate of Science - undefined
San Jacinto College South
High School Diploma - undefined
J.Frank Dobie High School