Summary
Overview
Work History
Skills
Timeline
Generic

Shalanda Davis

Snellville,GA

Summary

Highly efficient team player with strong organizational skills. Offering over 20 years of experience in a healthcare office. Ability to handle multiple projects simultaneously with a high degree of accuracy. Provides excellent customer service to patients and staff.

Overview

14
14
years of professional experience

Work History

Medical Records Coordinator

Execusource- Barbour Orthopedics
04.2023 - Current
  • Processed over 50 medical records requests per day from outside providers according to facility, state, and federal law.
  • Kept accurate log of requests for medical information and records.
  • Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
  • Maintained accuracy, completeness, and security for medical records and health information.
  • Uploaded records to patient's individual vault.
  • Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
  • Assisted in preparation of medical records to release to other medical facilities requesting for patient history and information.
  • Responded to patient inquiries to provide information and details of medical records.
  • Processed medical records requests from outside providers according to facility, state, and federal law.

Lead Registration Associate

Children's Healthcare Of Atlanta
04.2019 - 08.2021
  • Performs daily quality audits on team of registration coordinators to ensure all duties are performed correctly.
  • Orients new employees and acts as resource for staff to resolve/handle difficult situations or answer questions.
  • Partners with other areas for positive patient flow, and responds to issues that may arise related to safety, security, and disaster management.
  • May conduct performance evaluation of staff, provide input into hiring and disciplinary actions, and may act as supervisor as required or upon absence of supervisor.
  • Interviews patients and families to obtain complete and accurate demographic and financial information.
  • Ensures all necessary questionnaires and forms are completed according to pre-determined requirements by government or regulatory agencies.
  • Enters data into system for registration, billing, and patient tracking in fast, efficient way to minimize patient wait times.
  • Confirms insurance coverage and obtains authorizations if applicable.
  • Explains regulatory financial requirements to patient or responsible party, and collects/posts deposits or deductible amounts as required (for outside clinics, could include ensuring that referring physicians have obtained prior insurance authorization as needed and rescheduling appointments if necessary).
  • Assists Appeals department to provide all related information to overturn claims denial.
  • Serves as liaison between patient and department staff by informing patients and families of procedures and delays, answering questions, offering assistance, relaying messages, and other services that patients and families may require.
  • Ensures wait time communication occurs by updating schedulers and patient information tools as appropriate.
  • Schedules patient appointments when needed, including referral from faxes, phones, or other instructions, and contacts physician offices to resolve discrepancies.
  • Coordinates all aspects of scheduling, including procedures, provider visits, and use of resources.
  • May initiate and execute daily medical record maintenance while maintaining patient confidentiality, including creation of patient charts, filing encounter-specific paperwork, and maintaining correspondence via mailing/faxing with patient’s primary care provider and/or specialists as necessary.
  • Provides release of medical information as required.
  • Participates in meetings and may represent department on committees which could include multi-disciplinary quality and service improvement teams.
  • May prepare case review materials for court preparation for forensic interviewers and providers.
  • Coordinates subpoena process between court system, Child Protection Center, and Children's Healthcare of Atlanta Legal department.
  • Facilitates billing process for expert testimony in court cases.
    Assists supervisor and/or manager with development of staff by: being available to teammates, acting as resource to help complete complicated/complex tasks, providing on job training to team, and seeking out opportunities to become actively involved in staff workflow and development.
  • Provides supervisor and/or manager feedback on staff performance, educational needs, and workflow status.
  • Motivated and encouraged team members to communicate more openly and constructively with each other

Registration Associate

Children’s Healthcare Of Atlanta Inc
03.2016 - 04.2019
  • Obtains complete and accurate demographic and financial information from patients and families to ensure all necessary questionnaires and forms are completed according to predetermined requirements by government or regulatory agencies.
  • Enters data into system for registration, billing, patient tracking, charge capture, and reconciliation in fast, efficient way to minimize patient wait times.
  • Confirms insurance coverage Explains regulatory financial requirements to patient or responsible party and collects/post deposits or deductible amounts as required.
  • Initiate and perform administrative duties to ensure efficient daily business operations, including participating in office/department opening and closing procedures, assisting with maintaining, ordering, and restocking front office supplies, and receiving and distributing mail.
  • Coordinates all aspects of scheduling including procedures, provider visits, and use of resources.
  • Currently serving as Super User for department.
  • Assist Supervisor with development of staff by being available to teammates, acting as resource to help complete complicated/complex tasks, providing on job training to team, and seeking out opportunities to become actively involved in staff and workflow development.

Insurance Verifier

Children's Healthcare Of Atlanta
05.2011 - 03.2016
  • Obtained information from patient and/or family members to secure information concerning insurance coverage, eligibility, and qualifications for various financial programs.
  • Coordinates and performs verification of insurance benefits by contacting insurance providers and determining eligibility of coverage and communicates status of verification/authorization process with appropriate team members in timely and efficient manner.
  • Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre-certification process.
  • Confirmed referring physician has obtained prior authorization as needed from insurance company for all scheduled healthcare procedures within assigned department.
  • Contacts referring physicians and/or patients to discuss rescheduling of procedures due to incomplete/partial authorizations.
  • Acts as liaison between clinical staff, patients, referring physicians office, and insurance by informing patients and families of authorization delays/denials, answering questions, offering assistance, and relaying messages pertaining to authorization of procedure/service.

Collector

Children's Healthcare Of Atlanta
03.2009 - 05.2011
  • Performs daily billing of claims to third party insurance following guidelines of UB04 and HCFA 1500 manual.
  • Ensures that special billing needs by payor are performed to prevent denial of claims and delay in payment.
  • Prepares and submits all final bill claims, secondary claims, rebills and late charges on daily basis, maintaining current status.
  • Performs routine follow-up on unpaid insurance claims, taking appropriate action to resolve problems causing delay in reimbursement.
  • Document all telephone and correspondent communications with third party payors and guarantors thoroughly via online activity codes.
  • Prioritize and works proactively on accounts in assigned work queue to ensure all accounts are submitted in timely manner.
  • Contacts guarantors and other insured parties when additional information is needed, and takes appropriate action to resolve any delay in reimbursement.

Skills

  • Extremely organized
  • Self-motivated
  • Excellent verbal/written
  • Proven ability to multitask
  • Skilled in EPIC
  • HIPAA Compliance
  • Appointment Scheduling
  • Work Well Independently
  • Customer Service
  • Administrative Procedures

Timeline

Medical Records Coordinator

Execusource- Barbour Orthopedics
04.2023 - Current

Lead Registration Associate

Children's Healthcare Of Atlanta
04.2019 - 08.2021

Registration Associate

Children’s Healthcare Of Atlanta Inc
03.2016 - 04.2019

Insurance Verifier

Children's Healthcare Of Atlanta
05.2011 - 03.2016

Collector

Children's Healthcare Of Atlanta
03.2009 - 05.2011

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Shalanda Davis