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SB@shirleybailey
Experienced medical billing and coding specialist with leadership skills.
United StatesWith over 7 years of experience in medical billing and coding, I have honed my skills in various healthcare settings, including multi-specialty clinics and outpatient facilities. My expertise encompasses coding for health encounters, E&M coding, and a deep understanding of medical terminology and human anatomy. I am well-versed in the complex federal regulations from the Centers for Medicare and Medicaid Services (CMS), ensuring compliance and accuracy in all processes.
In my recent role as a Subject Matter Expert and Team Lead at BroadPath Healthcare Solutions, I successfully managed and developed a team of ten, focusing on enhancing performance and resolving issues proactively. My experience as a Medicaid Claims Analyst further solidified my ability to review claims for accuracy, evaluate coverage, and identify potential fraud. I am dedicated to improving outcomes and ensuring that all claims are processed efficiently and accurately.
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Work history, roles, and key accomplishments
BroadPath Healthcare Solutions
Feb 2024 - Present (1 year 9 months)
Collaborated with supervisors to manage, develop, and coach a team of ten people. Prepared daily production reports and proactively identified potential issues, initiating solutions.
BroadPath Healthcare Solutions
Jun 2021 - Present (4 years 5 months)
Reviewed claims for billing, coding accuracy, and completeness, determining coverage according to guidelines. Evaluated claims for and reported suspected fraud, waste, and abuse.
Anthem Blue Cross Blue Shield
Nov 2018 - Present (7 years)
Coded and processed claim forms for payment, ensuring all information was supplied before eligible payments were made. Researched and analyzed claims issues.
LifePoint Health
Mar 2015 - Present (10 years 8 months)
Processed E/M coding for Multi-Specialty Clinic, identifying diagnoses and procedures to assign proper ICD-10 CM and CPT codes. Initiated contact with medical staff to clarify discrepancies.
Degrees, certifications, and relevant coursework
PGBachelor of Science, Health Care Administration
Completed a Bachelor of Science degree with a focus on healthcare administration. Gained knowledge in managing healthcare systems and operations.
KUCertificate, Medical Billing & Coding
Obtained a certificate in Medical Billing & Coding. Developed expertise in medical terminology, coding standards (ICD-10-CM/PCS, CPT, HCPCS), and claims processing.
Software and tools used professionally
United StatesYou can contact Shirley and 90k+ other talented remote workers on Himalayas.
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