Shunara Maxey

Program Support Assistant

Department of Veterans Affairs

Dec 2024 - Current (1 year 7 months)

• Regularly review and update payroll system entries for assigned service, which included entering missed punches, PTO, FMLA, premiums and leave. • Meet all deadlines for payroll processing. Reports any discrepancies, unusual or questionable time entries to appropriate supervisors. • Maintains a strong and current knowledge of payroll policy and law by participating in applicable training and regularly reviewing policies. • Obtain approval for and documents, all additions, deletions, corrections, ect. Retains all required documentation. • Clearly and concisely communicates and coordinates timekeeper activities with all managers and approving staff. • Accountable for ongoing continuing education with staff on inputting premium pay, lea

AR Manager

Privia Health

Mar 2023 - Feb 2024 (1 year)

• I manage the salesforce work tickets to ensure that all customer service request is processed and resolved within Privia Health's current operating standards. Currently, this branch is exceeding our office goals. • We ensure that all customer service complaints or questions are resolved within 48 hours. We can do this based on our team environment established by my current employer. • Daily, I research and analyze billing discrepancies between the medical provider and the insurance companies. I send encrypted emails and mail in order to contact both parties to provide the findings of our research. • We meet weekly to discuss with our outsourced AR Specialists contractors regarding out auditing efforts. Things discussed claims that wer

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Revenue Cycle Management/Operations Support

Associates of Otolaryngology

Aug 2022 - Mar 2023 (8 months)

• I managed and oversaw the duties of the revenue department, which included the account management office, outgoing communications to insurance providers, collections, journal cash posting entries, contract analysis office, and the billing department. • I implemented a new financial system to ensure the accuracy of billing information when entered into the billing system. I've managed the patient billing complaints department and ensured all discrepancies were resolved. • I ensured that all coding issues were correct as needed and submitted the bill to claims if necessary. • Identified medical coding mistakes and underpayments/overpayments. • Resolved payment issues and processed refunds to patients or insurance companies. • Followed up by

Advanced Medical Support Assistant

Department of Veterans Affairs

Jan 2021 - Feb 2022 (1 year 2 months)

• Developed and processed claims for authorized and unauthorized medical services for non-VA hospitalization, (contract and non-contract), fee medical, fee dental outpatient treatment, and the State Veterans' Home program within the entire agency, and contract community out. • Created authorizations for care from the service consults approved by provider within the VA. Coordinate/schedule care with community providers while maintaining professional rapport with community provider staff and VA staff. • Worked closely with Third Party Administrator and generate patient workload reports dealing with scheduling, validation of appointment completion and record retrieval. • Administrative follow up and problem solving. - working with multiple

Teleservice Representative – Contractor

Kaiser Permanente

Oct 2020 - Dec 2020 (3 months)

• Made outbound calls to members by priority: which are chronic conditions, Diabetes Lab, Diabetes Foot Exam, Diabetes Retinal Screening, Colorectal Cancer Screening and Blood Pressure Checks. Provided information about location of medical centers, pre-appointment preparation, and limited, related member benefit information. • Scheduled follow up appointments for providers and opt members in for appointment SMS text reminders. Schedules video conferencing appointments and provides technical support for members with Telemedicine Appointments o Assisted members to select a personal provider and pre-enrolls callers as needed. • Made changes to callers' address, medical center, or other demographic information as needed.

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Advanced Medical Support Assistant

Department of Veterans Affair

Aug 2018 - Nov 2019 (1 year 4 months)

• As a clinical profile manager: it was my duties to build, modified, and improved (utilization management) new clinic grid for all services in Eastern Colorado Healthcare Systems (ECHS). • Performed special projects and management studies as requested by HAS Chief, Deputy Chief and/or Data Chief in an accurate and timely manner. • Completed training (service specific) and job specific to stay current on new regulations, processes, and procedures. • Developed a workflow process internally that ensures that the office goals and work objectives are met on time based off deadlines set by myself. • Ensured that the company's policies and regulations are followed always to ensure the objectives of the company are still intact. • Prepared b

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Medical Support Assistant- Contractor

Jan 2018 - Aug 2018 (8 months)

• Responsible for scheduling veterans for their specialty appointments. Including Podiatry, Ophthalmology, Orthopedics, Neurosurgery, Renal, Endocrinology, Geriatrics, Echocardiogram and Cardiology • Pull, edit, and update reports from database system and Excel for patients and departments. • Completed special projects required of me and navigated seamlessly on the activation team to properly link veterans with their PCP or gain a new one before transiting from this location to the next.

Patient Account Representative

Centura Health

Jun 2017 - Jan 2018 (8 months)

• While using Epic, processed paid procedural and some in-office medical appointment claims. • Oversaw verifying/checking for eligibility of the payers by their website or via the phone. If the patient didn't have insurance coverage, it was our responsibility to contact the patient to retrieve coverage or send the full amount of the bill to the patient. • Utilized multiple databases to track if the claim was denied, verify the accuracy of the denial. • Resolved payment issues and processed refunds to patients or insurance companies. • Identified medical coding mistakes and underpayments/overpayments. • I was the point of contact for member/patients when assisting them through the registration process while checking in for an appointme

Patient Registration Associate

Kaiser Permanente

Oct 2016 - Jun 2017 (9 months)

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Member Service Representative

Feb 2015 - Oct 2016 (1 year 9 months)

• Responsible for answering and documenting all incoming contacts to determine the nature of them and responding to complex calls about benefits, billing, claims, account status, etc. for Health Insurance. • Responded to concerns and complaints with empathy regarding all departments. • Initiated contact with the appropriate departments and/or facilities the member needs to speak with to get some resolution. • Accountable for making the first call resolution goals and assisting the department with reaching call handling goals. Effectively diffusing anger, tension, and hostility with the correct guidelines. • Providing superior customer service with consistency with accurate knowledge and skills. • Accomplished top tier for taking Conne

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