SHANNON WILLIAMS
Enfield,NC
Summary
A self-directed, personable professional with college experience and a successful track record of working in a team environment. Also, able to work independently with a high degree of self-motivation.
Healthcare professional with solid foundation in patient care coordination, consistently ensuring smooth operations and patient satisfaction. Proven ability to collaborate effectively with medical teams and adapt to dynamic healthcare environments. Known for excellent organizational skills and patient-focused approach.
Overview
21
21
years of professional experience
Work History
Patient Care Coordinator
Optum
10.2022 - Current
- Serve as a primary point of contact for patients — answering inbound calls, returning messages, providing accurate information regarding medications, care plans, referrals, appointments and pharmacy services.
- Work collaboratively with care teams and other internal departments to meet clinical, service and operational goals.
- Review patient medical records to assign accurate ICD-10, CPT, and HCPCS codes
- Ensure coding compliance with federal regulations, payer guidelines, and company policies
- Prepare, submit, and monitor insurance claims to Medicare, Medicaid, and commercial payers
- Verify patient insurance eligibility, coverage, and prior authorizations.
- Assist with benefits investigations, prior authorizations (in some roles), and ensure accurate insurance information is captured.
- Analyze and resolve claim rejections, denials, and underpayments in a timely manner
- Post payments, adjustments, and reconcile Explanation of Benefits (EOBs)
- Follow up on outstanding accounts to ensure timely reimbursement
- Communicate with insurance companies to clarify claim issues and resolve discrepancies
- Maintain accurate billing records and documentation within EHR/EMR systems
- Protect patient confidentiality in accordance with HIPAA regulations
- Collaborate with healthcare providers and internal teams to correct coding or billing errors
- Meet productivity, accuracy, and turnaround time standards.
- Coordinate patient scheduling and managed appointment workflows to enhance service delivery.
- Develop and maintain comprehensive patient records using electronic health record systems.
- Streamline communication between patients and healthcare providers, improving response times.
- Implement process improvements that increase operational efficiency within the care team.
- Adhere to Optum policies, HIPAA privacy standards, safety procedures, and other regulatory requirements..
Operations Team Manager
Alorica
01.2016 - 04.2022
- Maintains a full understanding of the team’s performance and individual’s performance using long- and short-term analysis of key performance indicators, observations, and anecdotal information
- Coached a team/department of 20-50 individuals to sustain positive patterns and mitigate negative patterns to improve or sustain performance
- Mentored team members, fostering skill development and promoting a collaborative environment.
- Controlled daily business operations by devising and deploying short and long-range strategies to grow profitability and accomplish objectives.
- Worked closely with senior leadership to define long-term operational strategies designed for scalable growth.
- Nurtures employee development with effective feedback and career planning conversations
- Sustains a process excellence culture to maintain consistent and iterative improvements in all aspects of the operation and employee experience
- Actively participates in routines and practices to accurately assess key performance indicators and executes on actions needed to improve and maintain the health of the operation and the employee experience
- Executes long and short-term strategic plans to drive improvements in client care, efficiency, employee engagement and growth
- Oversaw daily operations, ensuring adherence to quality standards and operational efficiency.
- Implemented process improvements, enhancing workflow and reducing turnaround times.
Customer Service Representative
Alorica
08.2014 - 01.2016
- Process a high volume of incoming phone calls for assigned clients and programs, which includes obtaining, entering, and verifying customer information
- Addresses client concerns in an empathetic manner
- Investigates, troubleshoots, and resolves client conferencing complaints and concerns
- Interacts with a network of individuals on a complex multifunctional Cisco IP telephone connected to Avaya Bridges
- Delivered exceptional customer service by addressing patient inquiries and resolving issues efficiently.
- Collaborated with medical staff to streamline communication and enhance patient experience throughout care processes.
- Maintained accurate patient records using electronic health record (EHR) systems to ensure compliance and confidentiality.
- Trained new team members on customer service protocols and effective communication strategies within healthcare settings
- Educated patients on healthcare services, insurance options, and appointment scheduling procedures.
Line Leader
Perdue Farms
06.2005 - 08.2014
- Oversees work at various stations along the production lines processing poultry food products
- Adheres to all safety requirements including PPE, preventing, and reporting unsafe acts and conditions, Lockout-Tagout procedures, and Process Safety Management related matters
- Ensures that the qualities of the products are being met according to the product specification of QA and USDA
- Ensures that all equipment throughout the departments are running smoothly
- Oversaw daily production activities, ensuring adherence to safety and quality standards. ~
- Oversaw daily production activities, ensuring adherence to safety and quality standards.
- Trained and mentored team members on efficient production techniques and equipment operation.
- Implemented process improvements that enhanced workflow efficiency and reduced downtime.
- Coordinated with cross-functional teams to resolve production issues and streamline operations.
- Established effective communication channels within the team to foster collaboration and productivity.
- Monitored key performance indicators, providing feedback for continuous improvement initiatives.
- Led regular team meetings to discuss performance metrics, set goals, and address challenges effectively.
- Implemented Lean Manufacturing principles, reducing waste throughout the production process without compromising quality or efficiency.
- Mentored new team members, fostering a positive work environment that encouraged professional growth.
- Developed training materials focused on best practices for equipment handling and safety compliance.
Education
Associate Degree - Nursing
Halifax Community College
06.2012
Diploma - undefined
Northwest Halifax High School
06.2003
Associate of Science - Health Information Management/Technology
Halifax Community College
Weldon, NC12-2027
Skills
- Analytical thinking skills
- HIPAA regulations adherence
- Proficient in organization techniques
- Appointment scheduling
- Team leadership
- Operations management
- Customer service
- Data Entry
- Quality control
- Production goal tracking
- Active listening
- Operational efficiency
- Training and mentoring
- Deadline management
- Staff development
Timeline
Patient Care Coordinator
Optum
10.2022 - Current
Operations Team Manager
Alorica
01.2016 - 04.2022
Customer Service Representative
Alorica
08.2014 - 01.2016
Line Leader
Perdue Farms
06.2005 - 08.2014
Diploma - undefined
Northwest Halifax High School
Associate Degree - Nursing
Halifax Community College
Associate of Science - Health Information Management/Technology
Halifax Community College