Kelly M. Shea

Directed end-to-end accounts receivable analysis and collections, consistently optimizing cash flow and significantly reducing outstanding balances for physician practices.

Developed and implemented robust staff training programs on financial policy, billing procedures, and compliance, elevating team performance and accuracy.

Managed all aspects of insurance verification, denial management, and contract guideline updates, enhancing revenue capture and minimizing claim rejections.

Spearheaded physician credentialing and fee schedule negotiations, securing favorable terms that directly impacted practice profitability and financial stability.

Established and enforced comprehensive compliance management protocols, ensuring adherence to Medicare, Medicaid, and JCACHO standards across all operations.

Led accounts receivable analysis, collections, and month-end reporting, consistently achieving financial targets and providing executive summaries for strategic decision-making.

Implemented targeted staff training initiatives on payment posting, charge entry, and insurance denial resolution, improving operational efficiency and reducing errors.

Managed complex insurance verification and physician credentialing processes, ensuring accurate billing and maximizing reimbursement rates.

Conducted detailed fee schedule analysis and contract negotiations, securing advantageous terms and staying current with local coverage determinations.

Developed and enforced financial policies, procedures, and compliance management frameworks, enhancing regulatory adherence and fiscal integrity.

Spearheaded the restructuring and implementation of healthcare reimbursement processes, significantly improving efficiency and compliance for multiple medical centers.

Achieved substantial cost savings through expert negotiations of all facility and physician credentialing, contracting, and fee schedules.

Ensured stringent compliance with current payments, rules, regulations, and legislative initiatives impacting physician, surgery, and specialty billing processes.

Managed and trained staff within a robust quality assurance structure, fostering a high-performing team focused on revenue cycle excellence.

Contributed to business growth through strategic marketing initiatives and effective off-site management of operations.

Directed comprehensive billing and accounts receivable functions, including auditing, A/R analysis, and payment posting, for multiple client accounts.

Implemented efficient lockbox setups and refined accounting procedures, streamlining financial operations and improving accuracy.

Provided essential staff training on charge entry, payment posting, and auditing, enhancing team capabilities and operational consistency.

Facilitated referrals and managed pre-authorizations, ensuring seamless patient access and appropriate reimbursement.