Sheneque L. Long-Davis is seeking a position that allows her to grow within a company. She has over 15 years of experience in revenue cycle management, medical billing, and insurance verification. Her most recent role was as a Revenue Cycle Specialist II at CCS Medical, where she assessed insurance reimbursement, verified documentation, and resolved credit balances. She is organized, a strong problem solver, and motivated to learn.

1. Sheneque L.Long-Davis
2639 Inadale Avenue, Dallas, Texas 75228
Phone: 214-900-8013
E-mail: Nikkiesback1@yahoo.com
Objective
Toworkin an environmentwhere experience andeducationallow metogrowwithinthe company.
Skills
Team Player Fast Learner Medicare/Medicaid/Gov.Insurance
Motivated Problem Solver Commercial/WorkCompInsurance
Organized Strong Desireto Learn/Grow Typing60+WPM
Knowledge ofPIMS Researcher Contractreview
WorkHistory
2/2014 - Present
Revenue Cycle Specialist II CCS Medical Farmers Branch, TX
 Assesses insurance reimbursement for individual supplies to ensure maximum reimbursement
 Works individual portfolio of accounts from CCS Medical billing/collection system
 Verifies that all appropriate supporting documentation are obtained prior to shipment and/orprior to billing
 Audits configuration of supplies based on supporting documentation,formulary requirements and
manufacturer compatibility
 Posting payments and / or adjustments to individual accounts
 Resolving credit balance accounts as needed
 Identifies problems or improvements within own area, develops resourceful and alternative solutions for work
improvement or problem solution
 Researches and follow up on all correspondence associated with assigned accounts,including EOB’s and
documentation letters, and generate correspondence requesting required information, when necessary
 Initiates appeals and ensure all required documentation is submitted in the appeals process.Research all
denials and follow up as necessary
 Receives inbound and places outbound calls to/from insurance companies and patients to collect outstanding
funds·
 Reduces delinquent accounts and achieving maximum collections from all sources
 Produces reports identifying trends or problem carriers, and identify areas of concern and present ideas to
correct or prevent future issues
 Analyzes and correct accounts receivable problems
 Documents all activities as completely as possible.
 Achieves productivity goals based on accounts touched,dollars collected, and aging period
 Reports any problems to the attention of the Management
 Must maintain a high degree of confidentiality at all times due to access to sensitive information

2. Sheneque L.Long-Davis
2639 Inadale Avenue, Dallas, Texas 75228
Phone: 214-900-8013
E-mail: Nikkiesback1@yahoo.com
A
9/2013 – 2/2014
Patient Account Specialist I CCS Medical Farmers Branch, TX
 Receives inbound and makes outbound calls from/to physician offices, referral sources,sales team and
patients concerning documentation, insurance and product shipments
 Achieves stated revenue goals, production,and performance objectives
 Initial intake and accurate processing and entry of new patient records to begin the workflow
 Ensures all medical documents,patient accounts and files are updated,consistent and complete
 Validates all signed PWOs match supplied orders including quantity,products,items and physician
information
 Logs PWOs into Billing systemin a timely manner to allow for order reimbursement
 Verifies that appropriate supporting documentation has been obtained prior to shipment including
prescription, PWO, or verbal dispensing order
 Obtains, reviews and maintains Physician Written Order (PWO) documents for new and existing patients
 Collects documents for CMN Hold accounts to allow shipment of future orders
 Reviews accounts and contacts referrals sources and sales team for accurate PWOs
 Verifies, reviews, documents and completes insurance verifications
 Reviews insurance records for accuracy and completeness
 Escalates recurring problem accounts orphysician groups or other trends to the management appropriately
and in a timely manner to reduce reimbursement issues
 Maintains a high degree of confidentiality at all times due to access to sensitive information
 Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
 Follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements
 Abides by all regulations, policies, procedures and standards
 Exercises appropriate cost controlmeasures
 Maintains positive internal and external customer service relationships
 Maintains open lines of communication
 Plans and organizes work effectively and ensures its completion
 Meets all productivity requirements
 Demonstrates team behavior and promotes a team-oriented environment
 Actively participates in Continuous Quality Improvement
 Represents the organization professionally at all times
1/2013 – 9/2013
Specialty Services Representative I CCS Medical Farmers Branch, TX
 Demonstratesanin-depthunderstandingofthe Diabetes,urologicalandOstomy diseasestates andrelated
products
 Utilizes sales skillsto sell our servicesandenrollpatients accordingtoCCSMedical’sformulary
 Verifies, reviews, documentsandcompletesinsuranceverifications
 Obtain,review and maintain PWO documentsfornew andexistingpatients
 Review accountandcontactreferralssourcesandsalesteam for accuratePWO’sandpatientfollow-up

3. Sheneque L.Long-Davis
2639 Inadale Avenue, Dallas, Texas 75228
Phone: 214-900-8013
E-mail: Nikkiesback1@yahoo.com
 Validate allsignedPWO’s matchsuppliedordersincludingquantity,products,itemsand physicianinformation
 Ensureall medical documentsandpatientaccountsareconsistentandcomplete
 Audits patientchartsand shipconfigurationofsuppliesbasedonphysicianauthorization
 Maintainstrackingmechanismforuniquereferralsourcesonthe referral’ssourcespreferred processonproviding
signedPWO’s
 Ensuresquality of documentationsupportingordersmeetsthecriteriarequiredbyinternaland external
organizations
 Accuratelyprocessesorderssubmittedinatimelymanner
 Achieves stated revenue goals, production,andobjectives
 Maintainahighdegreeof confidentialityat alltimesdue to accesstosensitive information
 Maintainregular,predictable,consistentattendanceandisflexibleto meetthe needsof the department
 FollowallMedicare,Medicaid,HIPAA, and Private Insuranceregulationsandrequirements whileabiding toall
regulations,policies,proceduresandstandards
 Exercisesappropriatecostcontrolmeasures
 Maintainspositiveinternalandexternalcustomerservicerelationships
 Maintainsopenlinesofcommunication
 Planand organizeswork effectively andensures its completion
 Meetallproductivity requirements
 Demonstrateteam behaviorandpromotesa team-orientedenvironment
 Actively participatesinContinuousQualityImprovement
 Representthe organizationprofessionallyat all times
5/2012 – 1/2013
Revenue Cycle Specialist CCS Medical Farmers Branch, TX
 Accuratelyandtimelyworkinsurancecarrierdenials,insurancecarriercorrespondence,andinsurancecarrierno
responsereports
 Appealeddeniedclaimsandclaimsunderpaidbyinsurancecompaniestogetcorrectreimbursement
 Usedan agingreport, telephone,fax andmailto collectonbalancespastdue
 Determinedandcorrectedmistakesmadeonbothcurrentandpast duebills.
 Usedinformationfoundto adjust andresubmittedbills.
 Correctcodesusedonclaimstoresubmitfor payment accordingtoMedicareguidelines
 Researchedandsubmittedfirstandsecondlevel appealsondeniedclaimsbytelephoneandinwriting
11/2011 – 5/2012
Billing Analyst II/Compliance Coordinator EMBCC Dallas, TX
 ResearchedbillingguidelinesforMedicare,Medicaid,MedicaidHMOs,andMLPbillingrequirements
 Researchedproviderenrollmentrequirements for allpayers and resolved anyissues that prevented prompt
adjudicationofclaims.
 As ComplianceBillingCommittee Coordinator;responsibleforkeeping ManagementandBilling Support
Departmentawareof anynew billingdecisions.
 Developedandmaintainedanyspecialbillingrequirementssetforth by ManagedCare carriers.
 NewState Start-up tasks and researchregardingbillingspecifications

4. Sheneque L.Long-Davis
2639 Inadale Avenue, Dallas, Texas 75228
Phone: 214-900-8013
E-mail: Nikkiesback1@yahoo.com
 Team memberofvarious projectsandimplementationofindustryregulationsandmandates
 Leadfor various committeestoensurebillingrulesweredefined andall departmentsaffectedbynew rules/laws
werenotified promptly.
 Write PolicyandProceduresbasedonclosecollaborationwiththeA/R, BillingandIT Support management.
 Responsible forcommunicationwithonshoreaswellas offshore staff to includetrainingandmanagementof
systems and AR duties.
 Any other dutiesas assigned
05/2010 – 11/2011
Insurance Analyst/ Client Rep EMBCC Dallas, TX
 Accuratelyandtimelyworkinsurancecarrierdenials,insurancecarriercorrespondence,andinsurancecarrierno
responsereports
 Identify and reportto regionalsupervisorpayer trends affectingcashflow
 Appealeddeniedclaimsandclaimsunderpaidbyinsurancecompaniestogetcorrectreimbursement
 Proactivelyidentified,researched,andtransferred informationregardingclaimlogicrequirementstosupervisor for
correctbillingrequirements.
 Responsibleforresearching,reading,andunderstandingtherulesandregulationspertainingto both governmental
andcommercialpayers.
 Ranvarious reportsfor managementincludingthedailyproductionreport, the Inventory count
 Acted as the interim trainerfor region3duringthe reorganizationof the AccountsReceivable department
responsiblefortrainingoff shorestaff and inhouse staff onETM,Various reportsand State specific Guidelines
 Wrote PolicyandProceduresandthe State Specific Guidelinesused to trainboth the off shorepartners andthe in
housestaff. Thesearecurrentlybeingusedin the AccountsReceivableDepartment
 Part of the Reimbursementteam asthe underpaymentresearchpersonduringthe launchofPCM
8/2009 - 5/2010
Collector Job Net America Richardson, TX
 Usedan agingreport, telephone,fax andmailto collectonbalancespastdueover 30 days.
 Determinedandcorrectedmistakesmadeonbothcurrentandpast duebills.
 Usedinformationfoundto adjust andresubmittedbills.
 Correctcodesusedonclaimstoresubmitfor payment accordingtoMedicareandMedicaidguidelines
 Researchedandsubmittedfirstandsecondlevel appealsondeniedclaims bytelephoneandinwriting
 Collectonprivate pay accountspastdue
2008 - 6/2009
Collector/Team Lead American Institute of Gastric Banding Dallas, TX
 Usedan agingreport, telephone,fax andmailto collectonbalancespastdueover 30 days.
 Determinedand correctedmistakesmadeonbothcurrentandpast duebills.

5. Sheneque L.Long-Davis
2639 Inadale Avenue, Dallas, Texas 75228
Phone: 214-900-8013
E-mail: Nikkiesback1@yahoo.com
 Usedinformationfoundto adjust andresubmittedbills.
 Correctcodesusedonclaimstoresubmitfor payment
 Researchedandsubmittedfirstandsecondlevel appealsondeniedclaims
 Requestwrite offs as necessary
 Electronicallybillclaimsandreviewedthe rejectionreportto makeallclaimswereproperlytransmitted
 Assisted managementwithhighpriorityprojectsthat directlyaffect clientrelationships
2004-2007
Account Rep/Team Lead McKesson Specialty Corporation Lewisville, TX
 Work with Managers and Credit Associates to collect past due accounts over 31 days.
 Contact clients to identifyproblems and ensure prompt payment of all invoices.
 Work with sales representatives to improve and speed up payment process.
 Identify issues, submit corrections, calculate billing or pricing adjustments, and request write-offs as
appropriate.
 Analyze credit applications to approve new accounts and appropriate credit limits.
 Act as back up to Assistant Manager with duties and administrative functions
2001-2004
Account Rep Concentra Addison, TX
 Usedan agingreport, telephone,fax, and mailto collect on outstanding balances on Workers Compensation
claims
 Determined whether mistakes were made on both current and past due bills
 Adjusted and resubmitted claims
 Obtainedinformationfrom clients and various other sources to aid in the collection of workers compensation
claims
 Worked closelywith the center administrators to resolve problems with billing and client protocols.
 Reviewed employee contracts to ensure proper billing, collections and reimbursements were being made.
 Trained new hires
Education
Present Strayer University – Juniorlevel seekingBA BusinessManagement
2006to 2009 University of Phoenix
1991to 1992 Hostos CommunityCollege
VolunteerActivities

6. Sheneque L.Long-Davis
2639 Inadale Avenue, Dallas, Texas 75228
Phone: 214-900-8013
E-mail: Nikkiesback1@yahoo.com
2013- Present Directorof Heartline MinistriesButterflyMinistry
2012– Present Secretaryof Womenof Wonder
References
Will befurnisheduponrequest