Shemelia Mcknuckles is seeking a position in healthcare or customer service that utilizes her business management education and skills. She has over 10 years of experience in various healthcare roles including complex authorization specialist, pre-authorization specialist, patient access specialist, and health insurance representative. She is proficient in Microsoft Office, various medical coding systems, and healthcare IT systems.

1. Shemelia Mcknuckles
Creative learning with a strong desire to succeed is my strategy for success
mcknuckles.shemelia@gmail.com
CELL 414-739-8246
CURRENT ADDRESS
10 E Bell Rd 1064
Phoenix, AZ 85022
Objective Statement
A position utilizing skills and education in healthcare as well as customer service.Seeking a position with a growing organization to
make a positive impacton revenues,and experience long term career growth.
Education And Training
◦ General business managementand secretarial college-level courses.
◦ Associate Degree in Business Management - Concordia University
◦ Excel proficient
Employment Experience
AEROTEK 1860 N 95th Lane, Suite 135, Phoenix, AZ 85037 10/13/2015-12/15/2015
ComplexAuthorization Specialist
o Conducts research to ensure accurate documentation ofthe patient's clinical
information.
o Review and respond to complexreferral requests from VA and civilian providers with
appropriate coding and provider selection.
o Responds to inquiries from beneficiaries and providers regarding specific aspects ofthe
VA program.Information and assistance includes referrals,authorizations,and the location
and use of network and certified providers.
o Displayprofessional and courteous service skills to internal and external customers.
o Takes appropriate measures to complywith HIPAA regulations to protectprivacy of
beneficiaries'health information.
o Documents the transmission ofmedical referrals to the Facility or the network provider
in line with procedures.
o Documents all communications involving beneficiaryand provider contacts.
o Develops knowledge ofvarious software applications in use atTriWest, including
procedures and processes ofthe VA program.
o Assesses faxed documents,to ensure appropriate entryinto the medical management
system.
o Works with standard coding systems including:standard medical taxonomy,
International Classification for Diseases,CurrentProcedural Terminology,and Health Care
Common Procedure Coding System.
o Key-enters data into the medical managementsystem.
o Identifies potential qualityof care issues
o Requests medical records as directed,scans records into the medical management
system,and prepares records for quality of care review.
o Identifies potential discrepancies in the medical managementsystem to assure quality
compliance.
o Consistentlymeetdepartmentproductivity and performance metrics.
Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 June 2015-August2015
◦ Obtains all necessaryauthorizations for scheduled professional and hospital procedures and office visits and accurately docu ments
all information in the appropriate fields and/or accountnotes.
◦ Organizes,prioritizes and reviews daily work activity to ensure thatcomplete,accurate and compliantpre -registration has been
performed.
◦ Participates in a variety of unitand hospital educational programs to maintain currentskill and competencylevels.
Pre-Authorization Specialist
◦ Ability to work effectively in a high-volume,fast-paced environmentwith changing priorities.Mustpossess customer-focused attitude
and professional demeanor.
◦ Excellent communication skills (Written and Oral).
◦ Knowledge ofMedical Terminologyand ICD-9/CPT codes and an understanding ofHIPAA privacy laws.
◦ Analytical skills with strong attention to detail and a high degree of accuracy.

2. ◦
HP 6091 N Teutonia Ave, Milwaukee, WI 53209 March 2014- April 2015
Health Insurance Rep II
•Completes complextasks,assignments and defined Greeting,registering patients,obtaining demographics and insurance informa tion,
verification, posting and collecting payments.
◦ Scheduling appointments,filling outnecessaryforms,protecting patient’s privacyand rights while answering,screening phone calls
and taking messages,processes independently.
◦ Retrieve patient’s medical records for physicians,technicians,or other medical personnel.
◦ Release information to persons or agencies according to regulations.
◦ Review records for completeness,accuracyand compliance with regulations.
◦ Plan, develop, maintain,or operate a variety of health record indexes or storage and retrieval systems to collect,classifystore or
analyze information.
◦ Maintain call-center database byentering information,fulfill requestby clarifying desired,completing request.
◦ Problem resolution,escalating unresolved problems,researching and exploring answers and alternative solutions and
implementing them.
Aurora Sinai Medical Center 945 N 12th St, Milwaukee, WI 53233 August 2011-August2013
Patient Access Specialist
◦ Accurately documents all information in the appropriate fields and/or accountnotes.Maintains accuracywhen entering demographic
and insurance information in the system.
◦ Arrives patients who presentfor professional and hospital services thathave been pre-registered and collectco-pay and deductible
amounts.Obtains all necessarysignatures from the Guarantor at the time of registration or arrival.
◦ Courteouslyanswers the telephone and answers all questions in a timely manner.
◦ Identifies and refers uninsured and underinsured patients to the Financial Counselor.
◦ Inquires patientaccountsystem(s) to identify any previous unpaid liabilityin AMPFM/Misys.
◦ Maintains a positive working relationship with patients/guarantors,insurance companies,governmententities,clinical personnel,
co-workers and managementto promote teamwork,cooperation and a positive public image for PCH.
◦ Organizes, prioritizes,and monitors dailywork activity to ensure thatcomplete,accurate,and compliantregistration has be en
performed in a timelymanner.
◦ Participates in a variety of unit and hospital educational programs to maintain currentskill and competencylevels.
◦ Performs registration in appropriate HIS system,verifies insurance coverage,obtains authorization for patients who present for
professional and hospital services and have notbeen pre-registered.
Renee's Baby Nirvana 1629 N 23rd st Milwaukee, WI 53205 August 2004- March2008
Owner
◦ work with qualified center staffto develop an appropriate curriculum and ensure thatit complies with state and federal
requirements.
◦ make sure that the center's physical facilities complywith local,state and federal laws and are a safe and appropriate environment
for children.
◦ manages staff,developing job descriptions,interviewing candidates,maintaining staffdevelopmentand education and,if necessary,
managing disciplinaryprocesses.
◦ financial managementofthe center, develop budget,manage the accounting and oversee accounts payable and receivable.
Computer Skills
◦ AMPFM/Misys system
◦ Emdeon,insurance carrier websites
◦ Microsoft
◦ Excel
◦ Word
◦ Internet Explorer
◦ ICD 9 & 10 certified
◦ Chartmaxx
◦ Payor Websites
◦ Centricity
◦ Docutrax
References
Tunesia Denton -Supervisor

3. Phone:(414)865-6331
Edward King- Supervisor
Phone:(414)477-7799
Brenda Davis- Collegue
Phone:(720)495-8050