Shanelle Brown

Healthcare operations and revenue cycle professional with 5+ years of experience supporting insurance verification, prior authorizations, patient account management, payer communications, reimbursement support, and healthcare administration. Demonstrated success working with commercial insurance, Medicare, PPO, and supplemental plans to resolve coverage issues, maintain accurate documentation, and support timely payment processes. Experienced reviewing insurance benefits, investigating account discrepancies, performing audits, and collaborating with providers, patients, and payers to ensure compliance and operational efficiency.

Proficient in EMR systems, Microsoft Office Suite, healthcare documentation, and cross-functional collaboration within fast-paced healthcare environments.

Patient Care Coordinator (2021-03 – Present)

• Verify insurance eligibility, benefits, coverage limitations, and payer requirements for commercial, Medicare, PPO, and supplemental insurance plans.
• Coordinate prior authorization requests and obtain approvals to support timely patient treatment and reimbursement.
• Investigate insurance discrepancies, research claim-related issues, and collaborate with payers to resolve coverage and reimbursement concerns.
• Maintain accurate patient account records, insurance documentation, and authorization status within EMR systems.
• Review account information for completeness and compliance with payer and organizational requirements.
• Perform follow-up with insurance carriers regarding pending authorizations, benefit investigations, and coverage determinations.
• Conduct account audits and documentation reviews to ensure data accuracy and regulatory compliance.
• Collaborate with providers, billing teams, pharmacies, and insurance representatives to resolve complex patient access issues.
• Support reimbursement workflows by ensuring accurate insurance information and complete documentation.
• Manage high-volume caseloads while maintaining productivity, accuracy, and exceptional customer service.

Unit Secretary & Nursing Assistant (2019-11 – 2020-05)

• Coordinated patient documentation, insurance verification, and intake processes.
• Maintained accurate medical records and supported compliance requirements.
• Managed scheduling, chart management, and communication between patients and clinical staff.

Patient Account Registrar (2018-08 – 2019-11)

• Verified insurance eligibility, benefits, and patient demographics for accurate account setup and billing.
• Resolved account discrepancies through detailed account review and payer communication.
• Conducted pre-admission and discharge audits to ensure billing accuracy and compliance.
• Educated patients on insurance coverage, payment options, and account responsibilities.

Bachelors of Science in Health Science – Stetson University (2014-08 – 2017-12)