Sheldrian Wayne Email & Phone Number

Greater Atlanta Area

• Provided documentation and coding coaching support for 8 specialty groups comprised of 185 providers. Trained providers and lead in-service presentations on compliant documentation and coding guidelines. Performed.
• Improved providers’ coding accuracy rates by 20%-25% in 5 specialty departments
• Resolved gaps in charge capture, resulting in improved physician productivity measures
• Recommended enhancements to Epic smart sets, preference lists, and order sets to improve clinician workflow
• Identified coding and compliance risks and communicated findings to leadership

Greater San Diego Area

• Managed the expectations and performance of 6 hospital systems’ revenue integrity departments including charge audit, defense audit, managed care, denials, CDM, payer edit, coding and process improvement functions.
• Facilitated client implementation from sales kick-off to onsite implementation
• Monitored and analyzed key performance indicators for all revenue integrity divisions
• Presented financial results, observations and recommendations to hospital CFO/ VP of Revenue Cycle and explained actual-to-budget variances
• Prepared revenue profile analysis for hospital departments identifying charge discrepancies
• Analyzed managed care contracts to evaluate rate structure, rate levels and contract language

Greater Atlanta Area

• Facilitated establishment of physician practices including recruitment, credentialing, fee schedule development, and training on OSHA, HIPAA and medical office policy and procedures. Performed operational assessments.
• Reviewed front-end processes, revenue cycle and practice operations
• Analyzed denials and identified solutions to reduce denials, increase cash flow and improve net days in A/R
• Used E&M bell curve analysis to assess E&M billing and utilization for select specialties
• Developed and maintained strong business relationship with clients
• Designed and developed a preparatory course for the certified professional coding certificate

Greater Atlanta Area

• Audited outpatient hospital and physician documentation and coding for varied specialties, ensuring regulation compliance and industry standards adherence. Developed and presented coding workshops with a focus on.
• Provided coding services analysis for healthcare attorneys, insurance carriers, medical practices, and hospitals
• Designed and developed the first cardiology coding workbook and job aides
• Co-authored and edited coding guides

Greater Atlanta Area

Mentored and trained front office and business office personnel and monitored daily work activities. Developed and implemented collection policies and procedures. Drafted productivity reports and monitored financial benchmarks. Created training course on ICD-9-CM and CPT coding and select Microsoft products and Misys medical package.