Shermika Mitchell Dunbar Email & Phone Number

Florida, United States

Tampa, Florida

Establishes and maintains efficient methods of ensuring the medical necessity and appropriateness of hospital admissions. Performs concurrent reviews for patients to ensure that extended stays are medically justified and are so documented in patient's medical records.Calculates the lengths of stay and continued-stay days for patients and ensure that all projects are delivered on-time within scope and within budgetRefers to the Utilization Review Physician Advisor cases that do not meet established guidelines for admission or continued stay, report, and escalate to management as neededManage changes to the project scope, project schedule, and project costs using appropriate verification techniques. Develop spreadsheets, diagrams, and process maps to document needs Identifies problems related to the quality of patient care and refers them to the Quality Assurance Department and create and maintain comprehensive project documentationMaintains communication with the Care Management Department to facilitate timely discharge planning. Coordinate internal resources and third party/vendors for the flawless execution of multiple projectsUse and continually develop leadership skills. Attend training as required to maintain proficiency. Train and mentor newly hired staff.Review claim submissions and verify the information to insure clean claim. Record and maintain insurance policy, determine policy coverage, and calculate claim amounts in database system and process claims payments

Tampa, Florida

Provided customer service to patients as well as internal staff members to maintain customer satisfaction Scheduled patient appointments via phone, email, and online scheduling request system pre-registered patients in EMR system and maintained up to date patient recordsVerified insurance benefits and eligibility prior to admissions and/or appointments and communicated with patients regarding outstanding balances. Obtained authorizations for various treatment facilities, billing of insurance and processing payments and managed patient information in a billing software database.Processed incoming referrals and interpreted patients’ charts and medial codes to determine how much they owe and how much is billed to insurance provider. Placed outbound calls to patients to confirm appointment dates and times, scheduled surgical procedures for physician at assigned hospitals utilizing block time, assisted with back office clinical duties as needed, roomed patients, took medical history and vitals assisted physician within office procedures.

Bachelor Of Arts - Ba, Psychology

Health/Health Care Administration/Management

High School Diploma

Activities and Societies: Student Government, Captain of Varsity Basketball teamwhile dual enrolled at HCC and earned 12 college credits.