Sheree Pitchford
Alexandria
Summary
Revenue cycle professional with experience in healthcare operations, payer compliance, and data-driven performance improvement. Skilled in managing end-to-end revenue workflows including prior authorizations, claims reconciliation, utilization tracking, and denial prevention to ensure accurate reimbursement and revenue integrity. Experienced in analyzing authorization trends, forecasting renewals, and identifying operational gaps that contribute to denials and revenue leakage. Background in clinical ABA services strengthens expertise in healthcare documentation, compliance, and data analysis. Currently pursuing a Master’s in Health Information Management and Technology and seeking to transition into a Revenue Cycle Analyst role.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Revenue Operations Lead
Coastal Healthcare Services
Washington DC
12.2023 - Current
- Managed prior authorization workflows across multiple therapy service lines, coordinating with payers to secure approvals, track authorized units, and maintain reimbursement continuity.
- Analyzed authorized units against scheduled and billed services to prevent revenue leakage and ensure compliance with payer billing guidelines.
- Conducted proactive authorization renewal reviews 30–45 days prior to expiration to prevent service interruptions and reimbursement delays.
- Investigated payer coverage policies, documentation requirements, and denial trends to reduce authorization delays and downstream claim denials.
- Reconciled authorization records with claims submissions and accounts receivable data to identify discrepancies and maintain revenue integrity.
- Processed and managed claims, denials, and appeals while verifying service validity, payer coverage requirements, and reimbursement accuracy.
- Reviewed clinical documentation for medical necessity alignment to support authorization approvals and maintain audit readiness.
- Monitored updates to ICD-10, CPT/HCPCS, Medicaid, and commercial payer policies to ensure ongoing regulatory and billing compliance.
- Conducted financial and operational analyses to identify reimbursement gaps, improve billing accuracy, and support data-driven decision-making.
- Led internal financial and documentation audits to identify discrepancies, strengthen compliance controls, and improve revenue cycle accuracy.
- Secured and maintained payer and insurance contracts while reviewing reimbursement structures to support favorable financial outcomes.
- Partnered cross-functionally with intake, billing, and clinical teams to streamline revenue cycle workflows and improve operational efficiency.
Registered Behavior Technician
Brighter Strides
Alexandria, VA
08.2023 - 02.2024
- Provided direct ABA therapy while mentoring and supervising junior RBT staff to ensure consistent, high-quality implementation of treatment plans.
- Collected, tracked, and analyzed behavioral data to monitor client progress and inform evidence-based adjustments.
- Developed and delivered staff training and workshops on behavior plan implementation, data documentation, and best practices.
- Maintained audit-ready records and ensured compliance with HIPAA, ethical standards, and organizational protocols.
- Collaborated with interdisciplinary teams to optimize workflows, improve operational efficiency, and support client outcomes.
- Part-Time
Data Support Specialist
Comprehensive Autism Partnership
Alexandria, VA
02.2022 - 09.2023
- Collected, tracked, and analyzed behavioral and environmental data to identify patterns and inform evidence-based interventions.
- Assisted in developing and monitoring individualized plans, ensuring adherence to protocols and data-driven decision-making.
- Collaborated with interdisciplinary teams, including educators, psychologists, and caregivers, to implement coordinated workflows and processes.
- Provided guidance and training to staff and stakeholders on plan execution and documentation best practices.
- Monitored intervention effectiveness using continuous data analysis and provided actionable recommendations for adjustments.
- Maintained audit-ready documentation and ensured compliance with ethical standards, HIPAA, and relevant regulations.
- Applied research and best practices to optimize processes, improve outcomes, and support informed operational decisions.
Compliance Specialist
ABA Today
Haymarket, VA
10.2020 - 01.2022
- Coordinated resources and workflows to support operational and strategic compliance initiatives.
- Conducted risk assessments, developed mitigation strategies, and implemented compliance frameworks to ensure regulatory adherence.
- Developed policies and procedures, and delivered compliance training to staff across organizational levels.
- Reviewed and analyzed documentation and data to maintain operational accuracy and regulatory compliance.
- Monitored database security, user access, and audit activity, ensuring HIPAA and organizational standards were met.
- Provided analytical insights and interpreted regulatory requirements to guide process improvements and decision-making.
- Supported cross-functional teams in implementing compliance initiatives and tracking progress on key projects.
Lead RBT
Comprehensive Autism Partnership
Alexandria, VA
11.2019 - 03.2020
- Provided consultation and technical assistance to individuals with cognitive, developmental, physical, and health related needs.
- Performed observations and assessments relevant to the design of positive interventions and support for individuals.
- Trained staff in treatment and behavior plan implementation to ensure fidelity.
- Provided training on how to create well-written documentation for progress that detailed daily activities and specific learning milestones.
Registered Behavior Technician
Family Insight
Manassas, VA
03.2017 - 11.2019
- Delivered data-informed Applied Behavior Analysis (ABA) services to pediatric and adolescent patients diagnosed with autism spectrum disorder and other developmental disabilities across home and community-based settings.
- Partnered with a Board-Certified Behavior Analyst (BCBA) to implement and monitor individualized treatment plans, ensuring data integrity, protocol adherence, and measurable clinical outcomes.
- Collected, analyzed, and interpreted behavioral and functional performance data to evaluate treatment efficacy, optimize intervention strategies, and support improvements in functional communication and social skill acquisition while reducing maladaptive behaviors.
- Maintained strict compliance with healthcare privacy regulations, including HIPAA, ensuring secure handling, documentation, and reporting of protected health information (PHI).
- Utilized Microsoft Excel to clean, organize, and visualize longitudinal client data; developed trend analyses and monthly progress reports to support clinical decision-making.
- Designed and maintained performance dashboards to track key behavioral metrics, treatment progress, and outcome indicators for interdisciplinary review.
Education
Master of Science - Health Information Management and Technology
University of Maryland Global Campus
12.2026
Bachelor of Science - Education
Virginia State University
05.2015
Skills
Revenue Cycle & Financial Operations
Prior Authorizations & Credentialing, Claims Processing & Reconciliation, Denial Management & Appeals, Utilization Review, Revenue Integrity, ICD-10 / CPT Coding, Payer Policy Analysis
Technical & Analytical Tools
SQL, Tableau, Microsoft Excel, EHR Systems, Data Reconciliation & Validation
Professional Skills
Analytical Thinking, Attention to Detail, Organization & Time Management, Effective Communication
Certification
- CompTIA Sec+
- CAPM (exp: April 2026)
Timeline
Revenue Operations Lead
Coastal Healthcare Services
12.2023 - Current
Registered Behavior Technician
Brighter Strides
08.2023 - 02.2024
Data Support Specialist
Comprehensive Autism Partnership
02.2022 - 09.2023
Compliance Specialist
ABA Today
10.2020 - 01.2022
Lead RBT
Comprehensive Autism Partnership
11.2019 - 03.2020
Registered Behavior Technician
Family Insight
03.2017 - 11.2019
Bachelor of Science - Education
Virginia State University
Master of Science - Health Information Management and Technology
University of Maryland Global Campus