Shaniecia Holland
Atlanta
Summary
Dynamic Escalation Response Specialist IV at Centene with proven expertise in insurance verification and exceptional customer service. Adept at enhancing workflow processes and resolving complex issues, ensuring accurate billing and member satisfaction. Recognized for meticulous attention to detail and effective communication, driving improvements in operational efficiency.
Overview
19
19
years of professional experience
Work History
Escalation Response Specialist IV
Centene
06.2018 - Current
- Ensured accurate dissemination of information regarding member benefits and eligibility for Medicaid and Medicare.
- Researched and analyzed customer feedback to identify areas of improvement.
- Coordinated with other departments to ensure efficient workflow processes.
- Facilitated transparency by communicating claim statuses to healthcare providers via calls and chat.
- Maintained accuracy in billing and record-keeping by adjusting medical claims as per procedures.
Crew Trainer
McDonald's Corporation
Dunwoody
06.2006 - 04.2020
- Delivered high-quality customer service by efficiently handling inquiries and resolving conflicts, ensuring customer satisfaction.
- Collaborated effectively with team members to maintain a cooperative and productive work environment.
- Ensured accuracy in order taking, preparation, and delivery of meals through meticulous communication and attention to detail.
Insurance Verification Specialist
Bay Area Credit
Norcross
10.2017 - 06.2018
- Verified customer insurance coverage and processed payments to ensure accurate and timely account updates in Overby system.
- Managed communications with insurance agencies to confirm policy details and maintain precise client records.
- Contacted insurance carriers to verify patient eligibility and obtain necessary authorization numbers.
- Assisted in resolving billing and reimbursement inquiries related to claims.
ROI Specialist
Iron Mountain
Atlanta
04.2017 - 10.2017
- Managed the release of medical documentation, maintaining patient confidentiality and data integrity.
- Data entered medical requests.
- Scanned and validated medical records for upload.
- Processed and invoiced records requests from patients, providers and third parties.
Education
Diploma -
Frederick Douglas High School
Atlanta, GASkills
- Data entry
- ICD-10
- CPT coding
- EMR systems
- Customer service
- Medical records
- Communication skills
- Insurance verification
- Attention to detail
- Time management
- Problem solving
- Team leadership
- Team building
Timeline
Escalation Response Specialist IV
Centene
06.2018 - Current
Insurance Verification Specialist
Bay Area Credit
10.2017 - 06.2018
ROI Specialist
Iron Mountain
04.2017 - 10.2017
Crew Trainer
McDonald's Corporation
06.2006 - 04.2020
Diploma -
Frederick Douglas High School
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