Angela Shaw
Huntertown,IN
Summary
Service Oriented Professional with deep knowledge of the healthcare industry. Solid abilities in developing objectives and strategies to improve performance and effectiveness. Excellent skills compiling, coding, categorizing and auditing information to process claims and patient information.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Claims Analyst
Physicians Health Plan
03.2021 - Current
- Maintained strict confidentiality with all personal data as per company guidelines.
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
- Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
- Enhanced customer satisfaction by resolving complex claims issues in a timely manner.
- Participated in ongoing training programs to stay current on industry developments and maintain a strong understanding of relevant laws and regulations affecting the claims process.
- Reduced claims processing time by implementing efficient analytical techniques and strategies.
- Provided exceptional customer service by promptly addressing inquiries from policyholders, agents, and other stakeholders regarding the status of their claims.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
Warehouse Worker
Amazon
12.2019 - 03.2021
- Loaded, unloaded, and moved material to and from storage and production areas.
- Consistently lifted materials weighing as much as 50 pounds.
- Maintained clean workspaces by enforcing strict housekeeping guidelines for storage areas, dock bays, and equipment zones.
- Reduced order processing times with streamlined picking, packing, and shipping procedures.
- Contributed to achieving team goals with consistent punctuality, reliability, and adherence to established performance standards.
- Ensured accurate order fulfillment by diligently cross-checking pick lists against packed items for consistency.
- Promoted a positive work environment by actively participating in team-building activities and taking initiative in group projects.
- Achieved timely dispatch of orders using effective time management strategies during the picking process.
Machine Operator
Aardvark Straws
12.2017 - 12.2019
- Followed detailed instructions to operate machines with accuracy and produce quality products.
- Set up and adjusted equipment and properly configured machines for daily operation.
- Complied with company and OSHA safety rules and regulations.
- Trained new employees on proper machine operation, ensuring adherence to company standards and safety guidelines.
- Loaded raw materials into machines and unloaded finished products to keep manufacturing process running smoothly.
- Set up and ran machinery to produce exceptional products for industrial needs.
- Streamlined workflow by maintaining a clean and organized workstation, adhering to safety protocols.
- Monitored machines during operation to detect sounds of malfunction or excessive vibration and adjusted machines to eliminate problems.
- Collaborated with team members to optimize production processes and improve overall performance.
- Maintained open communication lines with supervisors regarding project status updates, potential delays, or any concerns affecting production timelines.
Billing Specialist
Shared Services Center
04.2015 - 12.2017
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked with multiple departments to check proper billing information.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Enhanced accuracy in patient billing through meticulous record-keeping and verification of insurance details.
- Fostered strong relationships with healthcare providers and insurance representatives to facilitate efficient resolution of billing issues.
- Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.
- Negotiated with insurance companies to resolve disputed claims, securing rightful payments.
- Collaborated with healthcare team to ensure billing codes were accurately applied, optimizing reimbursement from insurance companies.
Certified Nursing Assistant
Park Place Senior Living
10.2013 - 04.2015
- Implemented patient care for up to 12 patients per section in a memory care unit
- Documented patient admissions and discharges
- Assessed patient status and notify Nursing Manager of clinical changes
- Interacted with different departments regarding patient care
- Document health care needs, conditions, options etc
- Provided assistance to Nursing Manager in the supervision of residence in an assistant living environment
- Maintained staffing requirements including floor assignments
- Maintained patient charts and confidential files.
Associate Trainer
Panera Bread
07.2008 - 10.2013
- Responsible for the training of new sales associate
- Responsible for customer service
- Ordered merchandise and kept track of inventory
- Created displays
- Introduction of new product roll out
- Helped on the front line (Cashier)
- Unloaded merchandise off truck
- Assembly line and food preparation.
Education
Associate Of Applied Science - Medical Billing Administration
Ross College
Sylvania, OH04.2024
Medical Billing And Coding Certification - Medical Insurance Billing
Ross Medical Education Center
Fort Wayne, IN03.2016
Nursing Program, Certified Nursing Assistant - Nursing
Ivy Tech Community College
Fort Wayne, IN06.2013
Skills
- Interpersonal and written communication
- Policy Interpretation
- Proficient in Software
- Claims Processing
- Customer service and support
- Computer Skills
- Customer Service
- Data Entry
- Call center experience
- Computer Proficiency
- Microsoft Excel
- Documentation
- Microsoft PowerPoint
- Live chat support
- Medical terminology knowledge
Community Service
Alpha Omega club, 2000-Current, South Side High School.
Zeta Amica Fort Wayne Zeta Phi Beta Eta Upsilon, 2018-Current
Certification
- CBCS - Certified Billing and Coding Specialist
- CNA - Certified Nurse Assistant
Timeline
Claims Analyst
Physicians Health Plan
03.2021 - Current
Warehouse Worker
Amazon
12.2019 - 03.2021
Machine Operator
Aardvark Straws
12.2017 - 12.2019
Billing Specialist
Shared Services Center
04.2015 - 12.2017
Certified Nursing Assistant
Park Place Senior Living
10.2013 - 04.2015
Associate Trainer
Panera Bread
07.2008 - 10.2013
Associate Of Applied Science - Medical Billing Administration
Ross College
Medical Billing And Coding Certification - Medical Insurance Billing
Ross Medical Education Center
Nursing Program, Certified Nursing Assistant - Nursing
Ivy Tech Community College
Similar Profiles
Lisa S ReyesLisa S Reyes
Customer Service Representative at Physicians Health PlanCustomer Service Representative at Physicians Health Plan
Shelley KibiloskiShelley Kibiloski
Case Management Coordinator at Physicians Health PlanCase Management Coordinator at Physicians Health Plan
Scott StevensScott Stevens
Director of IT Infrastructure and Security at Physicians Health PlanDirector of IT Infrastructure and Security at Physicians Health Plan
Amy LeeAmy Lee
Prior Authorization Specialist /Surgery Scheduling at Women’s Health AdvantagePrior Authorization Specialist /Surgery Scheduling at Women’s Health Advantage
Dallas StoreyDallas Storey
Crew Member at Dunkin' DonutsCrew Member at Dunkin' Donuts