Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
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Angela Shaw

Indianapolis,IN

Summary

Results-driven professional with extensive experience at Managed Health Services, specializing in grievance handling and client documentation. Proven ability to resolve complex issues with patience and professionalism while ensuring HIPAA compliance. Skilled in eligibility determination and case management, consistently enhancing client satisfaction through effective communication and problem-solving.

Overview

10
10
years of professional experience

Work History

Eligibility Specialist

Knowledge Services
Indianapolis, Indiana
03.2024 - Current
  • Maintained accurate records of client interactions and documentation in systems.
  • Reviewed applications to verify client information and resolve discrepancies.
  • Processed client applications in accordance with established guidelines.
  • Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
  • Attended regular training sessions to stay up-to-date on new rules and regulations.
  • Conducted detailed interviews with applicants to determine their eligibility for assistance programs.
  • Verified applicant's identity and other relevant documents such as birth certificates or Social Security cards.
  • Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.

Grievance Appeals Specialist

Managed Health Services
Indianapolis, Indiana
08.2018 - 02.2024
  • Maintained up-to-date knowledge of industry regulations and best practices in grievance handling.
  • Maintained confidentiality regarding all matters related to personnel issues and grievances.
  • Provided feedback to senior leadership on trends identified through the grievance process.
  • Investigated and resolved customer grievances to ensure satisfaction and compliance.
  • Documented complaint resolutions in case management systems for tracking purposes.
  • Educated clients on grievance procedures and available resources for assistance.
  • Monitored compliance with established policies and procedures governing grievances handling process.

Customer Service Team Lead

Managed Health Services
Indianapolis, Indiana
04.2015 - 08.2018
  • Trained new team members on proper service methods and evaluated service delivery using quality assurance program.
  • Volunteered to handle complaints and issues for manager during busy time periods.
  • Utilized active listening skills and asked open-ended questions to ascertain customer call needs.
  • Assisted in resolving escalated customer complaints or issues in a timely manner.
  • Collaborated with other departments to ensure that customers' needs were met within established timelines.
  • Resolved escalated customer issues with professionalism and patience.
  • Maintained an up-to-date knowledge base of products, services, pricing information, processes.

Education

Associate of Science - Liberal Arts

Vincennes University
Vincennes, IN
05-1985

High School Diploma -

Worthington-Jefferson High School
Worthington, IN
05-1983

Skills

  • Client documentation
  • Application review
  • Eligibility determination
  • HIPAA compliance
  • Case management
  • Grievance handling

Additional Information

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Timeline

Eligibility Specialist

Knowledge Services
03.2024 - Current

Grievance Appeals Specialist

Managed Health Services
08.2018 - 02.2024

Customer Service Team Lead

Managed Health Services
04.2015 - 08.2018

Associate of Science - Liberal Arts

Vincennes University

High School Diploma -

Worthington-Jefferson High School

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