Summary
Overview
Work History
Education
Skills
Timeline
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Charisse Shannon

Roseville,MI

Summary

Results-oriented Analyst skillful in managing and breaking down large volumes of information. Proactive at heading off issues in operations, workflow and production by uncovering trends affecting business success.

Overview

11
11
years of professional experience

Work History

Associate Analyst, Provider Configuration

Molina Healthcare
Troy, MI
02.2020 - Current
  • Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases.
  • Synchronizes data among multiple claims systems and application of business rules as they apply to each database.
  • Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
  • Analyzed data sets using Excel and other quantitative and statistical modeling technologies and tools to effectively meet company analysis and reporting requirements.

OTR Truck Driver

U.S. Xpress
Chattanooga, TN
08.2018 - 09.2019
  • Made sure that deliveries were on time for scheduled appointments
  • Optimized routes based on road knowledge, traffic updates and GPS data
  • Kept meticulous logs of all correspondence with customers and freight recipients

Membership and Billing Specialist

Health Alliance Plan Of Michigan
Detroit, MI
12.2010 - 08.2018
  • Identified, researched and resolved billing variances to maintain system accuracy and currency
  • Verify enrollment status, and make changes to customer records
  • Run daily enrollment reports, identify and resolve enrollment rejections
  • Manage Appeals and HICS Grievances cases daily, investigate and respond appropriately within 72 hour timeframe
  • Request membership identification cards
  • Manage customer, management and support department request via email, caseload, phone calls and mail
  • Bills, collects premiums, and reconcile member payments
  • Generated and submitted invoices based upon established accounts receivable schedules and terms
  • Enrolls members manually and electronically, and make changes to policies as requested by customers
  • Confirm applicable documentation is received, scanned and electronically stored

Education

Bachelor of Science - Applied Behavior Analysis

Kaplan University
Davenport, IA
05.2017

Skills

  • Proficient in following Applications: Internet Explorer; Microsoft Applications; Oracle, OpenScape Contact Center Enterprise; CRM; Claims Workflow; QNXT; I-Serve
  • Appeals and Grievances
  • Accounts Receivables
  • Customer Service experience
  • Billing systems and software/dispute resolution
  • HIPAA regulations/CMS compliance
  • Data entry
  • Order processing
  • Problem-solving
  • Effective time management
  • Detail Oriented
  • Report Preparation and Presentation
  • Quality Evaluation
  • Chart and Graph Preparation

Timeline

Associate Analyst, Provider Configuration

Molina Healthcare
02.2020 - Current

OTR Truck Driver

U.S. Xpress
08.2018 - 09.2019

Membership and Billing Specialist

Health Alliance Plan Of Michigan
12.2010 - 08.2018

Bachelor of Science - Applied Behavior Analysis

Kaplan University

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Charisse Shannon