Katrina Shelton
Conroe,TX
Summary
Detail-focused Insurance Resolution Specialist with a proven track record at Omni Interactions, adept at navigating complex benefit verifications, and ensuring compliance with HIPAA regulations. Skilled in verbal and written communication, with analytical thinking, I excel in problem-solving, teamwork, and adaptability to meet strict deadlines, and handle multiple tasks simultaneously. Committed to maintaining confidentiality and providing exceptional service to patients and healthcare providers, while ensuring timely benefit verifications and claim processing. Recognized for exceptional audit ratings.
Overview
29
29
years of professional experience
Work History
Insurance Resolution/Benefits Verification Specialist
Omni Interactions
Remote, USA
09.2022 - Current
- Initiated contact with insurance companies, physician offices, and patients as necessary to obtain additional information needed for verification purposes.
- Reviewed and verified the eligibility of patients for benefits coverage to process claims, including Medicare and Medicaid.
- Performed follow-up calls to verify that insurance companies received requests for authorization of services.
- Worked closely with internal teams such as the billing department and utilization management team to resolve any issues related to benefit verifications.
- Maintained accurate records of all verification activities in a timely manner.
- Managed daily workloads containing tasks for prior authorizations, copay assistance, major medical reviews, insurance updates, and many others, while meeting deadlines.
- Adhered to HIPAA regulations when handling confidential patient information.
- Utilized various software and tools to streamline processes and optimize performance.
- Maintained updated knowledge through continuing education and advanced training.
Senior Loan Analyst / Real Estate Assistant
Independent Contractor
Pearland and Montgomery, USA
12.2003 - 12.2023
- Research and analyze potential loan markets, and develop referral networks to locate prospects for loans.
- Analyze applicants to determine the feasibility of granting loans and entering all information into Salesforce.
- Review loan agreements to ensure they are complete and accurate according to policy and law
- Collaborated with underwriters to ensure the accurate completion of required documentation prior to closing a loan, including aiding in resolving mortgage application problems.
- Reviewed client documentation and contracts for discrepancies and mistakes.
- Generate lists of properties that are compatible with buyers' needs and financial resources
- Coordinate appointments for agents to show homes to prospective buyers
- Research local utilities and school districts for agents to ensure accuracy when posting on HAR.com, and put together lists for agents and myself to give to buyers in their packets, with neighborhood resources and local utilities that service the area.
- Reviewed financial data, pay stubs and credit history for borrowers to ascertain loan qualification.
- Advised customers on strategies for improving their credit scores so they can qualify for more favorable rates and terms when obtaining a loan.
- Conducted market research to identify trends in mortgage rates and terms that could affect loan decisions.
- Maintained up-to-date records of all loans originated or serviced within the organization.
Customer Service Representative
Arise Virtual Solutions
Virtual
05.2021 - 11.2022
- Inbound/Outbound sales and service utilizing CRM and Avaya.
- One call resolution using a knowledge base and internet research for price matching of qualified competitors.
- Maintain metrics-based compliance.
- Adhere to NDA and confidentiality requirements.
- Identified opportunities for upselling additional products or services based on customer needs.
- Answered incoming calls, providing frontline customer support, or assistance with product and service transactions.
- Resolved customer complaints promptly and efficiently by de-escalating problematic customer concerns, while maintaining a calm, friendly demeanor.
- Maintained detailed records of customer interactions, transactions, and comments for future reference.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
Property Compliance Specialist
The Woodlands Township
The Woodlands, USA
07.2016 - 03.2017
- Research deeds and covenants, and attend design committee meetings to stay up to date on changes.
- Always provide a high level of customer service, and project and maintain a positive image on behalf of the Community Associations.
- Conduct field investigations, take photographs, prepare forms, reports, and PowerPoint presentations to provide documentation for property violations, property improvement applications, property improvement progress, commercial, and street right-of-way violations, and improvements.
- Write letters and notices to property owners describing the condition, citing the section of the standards or covenants violated, specifying the corrective action required, and the date by which the corrective action is required.
- Initiate follow-up letters.
- Maintain accurate and detailed records of complaints and actions taken; write reports, and update the department database.
- Interpret documents such as covenants, development standards, building codes, and plans.
- Evaluated applications and associated documentation to determine eligibility.
- Maintained accurate records of all activities related to compliance monitoring, including a detailed database of compliance data, activities, and actions taken.
Research Specialist / Field Technician
Texas Land Coordinators, Inc.
Pearland, USA
05.1996 - 12.2003
- Project management: Support, plan, and coordinate single or multiple survey operations, while maintaining databases of relevant data.
- Research legal and map records, survey records, and land titles to obtain information about property boundaries in areas to be surveyed from in-house map records, third-party resources such as Courthouse Direct, or on-site at each specific county courthouse by reviewing plats or microfiche records.
- Compile information necessary to stake projects for construction or purchase, using plats.
- Write legal descriptions of property boundary surveys for deeds, leases, or other legal documents.
- Record survey measurements and descriptive data using notes, drawings, and sketches.
- Locate section corners, property markers, and survey points.
Education
Associate Degree -
Lone Star College System
Conroe, TX08-2022
Skills
- Verbal and written communication, including conflict resolution
- Healthcare compliance, HIPAA/PIP
- Citrix software, VDI with internal applications such as UI Path and Sprx for claim processing
- Flexibility to work as a team or an individual
- On-site, online, and third-party research
- Record and database maintenance
Volunteer Experience
- Houston Livestock Show & Rodeo - Breeder Greeter committee member
- Conroe Little League
- Girl Scouts of America-San Jacinto Council
Timeline
Insurance Resolution/Benefits Verification Specialist
Omni Interactions
09.2022 - Current
Customer Service Representative
Arise Virtual Solutions
05.2021 - 11.2022
Property Compliance Specialist
The Woodlands Township
07.2016 - 03.2017
Senior Loan Analyst / Real Estate Assistant
Independent Contractor
12.2003 - 12.2023
Research Specialist / Field Technician
Texas Land Coordinators, Inc.
05.1996 - 12.2003
Associate Degree -
Lone Star College System