Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Symone Shelby

Houston,TX

Summary

Passionate about promoting lasting customer satisfaction by delivering quality service. Proficient in customer service best practices and related options professional well-versed in healthcare practices, compliance standards and operations. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

13
13
years of professional experience
1
1
Certification

Work History

Insurance Verification Specialist

Inovalon
06.2022 - Current
  • Complied with HIPAA guidelines and regulations for confidential patient data.
  • Assisted patients with understanding personalized insurance coverage and benefits, accurately addressing all questions and concerns.
  • Assured timely verification of insurance benefits prior to patient procedures and appointments.
  • Made contact with insurance carriers to discuss policies and individual patient benefits, provided insurance data support to the clinics and Central billing office.

Appointment Setter/Medical Claims Adjuster

CVS Continuum Global Sol.
03.2019 - 06.2022
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
  • Verified patient insurance coverage and benefits for medical claims.
  • Paid or denied medical claims based upon established claims processing criteria.
  • Researched and resolved complex medical claims issues to support timely processing.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.

Medical Insurance Verification Specialist

Dr.Raza Pasha
02.2016 - 03.2019
  • Assisted patients with understanding personalized insurance coverage and benefits prior to their appointment
  • Made contact with insurance carriers to discuss policies and individual patient benefits, prior patients appointment or procedures.
  • Answered telephone calls to offer office information, answer questions, and direct calls to staff, also scheduling patient appointments in respective doctors' calendars and followed up with reminder phone calls.
  • Completed administrative patient intakes with case histories, insurance information and mandated forms.


Customer Service Specialist

Emperon Constar
03.2010 - 02.2016
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
  • Updated account information to maintain customer records while answering customer telephone calls to avoid on hold wait times.
  • Offered advice and assistance to customers, paying attention to special needs or wants.

Education

Phlebotomist - Nursing Science

San Jacinto College
110851 Scarsdale Blvd Houston Tx 77089
01.2027

High School Diploma -

J.Frank Dobie High School
10220 BlackhawkBlvd, Houston Tx
09.2010

Skills

  • Electronic Authorization Processing
  • Deductible and Co-Pay Calculation
  • Schedule Patients ,Verify Insurance Plan and Medical Records
  • Insurance Authorizations, Attention to Detail
  • CPT Coding , Patient Care
  • Patient Database Maintenance
  • Collecting Patient Specimens and Tests

Certification

  • CNA - Certified Nurse Assistant
  • PT - Phlebotomy Technician

Timeline

Insurance Verification Specialist

Inovalon
06.2022 - Current

Appointment Setter/Medical Claims Adjuster

CVS Continuum Global Sol.
03.2019 - 06.2022

Medical Insurance Verification Specialist

Dr.Raza Pasha
02.2016 - 03.2019

Customer Service Specialist

Emperon Constar
03.2010 - 02.2016

Phlebotomist - Nursing Science

San Jacinto College

High School Diploma -

J.Frank Dobie High School

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Symone Shelby