Shaikeem Price
Columbus
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
8
8
years of professional experience
Work History
Claims Examiner
Sedgwick Claims Management
08.2021 - Current
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Evaluated and interpreted state and federal regulations to ensure compliance in the handling of all disability claims.
- Participated in cross-functional team meetings to address organizational challenges related to claims management and develop solutions collaboratively.
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
Unemployment Claims Specialist
Sedgwick/ Ranstad
08.2020 - 08.2021
- Assisted claimants in navigating the unemployment benefits system, addressing concerns, and answering inquiries promptly.
- Enhanced customer satisfaction by resolving complex claim issues in a timely and professional manner.
- Maintained up-to-date knowledge of federal and state regulations governing unemployment insurance programs, ensuring compliance at all times.
- Maintained strict confidentiality when dealing with sensitive claimant information, adhering to all privacy regulations and guidelines.
Medical Claims Coordinator
Trinity Health
11.2018 - 07.2020
- Evaluated provider contracts for adherence to reimbursement guidelines, thus preventing costly overpayments or denials.
- Collaborated with billing team to address issues, resulting in fewer denials and increased revenue.
- Implemented electronic filing systems to increase organizational efficiency within the department.
- Expedited claims resolution by effectively collaborating with providers and payers to obtain necessary documentation or missing information.
- Reduced denial rates with comprehensive documentation and accurate coding practices.
Administrative Assistant
Marriott
07.2016 - 11.2019
- Welcomed each new arrival pleasantly and confirmed reservations and identification.
- Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.
- Handled financial transactions accurately, ensuring proper billing and payment processing.
- Collaborated with housekeeping to maintain room readiness, enhancing guest comfort.
- Oversaw and organized calendar to schedule reservations and monitor cancellations.
Education
Associate of Science - Information Technology
Midlands Technical College
West Columbia, SC06.2009
Business Administration
Morris College
Sumter, SC05.2006
Skills
- Claims Processing
- Verbal Communication
- Data Verification
- Disability claims process
- Problem-solving abilities
- Active Listening
- Critical Thinking
- Customer Relations
- Problem Resolution
- Computer Proficiency
- Call center experience
- Complaint Handling
- Microsoft Excel
- Professional telephone demeanor
- Microsoft Outlook
- Paperwork Processing
Affiliations
- Alpha Kappa Alpha Inc Member since 2005
- Charter Member Marriott Hotels
Timeline
Claims Examiner
Sedgwick Claims Management
08.2021 - Current
Unemployment Claims Specialist
Sedgwick/ Ranstad
08.2020 - 08.2021
Medical Claims Coordinator
Trinity Health
11.2018 - 07.2020
Administrative Assistant
Marriott
07.2016 - 11.2019
Associate of Science - Information Technology
Midlands Technical College
Business Administration
Morris College
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