Shamalle Gant
Princeton,TX
Summary
Operations specialist focused on transaction research, discrepancy resolution, and data integrity across claims, insurance, and credit balance workflows. Reviews complex records in multiple systems, resolves account issues, and maintains complete documentation that supports audit readiness, quality control, and cost-basis operations.
Overview
1
1
Certification
4
4
years of professional experience
Work History
Credit Specialist
Guidehouse
Lewisville, TX
03.2024 - Current
- Analyze credit balances, overpayments, adjustments, and account transactions while maintaining accuracy and adherence to established policies.
- Researched account records, payment activity, documentation, and supporting information to identify discrepancies and implement resolutions.
- Coordinated with internal departments and external stakeholders to verify information, resolve issues, and secure missing documentation.
- Process account corrections and maintain complete, accurate, and audit-ready records.
- Review high-volume transactions and prioritize work according to deadlines, business needs, and issue complexity.
- Identified recurring discrepancies and communicated trends or process concerns, driving operational improvements.
- Handle confidential financial and customer information in accordance with company procedures and applicable requirements.
- Adapt to changing priorities and collaborate with team members to meet service-level and productivity expectations.
Claims Specialist / Claims Processor
Concentra
Addison, TX
12.2022 - 03.2024
- Applied company policies and payer requirements to evaluate and process claims.
- Reviewed claims, medical records, eligibility information, and supporting documentation to verify transaction accuracy and coverage requirements.
- Resolved discrepancies by researching multiple systems and comparing records to identify and correct missing or inconsistent information.
- Maintained high accuracy in data entry, updates, and corrections to ensure integrity of claims processing.
- Communicated with providers, payers, patients, and internal teams to resolve issues and obtain required information.
- Balanced competing priorities in a fast-paced environment to consistently meet productivity, quality, and turnaround-time expectations.
- Documented research findings, actions taken, and final resolutions for audit and operational purposes.
- Supported team objectives by sharing information, assisting with workload balancing, and adapting to changing procedures.
Insurance Verification Specialist
ChangeHealth Care
Charlotte, NC
05.2022 - 11.2022
- Verified insurance eligibility, benefits, coverage details, and account information across multiple payer and internal systems, ensuring accurate billing and claims processing.
- Investigated discrepancies between customer records, payer information, and billing data, resolving issues to maintain data integrity and enhance customer satisfaction.
- Updated account records and communicated accurate information to internal departments and customers, facilitating seamless operations and informed decision-making.
- Maintained detailed documentation while protecting confidential personal and financial information.
- Followed established procedures and escalated complex issues for further review.
Education
High School Diploma -
Parkway Central High School
Chesterfield, MoSkills
- Credit evaluation
- Reconciliation
- Discrepancy investigation
- Transaction research
- Payment resolution
- Cost basis support
- Quality control
- Process improvement
- Cross-functional collaboration
- Microsoft Office
- Office software proficiency
- Confidential handling
- Communication skills
- Policy compliance
- Records management
- Problem solving
- Attention to detail
- Cross functional collaboration
- Data analytics
Certification
- ADP Entry Level Payroll Specialist, July 2026, The Payroll Professional, July 2026
Accomplishments
- Resolved complex account, payment, or claim discrepancies through detailed research and cross-system verification.
- Maintained accurate records while processing high-volume workloads under deadline requirements.
- Reduced repeat errors by identifying documentation gaps, communicating root causes, and following established correction procedures.
- Consistently demonstrated flexibility by supporting multiple functions and adapting to changing priorities.
Timeline
Credit Specialist
Guidehouse
03.2024 - Current
Claims Specialist / Claims Processor
Concentra
12.2022 - 03.2024
Insurance Verification Specialist
ChangeHealth Care
05.2022 - 11.2022
High School Diploma -
Parkway Central High School