Shameelya Morris
Manor,TX
Summary
Friendly, loyal, and dedicated individual with a strong ambition to succeed in any given environment. Experienced in various areas of the workforce, thrives on continuous learning and embraces challenges with enthusiasm. Possesses excellent interpersonal skills and collaborates effectively with others, while also demonstrating efficiency when working independently. Currently seeking a position to further develop skills and excel, while delivering utmost dedication to an employer.
Overview
25
25
years of professional experience
Work History
Quality Assurance Specialist
Hootcall (SubjectWell)
10.2017 - 10.2019
- Listened to calls either live or recorded
- Encouraged good practices and discouraged bad ones
- Identified calls failing to meet predefined standards and identified any problem
- Implemented agent training and coaching initiatives
- Understood priority of organization and evaluated call behaviors for regulatory compliance cross-selling and adherence to policy
- Provided customer feedback and internal compliance feedback to management
- Prioritizing projects and activities and establishing objectives, tasks, and timelines for multiple projects.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
Career Advisor/Subject Well (Clinical Trial Pre-Qualifier)
Hootcall LLC
08.2014 - 10.2019
- Assist callers with finding open job positions in their area
- Connected callers to Education Matching reps to find colleges in their area
- Pre-Qualified clients for Clinical trials
- Connected callers to clinics for further screening.
- Developed customized job search strategies for clients facing unique challenges such as extended gaps in employment or career transitions.
Precertification Coordinator
Dell Children's Blood and Cancer Center
Austin, TX
01.2023 - Current
- Obtains authorization on for admissions as required by health plans
- Enters patient insurance authorizations and any pertinent information from insurance company into patient account history
- Documents insurance coverage of services to be provided
- Notifies case management about interactions with insurance companies regarding services
- Manages denials or potential denials as described by insurer
- Monitors and reviews applicable schedule to ensure that authorization and initial length of stay is obtained and on file.
- Coordinated closely with clinical staff to ensure that necessary medical tests were conducted prior to submitting pre-certification requests.
- Streamlined pre-certification processes by implementing a comprehensive tracking system for patient information and documentation.
CSR - Customer Service Representative
Ascension Seton
12.2020 - 01.2023
- Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed
- Develop and implement prior authorization workflow, policies, and procedures
- Review accuracy and completeness of information requested and ensure that all supporting documents are present
- Receive requests for pre-authorizations and ensure that hare properly and closely monitored
- Process referrals and submit medical records to insurance carriers to expedite prior authorization processes
- Manage correspondence with insurance companies, physicians, specialists, and patients as required
- Secure patients' demographics and medical information by using great discretion and ensuring that all procedures are in sync with HIPPA compliance and regulation.
Caseworker-Brokerage
EMSI
10.2012 - 06.2013
- Locating and retrieving medical records on insurance applicants by calling medical facilities
- Verifying applicant information
- Negotiating medical fees and expedition of records.
- Established trusting relationships with clients, fostering open communication and rapport building.
Therapist Technician
Heart of Texas MHMR
01.2008 - 09.2011
- Transporting consumers to and assisting them with activities
- Training and assisting consumers in completing household chores (cooking, cleaning, laundry, hygiene)
- Correctly administering medications.
- Built strong rapport with clients, fostering trust and open communication for effective therapy sessions.
- Improved patient outcomes by implementing evidence-based therapeutic techniques and interventions.
PSA
Westside Development Center, PSA
09.2006 - 10.2007
- Transporting consumers to and assisting them with activities
- Training and assisting consumers in completing household chores (cooking, cleaning, laundry, hygiene)
- Correctly administering medications.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Developed and maintained courteous and effective working relationships.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
Crew Member & Team Lead
Subway Sandwiches
01.2000 - 05.2003
- Exhibits a cheerful and helpful manner while greeting guests and preparing their orders
- Demonstrates a complete understanding of menu items and explains them to guests accurately
- Used Point of Sale system/cash register to record the order and compute the amount of the bill
- Collects payment from guests and makes change
- Performs Cash-In Procedure- accounting for all forms of money, bread, etc., during the shift
- Prepares food neatly, according to formula, and in a timely manner
- Checks products in sandwich unit area and restocks items to ensure a sufficient supply throughout the shift
- Understands and adheres to proper food handling, safety and sanitation standards during food preparation, service and clean up
- Cleans and maintains all areas of the restaurant to promote a clean image
- Understands and adheres to the Wash, Rinse, and Sanitize method of cleaning
- Performs light paperwork duties as assigned.
- Took orders, prepared meals, and collected payments.
- Demonstrated strong multitasking abilities, handling multiple orders simultaneously without compromising quality or efficiency.
- Frequently inspected production area to verify proper equipment operation.
Education
Criminal Justice - Criminal Justice
Temple College
Temple, TX01.2011
Criminal Justice - Criminal Justice
Navarro College
Corsicana, TX01.2007
Diploma in General Studies - General Studies
Waco High School
Waco, TX05.2003
Skills
- Insurance Verification
- Data entry proficiency
- Medical terminology knowledge
- Healthcare Industry Experience
- Customer Service
- Patient Communication
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Precertification Coordinator
Dell Children's Blood and Cancer Center
01.2023 - Current
CSR - Customer Service Representative
Ascension Seton
12.2020 - 01.2023
Quality Assurance Specialist
Hootcall (SubjectWell)
10.2017 - 10.2019
Career Advisor/Subject Well (Clinical Trial Pre-Qualifier)
Hootcall LLC
08.2014 - 10.2019
Caseworker-Brokerage
EMSI
10.2012 - 06.2013
Therapist Technician
Heart of Texas MHMR
01.2008 - 09.2011
PSA
Westside Development Center, PSA
09.2006 - 10.2007
Crew Member & Team Lead
Subway Sandwiches
01.2000 - 05.2003
Criminal Justice - Criminal Justice
Temple College
Criminal Justice - Criminal Justice
Navarro College
Diploma in General Studies - General Studies
Waco High School
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