SHANAE BRANTLEY
Westland
Summary
Healthcare and patient services professional with 15+ years of experience in Medicare operations, coordination of benefits, pharmacy services, billing analysis, and patient care. Skilled in Medicare Part C/D claims analysis, COB reconciliation, HIPAA compliance, 340B program auditing, prior authorizations, and patient-facing administrative support. Recognized for accuracy, regulatory compliance, communication, and cross-functional collaboration in fast-paced healthcare environments.
Overview
16
16
years of professional experience
Work History
Patient Reception Specialist
Village Medical
Livonia
01.2026 - Current
- Welcome and prepare patients for appointments while verifying demographics, insurance eligibility, and required documentation.
- Collect co-pays, reconcile payments, and explain insurance coverage and financial waivers to patients.
- Manage multi-line phone systems, appointment scheduling, and patient communications regarding delays and wait times.
- Maintain medical records through scanning, faxing, and documentation updates while ensuring HIPAA compliance.
COB Recovery Analyst
Blue Cross Blue Shield
Detroit
04.2020 - 11.2025
- Analyzed Medicare Part C/D claims to identify overpayments and recover funds with a 98% reconciliation accuracy rate.
- Updated coordination of benefits records in compliance with CMS and MSP regulations.
- Collaborated with providers, members, and insurance carriers to validate coverage and resolve discrepancies.
Prior Authorization Pharmacy Technician
Blue Cross Blue Shield
Southfield
02.2020 - 04.2020
- Reviewed and processed prior authorization requests while verifying insurance coverage and medication eligibility.
- Communicated with patients and providers regarding approvals, denials, and appeals.
- Tracked case status and ensured timely follow-up for Medicare Part D requests.
- Process prior authorization requests for medications and treatments efficiently.
340B Pharmacy Regulatory Analyst
Henry Ford Health System
Bingham Farms
03.2018 - 01.2020
- Analyzed pharmacy metrics and compliance reports to support 340B program effectiveness and audit readiness.
- Identified discrepancies impacting reimbursement and eligibility while supporting regulatory compliance initiatives.
- Collaborated across departments to strengthen operational efficiency and cost-saving strategies.
Billing Analyst
Henry Ford Health System
Bingham Farms
03.2015 - 03.2018
- Prepared and submitted insurance claims electronically and via paper submission while resolving billing discrepancies.
- Managed payment posting, collections, patient statements, and insurance follow-up.
- Maintained strict HIPAA compliance while supporting patients and insurance representatives.
Patient Care Associate
DMC Harper Hospital
Detroit
11.2013 - 02.2015
- Supported nursing staff with patient care, ADLs, documentation, vital signs, and patient transfers.
- Monitored patient conditions and communicated updates to RNs throughout shifts.
Pharmacy Technician
Henry Ford Hospital
Detroit
08.2010 - 07.2013
- Prepared and dispensed medications, processed prescription requests, and maintained pharmacy inventory records.
- Supported insurance claims processing and patient profile management.
Education
Bachelor’s Degree - Health Service Administration
Baker College
Associate’s Degree - Applied Health Science
Baker College
Medical Assistant Certificate -
National Institute of Technology
Skills
- Medicare Part C/D Claims
- Coordination of Benefits (COB)
- CMS & MSP Regulations
- 340B Program Compliance
- HIPAA Compliance
- Prior Authorizations
- Insurance Verification
- Medical Billing & Claims
- Patient Registration
- Data Analysis & Reporting
- Pharmacy Operations
- MS Office Suite
- Medical Terminology
- Payment Reconciliation
- Patient Scheduling
- Regulatory Auditing
- Communication & Collaboration
Timeline
Patient Reception Specialist
Village Medical
01.2026 - Current
COB Recovery Analyst
Blue Cross Blue Shield
04.2020 - 11.2025
Prior Authorization Pharmacy Technician
Blue Cross Blue Shield
02.2020 - 04.2020
340B Pharmacy Regulatory Analyst
Henry Ford Health System
03.2018 - 01.2020
Billing Analyst
Henry Ford Health System
03.2015 - 03.2018
Patient Care Associate
DMC Harper Hospital
11.2013 - 02.2015
Pharmacy Technician
Henry Ford Hospital
08.2010 - 07.2013
Bachelor’s Degree - Health Service Administration
Baker College
Associate’s Degree - Applied Health Science
Baker College
Medical Assistant Certificate -
National Institute of Technology