Shanavahia Stubbs
Tampa,FL
Summary
Skilled in navigating complex insurance claims and providing thorough investigations to ensure fair settlements. Have experience coordinating with legal teams, policyholders, and insurance companies to manage claims efficiently. Known for strong analytical skills, ability to interpret policy details accurately, and effective communication that results in resolved disputes. Made significant impacts by streamlining claims processing procedures, enhancing customer satisfaction through timely resolutions.
Overview
6
6
years of professional experience
Work History
Claims Analyst
GeneDX
Tampa, FL
03.2024 - Current
- Provide guidance to customers regarding their rights and obligations under policy terms.
- Assess medical records for coverage eligibility and benefit accuracy.
- Evaluate requests for additional benefits or changes in existing coverage levels.
- Analyze claim data to identify trends and recommend process improvements.
- Manage escalated cases involving high-value claims or multiple parties involved.
- Investigate fraudulent claims by gathering evidence from various sources.
Remote Claims Representative
Humana
Tampa, FL
02.2022 - 03.2024
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Documented changes in claim statuses using specialized software systems.
- Analyzed trends in claim denials or delays to identify areas for improvement within the organization.
- Collaborated with other departments to resolve billing disputes or address customer concerns quickly.
Chat Support Representative
Walt Disney World Parks and Resorts
Tampa, Florida
04.2020 - 01.2022
- Developed an understanding of customer needs by actively listening during conversations.
- Ensured compliance with company policies and procedures when dealing with customers.
- Documented all customer interactions and inquiries in the ticketing system accurately and completely.
- Performed quality assurance checks on completed tickets to ensure accuracy of information provided to customers.
Shift Leader
Chic-Fil-A
Tampa, Florida
02.2019 - 04.2020
- Confirmed accuracy of daily sales reports before submitting them to management for review.
- Reviewed time sheets for accuracy before submitting them for payroll processing.
- Supervised the cleaning of dining areas, restrooms, kitchen equipment, and floors in order to maintain a safe and sanitary environment for customers and staff alike.
- Conducted regular meetings with team members to discuss upcoming events or changes in policy and procedures.
Education
High School Diploma -
Hillsborough High School
Tampa, FL05-2013
Associate of Arts - Business Administration And Management
Hillsborough Community College
Tampa, FLSkills
- Claims processing
- Data analysis
- Fraud investigation
- Policy interpretation
- Benefit assessment
- Customer service
- Process improvement
- Regulatory compliance
- Documentation accuracy
- Claims trend analysis
- Proficient in Microsoft word, Excel
- Time management
- Attention to detail
- Critical thinking
- Team collaboration
- Claims history analysis
- Claim investigation
Timeline
Claims Analyst
GeneDX
03.2024 - Current
Remote Claims Representative
Humana
02.2022 - 03.2024
Chat Support Representative
Walt Disney World Parks and Resorts
04.2020 - 01.2022
Shift Leader
Chic-Fil-A
02.2019 - 04.2020
High School Diploma -
Hillsborough High School
Associate of Arts - Business Administration And Management
Hillsborough Community College