Shaneka Nash
Las Vegas,NV
Summary
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
6
6
years of professional experience
Work History
Elite Advocate4me
11.2023 - Current
- Conduct provider searches
- Perform closed, denied and simple claim adjustments
- Meet quality and customer satisfaction
- Maintain accurate documentation and ORS
- Take accountability and ownership of any follow up work as needed
- Take ownership and resolution and inquiries end to end
- Resolve issues including benefits eligibility and claims as needed
- Identify and anticipate and resolve member issues to prevent future calls
Senior Health Advocate4me T2
United Health Group
10.2022 - 11.2023
- Respond to and resolve, on the first call, customer service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims
- Reprocess claims that were denied incorrectly using UNET, financial spending accounts and correspondence
- Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to select the best benefit plan options, maximize the value of their health plan benefits and choose a quality care provider
- Contact care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance
- Assist customers in navigating myuhc.com and other UnitedHealth Group websites and encourage and reassure them to become self-sufficient
Optum
04.2019 - 10.2022
- Charge entry to make sure all modifiers and office codes are correct before submitting
- Send a task to the provider or the clinic regarding any missing information
- Work the Adjust charge task
- Manage charge edits, correct result charges and work missing charge reports
- Import charges into APM and work any failed vouchers
- Void and re-enter any vouchers that need correction
Education
Medical Billing and Coding Diploma -
Brightwood College
Las Vegas, NV12.2016
High School Diploma -
Valley View High School
Moreno Valley, CA06.2004
Skills
- Billing
- Collections
- ICD-10
- CMS 1500
- Medical Terminology
- Medical / Clinical Office Procedures
- Customer Relations
- Microsoft Outlook
- Supervision and Team Work
- Basic Medical Billing and Coding
- HIPAA Compliance
- Confidentiality
- Friendly, positive attitude
- Teamwork and collaboration
Timeline
Elite Advocate4me
11.2023 - Current
Senior Health Advocate4me T2
United Health Group
10.2022 - 11.2023
Optum
04.2019 - 10.2022
Medical Billing and Coding Diploma -
Brightwood College
High School Diploma -
Valley View High School
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