Summary
Overview
Work History
Education
Skills
Timeline
Generic

Shanequa Mathieu

Springfield Township,NJ

Summary

Adept Medical Management Specialist with a proven track record at Elevance Health, showcasing expertise in healthcare management and Microsoft Office. Demonstrated ability to enhance data integrity and client satisfaction, achieving over 95% compliance in insurance verification and HIPAA standards. Skilled in effective communication and meticulous analysis, ensuring optimal operational efficiency.

Overview

9
9
years of professional experience

Work History

Medical Management Specialist

Elevance Health
Iselin, NJ
07.2019 - Current
  • Process authorizations for Personal Home Care, Adult Medical Day Services, Custodial Nursing Facilities, Home Modifications, Home Delivered Meals, Personal Emergency Response, and other healthcare services, ensuring compliance with all necessary guidelines and regulations.
  • Manage heavy phone communication with members and providers, handling over 25 calls daily and responding to over 20 immediate tasks, maintaining high professionalism and service quality.
  • Collect and analyze clinical information to assess and determine appropriate referrals to Utilization Management, Case Management, Quality Improvement, and Medical Review departments.
  • Review insurance claims for accuracy before submission, promptly resolving discrepancies, and ensuring timely processing.
  • Identify and correct errors in patient records, guaranteeing data integrity and compliance with healthcare standards.
  • Address customer service inquiries promptly, demonstrating a commitment to client satisfaction and effective issue resolution.

Senior Loan Servicing Specialist

Financial Resources Federal Credit Union
Bridgewater, NJ
09.2018 - 07.2019
  • Respond to GAP, CPI, and disability insurance inquiries for staff and members.
  • Review missing collateral report/send collateral notices to Members.
  • Prepare loan payoff letters, mortgage cancellations for recording, and mortgage subordinations.
  • Review and document LAS Maintenance reports.
  • Process MBP, GAP, debt protection cancellation & refunds.
  • Prepare Debt Protection reporting for CUNA.
  • Provide notices to members for expiring HELOC limits, PLOC limits; process requests to extend lines and/or modify accounts.
  • Notification of balloon payments, process skip payment, and vacation loan checks as received.
  • Provide backup for all staff as needed.
  • Complete all weekly, monthly, and annual reports, such as but not limited to paid-ahead loans, 0% rate review, zero balance, and paid auto loans.
  • Performs general office duties, including data entry, pulling loan files, fax correspondence, copying, filing, receiving, and sorting mail, and member business loan file maintenance.

Loan Servicing & Finance Coordinator

South Carolina Community Loan Fund
Charleston , SC
04.2016 - 05.2018
  • Supported the financial management and operations of the organization through the maintenance of loan accounting records..
  • Managed the servicing of the loan portfolio, including the maintenance of loan files, in both the organization's document management system (Docufree) and the loan servicing software (Salesforce and Downhome Loan Manager).
  • Assisted the Finance Department with the processing of deposits and outgoing payments.

Education

High School Diploma -

Plainfield High School
Plainfield, NJ
06-2003

Skills

  • Utilization review
  • Healthcare management
  • Microsoft office
  • Insurance verification
  • HIPAA compliance
  • Medical coding

Timeline

Medical Management Specialist

Elevance Health
07.2019 - Current

Senior Loan Servicing Specialist

Financial Resources Federal Credit Union
09.2018 - 07.2019

Loan Servicing & Finance Coordinator

South Carolina Community Loan Fund
04.2016 - 05.2018

High School Diploma -

Plainfield High School

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Shanequa Mathieu