SHANI WILHITE

• Claim Correction and Resubmission
• ICD - 9/ CPT coder
• Processes all Claims Appeal
• Insurance Verification
• Account Receivable/Payable
• Prior Authorizations Specialist
• Medical Records and Research
• Tri-Care Referral Specialist
• Maintained strict confidentiality with all personal data as per company guidelines.
• Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
• Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
• Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.

• Student Recruitment/Enrollment
• Marketing and advertising (branding the company)
• Processed enrollment documents/Received payments
• Maintained inventory/Administrative office duties
• Managed career fairs
• Scheduled State Board exams
• Managed approximately 80- 100 incoming calls, emails and faxes per day from customers.

• Generated 'Work Orders' for maintenance/facilities issues
• Coordinated/maintain building access cards
• Collected rent checks from tenants and keep records
• Interfaced with tenants/maintained files to keep them confidential
• Received incoming calls and routed them accordingly
• Monitored office equipment functions/order office supplies
• Received/Stamped/Dispersed mail/deliveries daily
• Reserved Conference Room for tenants
• Instrumental in Talent Development through strategic direction and team vision; contributed to development of associates through coaching, mentoring and management of individual development plans for all associates

• Processed applications/ Reappointment of paperwork
• Quality Control
• Maintained accurate database
• Organized Experience and Licensure
• Prepared records for audits
• Ensured that records were consistent and updated
• Maintained and made corrections to provider files
• Managed and maintained provider listings for Medicaid, TENN Care, and private insurance

Verified shipments against paperwork to minimize errors and company losses.

Utilized cycle counts to reconcile inventory and identify root cause of discrepancies.

Generated and verified necessary shipping paperwork, packing lists and bills of lading.

Analyzed and developed data, related to inventory levels to provide status reports to management.

• Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
• Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
• Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
• Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.