Shanna Savone

Work History

LA Care

Los Angeles, CA

04.2019 - 03.2023

Managed workloads efficiently by prioritizing tasks based on urgency or importance.
Process incoming claims: Determine correct level of reimbursement based on established criteria, provider contract, participating provider group, health plan and regulatory provisions.
Process all claims eligible or ineligible for payment accurately and conforming to quality, production standards and specifications in a timely manner.
Document provider claims/billing forms to support payments/decisions.
Negotiate reimbursement amounts for out-of-network claims; Identify dual coverage, Potential third party savings/recovery; Maintain department databases used for report production and tracking on-going work; Claims will be processed within the contractual and/or regulatory time frames within or less than 45 working days and as supported by the departmental policies.

UnitedHealth Group

Phoenix, AZ

01.2016 - 12.2018

Prepared and maintained various reports for management regarding clinical activities.
Monitored compliance with HIPAA regulations in regards to patient privacy rights.
Primarily responsible for initiation of cases by data entry of clinical into the Facets system, via telephone, fax or computer
Electronically routes cases to the nurse for review and decision
After decision, ensured case completion to include generation of approval letters while staying within compliance with time frames
Communicates with providers other departments as needed
Works independently with minimal supervision
Review and process fax and telephone requests to meet department key indicator productivity and accuracy standards; maintain minimum of 95% case data entry accuracy
Follow department policy regarding accurate documentation of clinical data, demographic and product information, provider / facility contract status, appropriately route cases to RN for clinical review, follow departmental policy for non – clinical level notifications
Maintain 100% accuracy of letter generation within compliance time frames
Provide high level of customer service while communicating with internal departments and provider office staff as pertains to performance of job responsibilities
Takes responsibility for problem solving to achieve key indicator goals

Hulu

Santa Monica, CA

01.2014 - 12.2015

Resolved escalated issues from customers or other departments within the organization.
Assisted customers in resolving inquiries or complaints via telephone, email, or chat.
Provided support and guidance to new customer service representatives; assisted with onboarding process.
Created training materials for new customer service representatives.
Assigned tasks and projects to team members based on individual strengths and weaknesses.
Conducted weekly team meetings to discuss customer service performance metrics, best practices, and any areas of improvement.