Hi, I’m
Shannan L. Guliano
Peoria,AZ
Summary
Results-driven customer service specialist with over 15 years of experience in the healthcare sector, consistently delivering exceptional patient and customer care. Proven ability to thrive in both collaborative and independent environments, enhancing organizational efficiency through effective problem-solving and communication skills. Committed to leveraging extensive expertise to elevate patient experiences and streamline support processes. Prepared to contribute valuable insights and skills to address complex challenges in a dynamic workplace.
Overview
21
years of professional experience
Work History
Discover Financial Services
Fraud Representative
05.2025 - Current
Job overview
- Investigated and resolved approximately 50-60 daily outbound calls concerning suspicious or fraudulent credit card activity
- Provided critical assistance to Discover card members, guiding them through charge disputes and identity verification processes
- Communicated sensitive information clearly and empathetically, de-escalating stressful situations for members concerned about account security
- Evaluated customer data to identify and prevent fraudulent activities
- Reviewed transactions and receipts to identify any suspicious activity
Consumer Cellular
Technical Support Customer Service Representative
07.2024 - 04.2025
Job overview
- Diagnosed and troubleshooted hardware and software issues on various mobile devices
- Responded to customer requests for products, services, and company information.
- Guided users through step-by-step solutions for common technical problems
- Assisted the customer with how to Install and configure applications and software updates as needed
- Educated customers on device features and best practices for maintenance
- Educated customers about billing, payment processing and support policies and procedures.
- Documented support interactions and resolutions for future reference
Accredo Specialty Pharmacy- Cigna Healthcare
Eligibility Representative
09.2022 - 03.2023
Job overview
- Eligibility Representative for Accredo Specialty Pharmacy gave the opportunity to daily work with patients in fulfilling their specialty medication needs in an urgent and timely manner
- Reviewed incoming prescriptions for accuracy, contacting the provider when an issue would arise to correct the issue preventing delay for the patient
- Responsible for coordinating the patient's insurance coverage to ensure a paid claim without issues as well as calculating the patient's responsibility (copay, coinsurance, and deductible)
- When necessary would verify medical benefits to see if additional coverage would be sufficient
- Initiate a prior authorization (PA) and track the status for medical and pharmacy claims for the medication
OPTUM Specialty Pharmacy - United Health Group
Pharmacy Help Desk Representative
05.2022 - 07.2022
Job overview
- Responded to incoming calls from pharmacies regarding pharmaceutical claim transactions and their status
- Guided pharmacies, providers, and patients on the process of claim transmission and payment
- Researched and explained prescription/ pharmacy benefits for the patient and confidently and compassionately engaged with the caller
- Identified and handled issues with physician orders and reorders and other complex issues
Cancer Treatment Centers of America
Financial Counselor
04.2013 - 06.2015
Job overview
- Assisted patient registration upon admission to the hospital
- Discussed insurance eligibility, benefits, and authorization with patients, explained their insurance coverage and what costs are and are not covered
- Identified healthcare resources and programs for patients unable to meet financial obligations.
- Assessed client financial situation and explored background through one-on-one interview process.
- Liaised between patient, doctor and insurance provider to smooth claims processes.
- Received training and certification as a Health Insurance Navigator in 2014 to assist uninsured patients with finding an insurance plan on the Health Insurance Marketplace
- Responsible for assisting patients with their Cobra insurance, offering them financial assistance as well as setting up and monitoring every Cobra patient that was currently treating (45-60 at one given time)
- Signed patients up and tracked accounts for patient assistance programs through various drug manufacturers to help relieve financial burden on the patients
- Contacted insurance providers to obtain key information regarding patient benefits and to submit documentation for accounts.
- Verified insurance coverage and obtained pre-authorizations.
- Confirmed patient appointments day before scheduled.
Kelly Services - John C Lincoln Hospital
Pre-Services Financial Counselor
01.2012 - 06.2012
Job overview
- Worked as a temporary employee for John C Lincoln Hospital as a Financial Counselor in the pre-services department
- In this position there were cross training in many areas; In/Outpatient surgeries, Inpatient direct admissions/ emergency room admissions, and radiology
- Using Meditech with Medifax and then upgraded to Epic operating system the responsibilities included; verifying all commercial plans, AHCCCS, and Medicare insurance plans (using Medifax, Internet, and calling insurance companies), requesting and/or submitting authorizations, and Pre-registering the patient over the phone including collecting demographic information for the medical record, completing the MSP (Medicare Secondary Payor Form), and collecting the co-payment
ADECCO - McKesson
Insurance Specialist
05.2010 - 12.2011
Job overview
- Worked as a Temporary Employee for McKesson as a Customer Service Representative
- Placed calls verifying medical and pharmacy benefits for high cost medications, verified if any state, federal, or pharmacy assistance programs were available to the patient, and verified if any pre-authorizations were required through the insurance company and if so what information was needed
- Maintained confidentiality of patient finances, records, and health statuses.
Vangent
Medicare Customer Service Rep I
07.2009 - 05.2010
Job overview
- Provided excellent customer service while answering in-bound calls from our Medicare beneficiaries and their families
- Met customer call guidelines for service levels, handle time and productivity
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates
- Investigated and resolved customer inquiries and complaints quickly
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals
- Assisted callers with finding sufficient drug coverage plans and Medicare advantage plans
Performance Health and Chiropractic Services
Finance Manager
02.2008 - 07.2009
Job overview
- Duties implied billing for medical and all commercial carriers, following up on unpaid or denying claims for their status, heavy data entry tasking, answering the phones and files, faxing and copying documents
- Also developed spreads for tracking claim checks for physicians, looked up ICD-9 codes and CPT codes and updated patients' demographics
- Also occasionally assisted in front office duties of: performing general administrative office assignments, scheduling appointments for patients' visits, documenting clinical notes, filling and maintaining health information records, complying and preparing reports and documents accurately, answering telephones, taking messages, preparing patient for x-rays and developing the x-rays, ordering, receiving, and maintaining office supplies
NATURAL LIFE CENTERS
Finance Manager
02.2005 - 01.2008
Job overview
- Started as a Front Desk clerk but was quickly trained in medical billing and finance
- Responsibilities included billing for 3 of the 5 Natural Life Center clinics, billing medical and all commercial carriers, following up on unpaid or denying claims for their status, heavy data entry tasking, answering the phones and files, faxing and copying documents
- Also developed spreads for tracking claim checks for physicians, looked up ICD-9 codes and CPT codes, and entered deposited and updated patients' demographics
- Also responsible for managing the front desk staff, when the office managers were not available
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Performed electric muscle stimulation, massage, and mechanical traction.
- Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
- Promoted office efficiency, coordinating charts, completing insurance forms, and helping patients with diverse needs.
- Trained new and existing staff members in various financial procedures to prepare for job requirements.
- Created organizational structures to improve accounting and finance functions.
Education
Phoenix CollegePhoenix
Certificate from Fire Sciences And Emergency Medical Technology
05-2000
Central High SchoolPhoenix, AZ
High School Diploma
05-1998
Skills
- Technical Proficiency
- Customer Service Excellence
- Data entry
- Proficient in Microsoft Office
- Medical terminology
- Verbal communication
- Effective Organization Skills
- Effective Time Management
- Self-Directed
- Investigation techniques
- Fraud prevention
- Customer and medical billing
- Patient registration
- EMR
- HIPAA compliance
- Insurance verification