SHANNETTA MOORE
Raleigh,NC
Summary
Detail-oriented and analytical professional with expertise in credit processing, documentation review, and payment processing. Skilled in assessing creditworthiness and ensuring compliance with underwriting guidelines. Seeking to leverage these skills as a Loan Officer to drive efficient loan processing and support financial growth for clients.
Experienced with credit application reviews and processing. Utilizes strong analytical skills to ensure accuracy and compliance. Knowledge of maintaining client confidentiality and streamlining workflow processes.
Overview
18
18
years of professional experience
Work History
CREDIT PROCESSOR
National Coatings and Supplies
04.2022 - Current
- Provided prompt responses to inquiries from both internal staff members and external clients regarding credit applications or issues.
- Maintained high level of confidentiality when handling sensitive customer information.
- Analyzed financial transactions, credit information and payment histories.
- Analyzed customer payment histories and issued denials and approvals based on creditworthiness.
- Communicated with supervisors to escalate issues and resolve complex errors.
- Notified individuals of application status, need for additional information, or approval and denial results.
- Assisted in development of improved processes and procedures related to credit processing tasks.
- Processed credit applications and performed credit checks for approval.
- Analyzed financial data to determine credit worthiness of customers.
- Processed credit applications efficiently and accurately for timely approvals and disbursements.
- Conducted thorough credit checks and analysis to assess risk and determine credit limits.
- Communicated with clients and vendors to gather necessary documentation and resolve credit issues.
CUSTOMER SERVICE BILLING REPRESENTATIVE, TEAM LEAD
Mindpath Care Centers
10.2020 - 03.2022
- Collaborating with patients, third party institutions and other team members to resolve billing inconsistencies and errors.
- Inputting payment history, upcoming payment information or other financial data into an individual account.
- Resolving any escalated calls where there are disputes with billing or payment history and making appropriate updates during that time.
- Generate financial reports to send over to upper management that lists all account history for each patient.
- Ensuring confidentiality according to the company guidelines and policies when discussing any sensitive information with customers.
- Led team in resolving complex billing issues, improving customer satisfaction by 20%
- Trained new team members on billing software and procedures, reducing onboarding time.
- Identified process inefficiencies and implemented solutions to streamline billing operations.
- Collaborated with cross-functional teams to improve communication and resolve customer inquiries efficiently.
FINANCIAL COUNSELOR
Strategic Behavioral Center
07.2019 - 10.2020
- Assessed patients' financials and their ability to pay offering options for payment plans on how to take care of any out-of-pocket costs.
- Explained insurance benefits such as deductibles, coinsurance, and what the out of pocket would be.
- Posting all payments that were provided over the phone, in person, or mailed.
- Monitoring patient accounts after admission ensuring that all agreements are met if there is an out-of-pocket cost.
- Contacting insurance companies to obtain benefit information and to obtain claim status.
- Maintaining a constant file on every patient that's still inpatient or has been discharged to ensure any negotiated payments are being satisfied and taking necessary steps to communicate with the patient or family about any updates.
- Staying in compliance with company policies while monitoring data being input or speaking with family members or patients.
- Created personalized financial plans for clients to achieve their financial goals.
- Conducted financial assessments to identify areas for saving opportunities.
- Provided financial education on maintaining all pay plans.
BUSINESS ACCOUNT REPRESENTATIVE
Holly Hill Hospital
08.2018 - 10.2019
- Assess patient finances and communicate with the patients while addressing any concerns regarding balances while the patient is still admitted.
- Contacting various insurance companies to verify patient benefits such as deductibles, coinsurance, or any other out of pocket costs.
- Prior to discharge, if any patient was not spoken with while in the hospital, there will be a final discussion regarding any balances or out of pocket whether it be self-pay or based on that patients' insurance.
- Negotiate any future payment agreements if the patient is not able to satisfy any financial obligations at the time of discharge.
- Maintaining daily spreadsheets with all patients that are currently in house or have discharge that still have financial obligations.
PATIENT ACCOUNTS REPRESENTATIVE
UNC Healthcare
01.2016 - 07.2017
- Maintaining patient records, which includes detailing patient treatments and, diagnoses as well as updating payment and medical insurance information.
- Processing patient payments and refunds.
- Identifying medical coding mistakes, typing errors, as well as patient underpayments or overpayments and rectifying them accordingly.
- Creating suitable payment plans for patients based on their monthly income and financial obligations.
- Answering patients' questions regarding unsettled medical bills, reimbursements, and billing discrepancies.
- Contacting patients via email, written correspondence, or telephone to inform them of overdue balances.
- Managed billing inquiries and reconciliations, demonstrating excellent customer service and attention to detail.
- Collaborated with healthcare providers to resolve outstanding balances and facilitate payment plans for patients.
CLAIMS PROCESSOR
Blue Cross Blue Shield
06.2014 - 12.2015
- Responsible for adjudication of all types of medical claims based on the contractual policies and procedures.
- Verifying eligibility for each insurance that includes but is not limited to, commercial, contract payers, Medicaid, or Medicare.
- Reviewing claim submissions and verifying all information is accurate on each submission.
- Returning any claims to providers or members if there is a denial, explaining the reason why claim was not adjudicated.
- Complying with all Federal, State, and company regulations and policies.
- Determining policy coverage and calculating each claim amounts.
- Keeping daily track of claim spreadsheets for claims that have been denied or adjudicated and sending these daily reports to team leaders.
- Performing audits on any previous claims to ensure that the proper denial or payment was accurate and reporting those claims that need correcting to team leaders.
- Processed and resolved insurance claims efficiently and accurately in a fast-paced environment.
MEDICAL INTERVIEWER
Blue Cross and Blue Shield of North Carolina
05.2013 - 06.2014
- Maintaining understanding of medical terminology as it pertains to the caller's medical history which would include prescription histories.
- Keeping in constant contact with the Underwriting team by providing updates from caller's that have been informed about their application.
- Responsible for providing team lead with spreadsheets of all caller's that were spoken with in regard to their applications.
- Conducted structured medical interviews with patients to gather relevant medical history.
- Recorded patient responses accurately and confidentially using electronic medical records software.
- Assessed patient understanding of medical terminology and explained complex medical concepts.
CUSTOMER SERVICE REPRESENTATIVE
Blue Cross and Blue Shield of North Carolina
01.2008 - 05.2013
- Answering on average between 60-100 regarding members insurance questions in a timely manner.
- Accessing member accounts and discussing detailed information regarding benefits, giving a breakdown of their benefits which includes deductible, coinsurance, and if there may be any out-of-pocket costs.
- Properly documenting every call diligently to ensure that every concern is addressed.
- Reaching out to team leaders or help desk teams if there is a major issue or concern regarding account updates.
- Review claim status and give strategic breakdowns to the members so they better understand what and how the decision was made on their claims.
- Follow Federal and State guidelines by giving disclaimers prior to discussing member benefits and/or claims.
- Exercise all HIPAA requirements by having the members verifying PHI to ensure that this information is accurate.
- Provided exceptional customer service and resolved inquiries promptly and courteously.
- Managed high volume of incoming calls, emails, and requests efficiently.
- Collaborated effectively with team to optimize productivity and achieve customer satisfaction targets.
Education
ASSOCIATE'S DEGREE - BUSINESS MANAGEMENT
Post University
CT06.2020
DIPLOMA - undefined
WASHINGTON HIGH SCHOOL
NC05.1998
Skills
- Underwriting guidelines
- Documentation review
- Payment processing
- Credit scoring
- Loan processing
- Credit policy compliance
Accomplishments
- Used Microsoft Excel to develop inventory tracking spreadsheets.
Timeline
CREDIT PROCESSOR
National Coatings and Supplies
04.2022 - Current
CUSTOMER SERVICE BILLING REPRESENTATIVE, TEAM LEAD
Mindpath Care Centers
10.2020 - 03.2022
FINANCIAL COUNSELOR
Strategic Behavioral Center
07.2019 - 10.2020
BUSINESS ACCOUNT REPRESENTATIVE
Holly Hill Hospital
08.2018 - 10.2019
PATIENT ACCOUNTS REPRESENTATIVE
UNC Healthcare
01.2016 - 07.2017
CLAIMS PROCESSOR
Blue Cross Blue Shield
06.2014 - 12.2015
MEDICAL INTERVIEWER
Blue Cross and Blue Shield of North Carolina
05.2013 - 06.2014
CUSTOMER SERVICE REPRESENTATIVE
Blue Cross and Blue Shield of North Carolina
01.2008 - 05.2013
DIPLOMA - undefined
WASHINGTON HIGH SCHOOL
ASSOCIATE'S DEGREE - BUSINESS MANAGEMENT
Post University