Shannon Baldridge
Inverness,FL
Summary
Dynamic professional with extensive experience as Clinical Insurance Reviewer at Ocala Oncology, specializing in clinical documentation and treatment compliance. Demonstrated ability to enhance workflow efficiency and improve customer satisfaction through analytical thinking and effective communication. Proficient in medical coding, consistently maintaining high-quality standards.
Overview
22
22
years of professional experience
Work History
Clinical Insurance Reviewer
Ocala Oncology
Ocala, FL
02.2020 - Current
- Reviewed patient files for accuracy and completeness.
- Collaborated with medical staff to ensure compliance with treatment protocols.
- Evaluated clinical documentation for coding and billing accuracy.
- Provided feedback on process improvements to enhance workflow efficiency.
- Maintained up-to-date knowledge of oncology guidelines and regulations.
- Maintained communication with customers throughout the review process ensuring they were updated regularly about progress being made.
Quality Analyst
Firstsource Solutions
Tampa, FL
03.2010 - 04.2019
- Collaborated with teams to identify and resolve quality issues effectively.
- Trained team members on quality assurance processes and best practices.
- Created detailed documentation for testing procedures and results.
- Monitored ongoing projects for adherence to quality benchmarks consistently.
- Maintained records of inspection results, test data, and other relevant information.
Customer Advocate
Blue Cross Blue Shield of Illinois
Rockford, IL
01.2004 - 03.2010
- Managed customer inquiries regarding health insurance plans and coverage options.
- Educated members about benefits, policies, and procedures effectively.
- Documented customer interactions accurately in the CRM system.
- Trained new staff on customer service protocols and system usage.
- Increased customer satisfaction ratings by effectively answering questions, suggesting effective solutions, and resolving issues quickly.
Education
High School Diploma -
East High School
Rockford, IL05-1995
Skills
- Clinical documentation
- Medical coding
- Treatment compliance
- Analytical thinking
- Research proficiency
Timeline
Clinical Insurance Reviewer
Ocala Oncology
02.2020 - Current
Quality Analyst
Firstsource Solutions
03.2010 - 04.2019
Customer Advocate
Blue Cross Blue Shield of Illinois
01.2004 - 03.2010
High School Diploma -
East High School