Shannon Easterling
Hartsville,SC
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
6
6
years of professional experience
Work History
TPL Claims Representative
Elevate Patient Financial Solutions
02.2023 - Current
- Worked productively in fast-moving work environment to process large volumes of claims.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Collaborated with internal departments and external vendors to achieve fast resolution of claims.
- Followed up with customers on unresolved issues.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Updated claims system to track claim status and provide relevant information to other department.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
Insurance Claims Processor
Blue Cross Blue Shield of South Carolina
08.2020 - 08.2022
- Checked documentation for appropriate coding, catching errors and making revisions.
- Prepared and reviewed insurance-claim forms and related documents for completeness.Collaborated with fellow team members to manage large volume of claims.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Maintains database with the aid of using new and up to date client and account information.
- Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items.
- Monitored reports to identify claims issues and worked with adjusters to resolve problems.
- Verified claim data correctness in preparation for processing.
- Maintained comprehensive database for enrollment data, claim submission and payment information.
- Processed claims according to established quality and production standards and made corrections and adjustments to solve problems.
Certified Nursing Assistant
Five Star Senior Living
08.2017 - 08.2018
- Vital signs and patient monitoring.
- Answering telephones and providing information to callers.
- Answer patient call signals to determine patients’ needs.
- Provide physical support to assist patients to perform daily living activities, such as: getting out of bed, bathing, dressing, standing, walking or exercising.
- Charting information on patients periodically throughout the work shift.
- Greet visitors professionally and provide friendly assistance.
- Aided in lifting residents when necessary.
- Participated in fun group activities with patients to boost mood, improve overall memory, and provide light entertainment.
Education
Bachelor of Science - Business Administration And Management
University of South Carolina - Columbia
Columbia, SC05.2025
Associate of Arts - Associate
Central Carolina Technical College
Sumter, SC10.2023
High School Diploma -
Hartsville High School
Hartsville, SC06.2017
Skills
- Medical terminology
- Insurance terminology
- Epic Systems software skills
- Claims review
- Task prioritization
- Organizational skills
- Teamwork skills
- Self-management skills
- Leadership Skills
- Customer Service Skills
- Computer Skills
- Policy Understanding
- Decision-Making
- Time Management
- Coverage Determination
Timeline
TPL Claims Representative
Elevate Patient Financial Solutions
02.2023 - Current
Insurance Claims Processor
Blue Cross Blue Shield of South Carolina
08.2020 - 08.2022
Certified Nursing Assistant
Five Star Senior Living
08.2017 - 08.2018
Bachelor of Science - Business Administration And Management
University of South Carolina - Columbia
Associate of Arts - Associate
Central Carolina Technical College
High School Diploma -
Hartsville High School
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