Shannon Mosley
Insurance Verification and Prior Authorization
Ballwin,MO
Summary
Self-Motivated and dedicated Customer Service Professional with extensive experience in the Healthcare field. Active team player with exceptional listening and problem solving skills. Enhances customer experiences by displaying the ability to understand customer desires and needs.
Overview
8
8
years of professional experience
Work History
Member Services Representative
CVS / Mercy Care (Remote Position)
05.2017 - 03.2023
- Verified eligibility and educated Plan Members about Medicaid and Medicare benefits and coverage.
- Assisted with billing inquiries and requested for claims to be reprocessed when necessary.
- Assisted members with several tasks including but not limited to; Ordering new ID cards, searching for in-network specialists, updating primary care providers, and updating demographic information.
- Verified CPT and ICD-10 codes and advised providers when an authorization was required.
- Utilized active listening skills to identify customer needs and provide appropriate solutions.
Prior Authorization Specialist
Aetna Medicaid / Better Health Of Missouri
11.2014 - 05.2017
- Processed non-medical and behavioral health inpatient prior authorization requests via phone and fax.
- Exceeded daily quota requirements of processed authorizations.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
Education
High School Diploma -
Parkway South High School
Manchester, MOSkills
- Excellent Customer Service
- Ability to multi-task
- Time Management
- Dependable
- Effective problem solving skills
- Attention to detail
- Strong organizational skills
- Ability to work from home
Timeline
Member Services Representative
CVS / Mercy Care (Remote Position)
05.2017 - 03.2023
Prior Authorization Specialist
Aetna Medicaid / Better Health Of Missouri
11.2014 - 05.2017
High School Diploma -
Parkway South High School
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