Summary
Overview
Work History
Education
Skills
Websites
Timeline
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Shannon Wheeler

Summary

Diligent, results-oriented, reliable, strong work ethic, and hard-working professional ready to contribute solid effort as a team member. Thorough and highly organized with excellent communication skills, interpersonal skills, excellent time management, and problem-solving skills. To seek and maintain full-time position with a reputable organization that offers professional challenges and growth.

Overview

6
6
years of professional experience

Work History

Freelancer

1099 Contractor
02.2023 - Current
  • Enhanced client satisfaction by delivering high-quality work within deadlines.
  • Strengthened client relationships with consistent communication and timely project updates.
  • Collaborated with cross-functional teams to ensure seamless delivery of services, increasing overall team productivity.
  • Adapted quickly to changing project requirements, demonstrating flexibility and adaptability under pressure.
  • Stayed current on industry trends by regularly participating in continuing education courses and workshops related to my field of expertise.

BILLING ANAYLST

UNITEDHEALTH GROUP/UMR
11.2022 - 01.2023
  • Interact with clients to gather support data to ensure invoice accuracy and work through specific billing discrepancies
  • Provide input to policies, systems, methods and procedures for the effective management and control of the premium billing function
  • Educate customers regarding the availability of receiving invoices and remitting payments through online applications
  • Manage the preparation of invoices and complete reconciliation of billing with accounts receivable
  • Reviews open delivery tickets and prioritizes billing activities
  • Enter Premium Billing Rates on a timely basis
  • Identifies any trends or billing inaccuracies with investigation and resolution, escalating to Supervisor or Manager when assistance is needed
  • Completes account reviews and correction requests submitted by other departments within established turnaround times
  • Adheres to Regulatory and Payor Guidelines and policies & procedures
  • Assist with special projects and other duties as assigned.
  • Improved billing accuracy by conducting thorough audits and identifying discrepancies in invoice data.
  • Streamlined billing processes for increased efficiency, implementing automated systems and software upgrades.

Associate Billing Specialist/HR Specialist

AMN HEALTHCARE (contractor)
12.2021 - 03.2022
  • Demonstrated understanding of the billing role and requirements, as well as interpret contract terms as they relate to billing exceptions, to accurately document expected payments in alignment with client agreement and ensure client satisfaction
  • Entered invoice data in client databases and proprietary software
  • Processed and Approved E-cards and timecards
  • Maintained and updated billing systems to document any invoicing changes and Implemented all Human Resources programs and policies
  • Prepared and processed billing adjustments, such as credits and debits, into billing software and technologies in an accurate manner
  • Supported various email boxes associated with timecard entry for bill
  • Tracked missing timecards and manually applied billing rules to ensure accuracy
  • Worked with team mentor to proactively research and resolve billing inquiries
  • Issued invoices to the client within specified timeframes and coordinated with client on invoices requiring special procedures and invoice delivery internal and external partners
  • Utilized Salesforce to update and input any data or any communications
  • Create, run, and reconcile Excel reports as requested.
  • Improved billing accuracy by implementing a streamlined invoicing process.
  • Enhanced customer satisfaction with timely and accurate invoice generation.

CREDENTIALING ONBOARDING I9 ANALYST/HR COORDINATOR

AMN HEALTH (Contractor)
08.2021 - 12.2021
  • Audited I-9 forms and supporting documentation via a third-party on-line application for completeness and accuracy following federal requirements
  • Maintained Human Resource information records and compiles reports
  • Performed E-Verify process on new-hires and rehires to ensure employment eligibility
  • Solved HR problems or issues that may have arisen
  • Logged I-9 audit and E-verification results into internal applications to track compliance and identify exceptions
  • Prepared I-9 exception reporting and notified recruiters of noncompliant I-9s following customer concern procedures
  • Monitored E-Verify exceptions to final resolution
  • Assisted recruiters with inquiries regarding validity of I-9 supporting documentation and procedural questions
  • Provided I-9 and E-Verify documentation to internal departments and uploaded to vendor management systems
  • Participated in and supported various projects, as requested.
  • Increased efficiency by streamlining data analysis processes and implementing automation tools.
  • Identified trends and patterns in large datasets, leading to actionable insights for business growth.

GRIEVANCE/APPEALS ANALYST

OPTUM SERVE VACCN (Contractor)
11.2020 - 05.2021
  • Responsible for providing expertise or general support to teams in reviewing, researching, investigating, and resolving all types of appeals and grievances
  • Worked with Payer contracts
  • Communicated with appropriate parties regarding appeals and grievance issues, implications, and decisions
  • Analyzed and identified trends for all appeals and grievances
  • Researched and resolved written Department of Insurance complaints and complex or multi-issue provider complaints submitted by physicians and providers
  • Made decisions whether to uphold or overturn an appeal
  • Worked with ICD 10 and CPT codes
  • Worked independently and within a team
  • Worked on other projects as requested.
  • Improved the efficiency of the appeals process by reviewing and analyzing claim denials and discrepancies.
  • Enhanced customer satisfaction with timely resolution of appeals, addressing concerns thoroughly and professionally.

KNOW YOUR CLIENT ANALYST(KYC)/TRANSACTION ANALYST

J.P. MORGAN CHASE(Contractor)
04.2020 - 07.2020
  • Carried out KYC due diligence reviews in a timely manner to high quality standards, as per the Banks policies
  • Reviewed, investigated, and understood organizational structure, accumulation, and domination methodologies to assist in determining ownership and control parties to identify all ultimate beneficiaries and potential Politically Exposed Persons
  • Performed and conducted full KYC reviews on all new client adoptions and/or periodic reviews of clients in accordance with relevant laws, regulations, and firm policies as appropriate
  • Investigated client data utilizing all available internal/external systems to develop a comprehensive analysis of who the client is and whether there are high risk factors
  • Provided guidance to front office staff for timely collection of client information/documentation to ensure compliance with all relevant Anti-Money Laundering (AML)/KYC regulations, policies, and risk management requirements
  • Coordinated and liaised with various departments Anti-Financial Crimes, Negative or Adverse News Screening, and Quality Control to ensure quality files are produced
  • Reviewed collateral functions including loan documentation preparation, loan closing process, documentation review, releases, image, scanning, and documentation storage
  • Responsible for minimizing credit and business risk through awareness of procedure, compliance, and bank policy
  • Adapted to internal tracking and monitoring systems effectively multi-task and prioritize workloads while working within tight service levels
  • Maintained high performance levels in stressful situations and high-volume environment
  • Monitored work queues
  • Resolved transaction exceptions or rejects Security Wire Transfer processing
  • Researched detailed requests from the line of business partners related to processed transactions
  • Developed and maintained internal client relationships with Middle Office and Originations teams
  • Working knowledge of trade bookings in Risk Management systems
  • Fulfillment of audit confirmation requests by clients and auditors in a timely manner within the firm's service level agreements
  • Provided first in class client services to internal and external clients
  • Regular liaison with Front Office regarding valuation or audit confirmations issues.
  • Enhanced client satisfaction by providing timely and accurate data analysis for informed decisionmaking.
  • Streamlined reporting processes for improved efficiency and reduced turnaround time on client requests.

EMPLOYER-PROVIDER INSTALLATION/SALES SUPPORT

AETNA(Contractor)
07.2018 - 01.2019
  • Manage overall administrative sales support process for new and existing business in all Health group insurance
  • Reviews incoming requests (in the group market space) Cultivate critical relationships both internal and external, field sales service, brokers, and group administrators
  • Audited the ERISA making sure it was signed by all parties and that the brokers had correct commissions
  • Coordinate and or complete case review of contractual requirements
  • Confirm and communicate sold case specifics to internal Aetna parties, consultant follow-up, match preliminary rates to final rates, ensure all requirement forms are received, updated in tracking system, follow up on missing requirements via telephone/email and move cases to shopping platform
  • Meet daily and monthly metrics with 98% quality and production metric
  • Demonstrate the ability to manage multiple priorities in a team environment
  • Utilize excellent communication skills, written, and verbal
  • General Business and applying reasoned judgment Work with underwriting
  • Collaborate with all applicable teams across the enterprise to onboard new clients and maintain existing clients by serving as communicator of implementation/migration information and convey to appropriate internal departments when applicable
  • Review all material as it pertains to onboarding new clients to ensure can be compliant and operationally and technically-sound when client is implemented / migrated
  • Participate in weekly internal and external meetings for client implementations
  • Review internal SOPs throughout the year to ensure no updates to process / procedures, etc
  • Resolve ServiceNow requests and ServiceNow Tasks / metrics are on track (maintain zero % overdue)
  • Client facing responsibilities
  • Other duties as assigned.
  • Enhanced client satisfaction by promptly addressing concerns and providing accurate information about provider installations.
  • Streamlined the provider installation process for improved efficiency and reduced errors.

Education

HIGH SCHOOL DIPLOMA -

PACE
JACKSONVILLE, FLORIDA
06.2003

Skills

  • Oracle
  • Peoplesoft 92
  • SQL
  • Accounting
  • FSCM
  • Microsoft Office
  • Microsoft Dynamics (GP)
  • EMR
  • I9
  • Concur
  • Loan IQ
  • Medical Terminology
  • Salesforce
  • Data Management
  • Pivot Tables
  • HCM
  • V Look up
  • EPIC
  • BILLING
  • Credentialing
  • Grievance & Appeals
  • ACBS
  • VLS
  • Workday
  • Payroll Processing
  • Onboarding
  • Auditing
  • CRM
  • Mainframe
  • Regulatory Compliance
  • Guardian
  • On Base
  • Human Resources
  • QNXT
  • Quality Assurance
  • Service Now
  • Ultipro- UKG
  • MCSW
  • Banking
  • Analytical Skills
  • Data Analysis
  • Risk Management
  • Know Your Client – KYC
  • Anti -Money Laundering- AML
  • Periodic Reviews
  • Due Diligence Reviews
  • Problem-solver Problem Resolution
  • Lexis Nexis
  • Excellent Interpersonal and Communication skills
  • Strong organizational skills
  • Attention to detail
  • Analytical abilities
  • Adherence to strict deadlines
  • Remains calm under pressure
  • Ability to work in a diverse work environment
  • Results-oriented
  • Strategic
  • Self-starter
  • Flexible
  • Transparent
  • Empathetic
  • Trustworthy
  • Take Initiative
  • Hard-working
  • Passionate
  • Competitive
  • Innovative
  • Adaptability
  • Ability to work independently and within a team

Timeline

Freelancer

1099 Contractor
02.2023 - Current

BILLING ANAYLST

UNITEDHEALTH GROUP/UMR
11.2022 - 01.2023

Associate Billing Specialist/HR Specialist

AMN HEALTHCARE (contractor)
12.2021 - 03.2022

CREDENTIALING ONBOARDING I9 ANALYST/HR COORDINATOR

AMN HEALTH (Contractor)
08.2021 - 12.2021

GRIEVANCE/APPEALS ANALYST

OPTUM SERVE VACCN (Contractor)
11.2020 - 05.2021

KNOW YOUR CLIENT ANALYST(KYC)/TRANSACTION ANALYST

J.P. MORGAN CHASE(Contractor)
04.2020 - 07.2020

EMPLOYER-PROVIDER INSTALLATION/SALES SUPPORT

AETNA(Contractor)
07.2018 - 01.2019

HIGH SCHOOL DIPLOMA -

PACE

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