Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Shantale Chery

Hauppauge,NY

Summary

Motivated professional with a strong work ethic, eager to contribute knowledge and skills to drive business performance. Strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm. Strong analytical, communication, and teamwork skills, proven ability to quickly adapt to new environments. Eager to continue contributing to team success and further develop professional skills. Positive attitude and commitment to continuous learning and growth, ready to make a meaningful impact.

Overview

31
31
years of professional experience

Work History

Senior Claims Service Processor & Adjuster

United Healthcare
04.2022 - Current
  • Maintained strong knowledge of basic medical terminology to better understand services and, posted and attached information to claim files
  • Verified client information by analyzing existing evidence on and recorded new policies and claims
  • Maintained confidentiality of patient finances, records and health statuses
  • Prepared insurance claim forms or related documents and reviewed for completeness
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt
  • Modified, updated and processed existing policies
  • Reviewed outstanding requests and redirected workloads to complete projects on time
  • Managed large volume of medical claims on daily basis
  • Managed high-volume service requests, maintaining accuracy and timely completion of tasks.
  • Utilized strong organizational skills while managing multiple projects simultaneously, ensuring successful completion within established deadlines.
  • Consistently met or exceeded performance goals set by management, reflecting a commitment to excellence in the Service Processor role.

Patient Access Representative

LI Community Hospital
11.2022 - 06.2023
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record
  • Performed patient scheduling and registration functions to serve as initial contact point for medical office visits
  • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered
  • Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks
  • Identified insurance payment sources and listed payers in proper sequence to establish chain of payment
  • Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services
  • Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance
  • Resolved patient financial problems with guidance from documented guidelines and procedures
  • Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance-related instructions
  • Facilitated communication between patients and various departments and staff
  • Applied administrative knowledge and courtesy to explain procedures and services to patients
  • Recommended service improvements to minimize recurring patient issues and complaints
  • Kept current with literature and field advancements to advocate to and for patients

Supervisor

NYC Health & Hospitals Corps
05.2020 - 04.2022
  • Created new patient charts to include personal and insurance information and reason for visit
  • Comforted patients by anticipating anxieties and thoroughly answering patient questions
  • Reviewed charts for accuracy and completeness prior to patient visits
  • Preserved patient accounts by obtaining and updating personal and financial information
  • Obtained signatures for financial responsibility and treatment procedures from patients or guardians
  • Provided excellent customer service to patients and their families
  • Protected patients' rights by maintaining confidentiality of personal and financial information
  • Registered patients by obtaining necessary and accurate financial and demographic information
  • Conflict resolution
  • Team leadership
  • Kept operations responsive and agile with proactive troubleshooting and problem-solving of routine and complex concerns
  • Expedited investigations, action plans and schedules for Covid-19 cases

Senior Office Manager

Suffolk County Medical Society
09.2018 - 07.2020
  • Assisted senior leadership in managing all aspects of operations
  • Identified best-known address to locate client's collateral or customer
  • Proactively monitored accounts and addressed various issues
  • Searched computer databases, credit reports, public records or other resources to locate persons or to compile information for investigations
  • Uploaded all evidence into case management system each day
  • Carried out day-to-day duties accurately and efficiently
  • Worked flexible hours, night, weekend, and holiday shifts
  • Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment
  • Notified and interviewed individuals to ascertain novel coronavirus exposure level
  • Communicated with documented COVID-19 patients and other exposed persons via phone call, text, e-mail and other platforms
  • Lent daily assessment of health screen and symptom data
  • Investigated and identified confirmed and suspected coronavirus cases, also documenting potentially affected contacts
  • Used coordination and planning skills to achieve results according to schedule
  • Improved operations through consistent hard work and dedication
  • Coordinated Information projects, defined scope and managed milestones
  • Communicated all capacity, and technology gaps with upper management
  • Organized team workload and prioritized tasks to streamline office functions in deadline-driven environment
  • Trained new employees in administrative procedures, company policies and performance standards
  • Reported on daily office activities to help managers stay on top of dynamic conditions and make proactive decisions
  • Oversaw accurate and efficient database management and digital file storage to support operational and record-keeper requirements
  • Routed correspondence to facilitate timely communication between team members, customers and vendors
  • Interacted with customers professionally by phone, email or in-person to provide information and directed to desired staff members
  • Delivered expert clerical support by efficiently handling wide range of routine and administrative tasks

Account Service Coordinator

Empire BlueCross BlueShield
10.2010 - 09.2018
  • Worked collaboratively with office staff to maintain smooth operations and team readiness for unexpected demands
  • Cultivated client and vendor loyalty by proactively reaching out with follow-ups and status updates
  • Kept physical files and digitized records organized for easy updating and retrieval by authorized team members
  • Efficiently supervised diverse office functions, including filing, sorting and handling incoming and outgoing mail
  • Increased team productivity by reorganizing office supplies and protocols
  • Organized company meetings and scheduling for 8-employee team
  • Implemented project management techniques to overcome obstacles and increase team productivity
  • Updated reports, managed accounts and generated reports for company database
  • Maintained computer and physical filing systems
  • Coordinated special projects and managed schedules
  • Developed standard operating procedures for all administrative employees
  • Coached new hires on company processes while managing employees to achieve maximum production
  • Sourced vendors for special project needs and negotiated contracts
  • Prepared meeting rooms and materials and recorded important information
  • Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving
  • Managed office operations while scheduling appointments for department managers
  • Communicated corporate objectives to various divisions to meet deadlines and adhere to company budgets
  • Evaluated employee records and productivity and submitted evaluation reports
  • Researched options and recommended services to address clients' needs
  • Educated clients on relevant policies and options and answered questions to remedy issues
  • Followed up with customers about resolved issues to maintain high standards of customer service

Customer Service Supervisor

Empire Blue Cross Blue Shield
01.2001 - 10.2010
  • Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences
  • Balanced up to 120 accounts simultaneously, maintaining regular contact and professional relationships with each
  • Promptly responded to inquiries and requests from prospective customers
  • Worked with upper management to ensure appropriate changes were made to improve customer satisfaction
  • Responded to small and large group inquiries as it relates to health benefits
  • Provided accurate and appropriate information in response to customer inquiries
  • Collected customer feedback and made process changes to exceed customer satisfaction goals
  • Demonstrated mastery of customer service call script within specified timeframe
  • Maintained up-to-date records at all times
  • Ran reports and supplied data to fulfill customer report requirements
  • Formulated and enforced Service Center policies, procedures and quality assurance measures
  • Trained staff on how to improve customer interactions
  • Developed process improvements to enhance efficiency and effectiveness of inter-department call center operations
  • Facilitated information flow between customer service, account management operations, quality assurance, training and payroll departments to guarantee call center objectives were met
  • Worked under strict deadlines and responded to service requests and emergency call-outs
  • Established and updated work schedules to account for changing staff levels and expected workloads
  • Actively supported service associates by quickly responding to questions via phone and email and finding appropriate solutions to customer issues
  • Set priorities and problem-solved workflow issues to maintain rapport with customers and managers
  • Created customer support strategies to increase customer retention
  • Conducted training and mentored team members to promote productivity and commitment to friendly service
  • Standardized office structures and processes to promote collaboration and increased performance
  • Coached team members to deliver hospitable, professional service while adhering to set service models
  • Resolved account issues to build rapport and relationships with clients
  • Monitored metrics and developed actionable insights to improve efficiency and performance
  • Assisted with preparing information required for quotes and addressed potential service concerns
  • Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff
  • Delegated tasks to administrative support staff to organize and improve office efficiency
  • Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills
  • Coordinated individual duties after careful evaluation of each employee's skill level and knowledge
  • Resolved issues through active listening and open-ended questioning, escalating major problems to upper management
  • Recruited, hired, trained and supervised staff of 5 and implemented mentoring program that offered positive employee engagement
  • Established and updated work schedules to account for changing staff levels and expected workloads
  • Set priorities and problem-solved workflow issues to maintain rapport with customers and managers
  • Researched and corrected customer concerns to promote company loyalty
  • Coached team members to deliver hospitable, professional service while adhering to set service models
  • Conducted training and mentored team members to promote productivity and commitment to friendly service
  • Exceeded team goals and collaborated with staff members to implement customer service initiatives
  • Trained representatives on retention skills and credit card enhancement programs
  • Provided accurate and appropriate information in response to customer inquiries
  • Addressed customer service inquiries accurately and timely
  • Developed effective relationships with all call center departments through clear communication
  • Worked with upper management to ensure appropriate changes were made to improve customer satisfaction
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
  • Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions
  • Clarified customer issues and determined root cause of problems to resolve product or service complaints
  • Answered customer telephone calls promptly to avoid on-hold wait times
  • Handled over 100 calls per shift signing up new customers, retrieving customer data, presenting relevant product information and cancelling services
  • Implemented and developed customer service training processes
  • Coached employees through day-to-day work and complex problems
  • Actively supported service associates by quickly responding to questions via phone and email and finding appropriate solutions to customer issues
  • Responded to customer inquiries and resolved complaints to establish trust and increase satisfaction
  • Developed and maintained strong relationships with customers to maintain loyalty and satisfaction

Customer Service Representative

Chemical Bank
06.1994 - 09.1996
  • Provided accurate and appropriate information in response to customer inquiries
  • Addressed customer service inquiries timely and accurately
  • Developed effective relationships with all call center departments through clear communication
  • Worked with upper management to ensure appropriate changes were made to improve customer satisfaction
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
  • Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions
  • Clarified customer issues and determined root cause of problems to resolve product or service complaints
  • Answered customer telephone calls promptly to avoid on-hold wait times
  • Handled over 100 calls per shift signing up new customers, retrieving customer data, presenting relevant product information and cancelling services
  • Implemented and developed customer service training processes

Education

Master Of Science - Healthcare Administration

Walden University
05.2013

Master Of Science - Social Welfare

SUNY-Stony Brook University
05.2005

Bachelor Of Arts - Psychology

SUNY College at Old Westbury
05.1993

Skills

  • Effective team collaboration
  • Effective time management
  • Proficient in insurance claims processing
  • Compassionate interpersonal communication
  • Experienced with Microsoft Office tools
  • Expert problem analysis
  • Understanding of compliance standards
  • Multitasking and organization

Languages

French
Native or Bilingual

Timeline

Patient Access Representative

LI Community Hospital
11.2022 - 06.2023

Senior Claims Service Processor & Adjuster

United Healthcare
04.2022 - Current

Supervisor

NYC Health & Hospitals Corps
05.2020 - 04.2022

Senior Office Manager

Suffolk County Medical Society
09.2018 - 07.2020

Account Service Coordinator

Empire BlueCross BlueShield
10.2010 - 09.2018

Customer Service Supervisor

Empire Blue Cross Blue Shield
01.2001 - 10.2010

Customer Service Representative

Chemical Bank
06.1994 - 09.1996

Master Of Science - Social Welfare

SUNY-Stony Brook University

Bachelor Of Arts - Psychology

SUNY College at Old Westbury

Master Of Science - Healthcare Administration

Walden University

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Shantale Chery