Summary
Overview
Work History
Education
Skills
Languages
Work Availability
Timeline
Shantale Chery

Shantale Chery

Charlotte,NC
Be more concerned with your character than your reputation, because your character is what you really are, while your reputation is merely what others think you are.
John R. Wooden

Summary

Hardworking Account Coordinator willing to lend a hand at any time and complete tasks with enthusiasm. Engaging and personable with the ability to improve quality control and provide dedicated service to clients. Well-organized Administrative professional bringing excellent multitasking abilities developed over 29 years of customer service experience. Commended for consistently driving team success with knowledgeable enforcement of company procedures and skillful personnel training. Proficient in SalesForce with expertise in database management.

Self-motivated Senior Customer Service Associate and Account Management bringing proven leadership, organizational and customer relations skills. Independently solved problems and kept teams on task to handle diverse business requirements.

Thorough and steadfast Office Worker with top-notch administrative skills and solid background in healthcare and insurance. Surpass business targets while satisfying diverse customer demands. Independently handle clerical tasks like routing correspondence and coordinating travel arrangements to keep business operations smooth and efficient.

Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.

Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Hardworking and passionate job seeker with strong organizational skills eager to secure a position, and ready to help team achieve company goals.

Overview

30
30
years of professional experience

Work History

Senior Claims Adjuster

United Healthcare Group
04.2022 - Current
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Generated, posted and attached information to claim files.
  • Verified client information by analyzing existing evidence on file.
  • Processed 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.

Patient Access Specialist

LI Community Hospital/NYU Langone
11.2022 - 06.2023
  • Collected and validated patient demographics and insurance information.
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Obtained signatures from financial responsibility and treatment procedures from patients or guardians.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
  • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.

Tracer

NYC Health & Hospitals Corps
05.2020 - 04.2022
  • 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
  • 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-day-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

Senior Office Coordinator

Suffolk County Medical Society
09.2018 - 07.2020
  • Managed data transfers and proactively resolved issuesat manufacturing sites through effectivetroubleshooting
  • Communicated all capacity, and technology gaps withupper management
  • Organized team workload and prioritized tasks tostreamline office functions in deadline-drivenenvironment
  • Trained new employees on administrative procedures,company policies and performance standards
  • Reported on daily office activities to help managersstay on top of dynamic conditions and make proactivedecisions
  • Oversaw accurate and efficient database managementand digital file storage to support operational andrecord-keeper requirements
  • Routed correspondence to facilitate timelycommunication between team members, customers andvendors
  • Interacted with customers professionally by phone,email or in-person to provide information and directedto desired staff members
  • Delivered expert clerical support by efficiently handlingwide range of routine and special requirements
  • Worked collaboratively with office staff to maintainsmooth operations and team readiness for unexpecteddemands
  • Cultivated client and vendor loyalty by proactivelyreaching out with follow- ups and status updates
  • Kept physical files and digitized records organized foreasy updating and retrieval by authorized teammembers
  • Efficiently supervised diverse office functions, includingfiling, sorting and handling incoming and outgoing mail
  • Increased team productivity by reorganizing officesupplies and protocols
  • Organized company meetings and scheduling for8-employee team.

Account Service Coordinator

Empire BlueCross BlueShield
10.2010 - 09.2018
  • Served as liaison between management, clinical staff and community
  • Expertly planned, coordinated, organized and directed all agency operations
  • Directed installation for improved work methods and procedures to achieve agency objectives
  • Corresponded with operations staff to ensure key client deliverables and revenue goals were met
  • Observed strict confidentiality and safeguarded all patient-related information
  • Made reasonable procedure exceptions to accommodate unusual customer requests
  • 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
  • Researched options and recommended services to address clients' needs
  • Educated clients on relevant policies and options and answered questions to remedy issues
  • Listened to clients and assisted with navigation of complex systems involved in website transactions
  • Maintained up-to-date knowledge of product and service changes
  • Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences

Senior Customer Service Associate

BlueCross BlueShield
01.2001 - 10.2010
  • Worked with upper management to ensure appropriate changes were made to improve customer satisfaction
  • Respond 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 time- frame
  • 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
  • Provided cross training to [number] staff members
  • Trained staff on how to improve customer interactions
  • Developed process improvements to enhance efficiency and effectiveness of inter- department call center operations
  • Led a team of customer service representatives to increase service center profitability
  • Facilitated information flow between customer service, account management operations, quality assurance, training and payroll departments to guarantee call center objectives were met
  • Properly directed inbound calls in phone queues to improve call flow
  • Worked under strict deadlines and responded to service requests and emergency call-outs.

Customer Service Representative

Chemical Bank
06.1994 - 09.1996
  • Handled over 110 calls a day with inquiries from customers in regards to their credit cards
  • Trained representatives on retention skills and credit card enhancement programs
  • Provided accurate and appropriate information in response to customer inquiries
  • Addressed customer service inquiries in a timely and accurate fashion
  • 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
  • Built customer loyalty by placing follow-up calls for

Education

Master of Science - Healthcare Administration

Walden University, Minneapolis, MN
05.2013

Health Administrators use strong management and organizational skills to oversee the administrative tasks of a healthcare facility. Health Administrators will typically have the following responsibilities:

  • Evaluate the budget and create reports with recommendations to cut costs
  • Schedule employees based on patient needs
  • Oversee the organization of all patient records
  • Stay up to date on healthcare laws and regulations
  • Offer recommendations to decision-makers on ways to improve the efficiency of the office
  • Develop a solid foundation in the core disciplines of health care administration and management.

Master of Science - Social Welfare

SUNY-Stony Brook University, Stony Brook, NY
05.2005

Master of Social Work program is designed to prepare students to gain the knowledge and skills to apply social work principles, values and ethics when helping individuals, families and communities overcome various social and behavioral health issues. By earning a Master of Social Work, one can position themselves for possible career advancement within the helping profession and continue a professional path of reward and purpose. Social workers become more than professionals and practitioners. They become advocates who fight alongside those who are struggling and help them live a more fulfilling life.

Bachelor of Arts - Psychology

SUNY College At Old Westbury, Old Westbury, NY
05.1993

Skills

  • Claim Form Analysis
  • Policy Investigations
  • Complex Coverage Issues
  • Complex Cases
  • Claims Procedures
  • Team Support
  • Verifying Eligibility
  • Electronic Health Records Systems
  • Effective Prioritization
  • Microsoft Word
  • Excellent Writing Skills
  • Insurance Policy Coverage Knowledge
  • Team Leadership
  • Insurance Information Collection
  • Call Center Operations
  • Eligibility Determinations
  • Inbound and Outbound Calling
  • Inter-Departmental Collaboration
  • Client Resolution
  • Critical Thinking
  • Patient Registration
  • Registration Processing
  • Registration Paperwork
  • Payment Processing
  • Operational Requirements
  • Patient Health Information Access
  • Insurance Verification
  • Patient Interviews
  • EHR Software
  • Administrative Support
  • Call Center Customer Service
  • Office Coordination
  • Medicare Regulation
  • Resolving Customer Issues
  • Answering Customer Questions
  • Customer Inquiries
  • Verifying Orders
  • Problem Resolution
  • Microsoft Office
  • High-Volume Environments
  • Managing Prescription Refills
  • HIPAA Regulations
  • Teamwork and Collaboration
  • Managing Customer Complaints
  • Customer Account Management
  • Key Performance Indicators (KPIs)
  • Special Assignments
  • Team Productivity
  • Motivational Leadership
  • Workforce Management
  • New Hire Training
  • Customer Relations
  • Information Updates
  • Goal Attainment
  • Team Meetings
  • Staff Training

Languages

French
Native or Bilingual
Haitian Creole
Professional Working

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Patient Access Specialist - LI Community Hospital/NYU Langone
11.2022 - 06.2023
Senior Claims Adjuster - United Healthcare Group
04.2022 - Current
Tracer - NYC Health & Hospitals Corps
05.2020 - 04.2022
Senior Office Coordinator - Suffolk County Medical Society
09.2018 - 07.2020
Account Service Coordinator - Empire BlueCross BlueShield
10.2010 - 09.2018
Senior Customer Service Associate - BlueCross BlueShield
01.2001 - 10.2010
Customer Service Representative - Chemical Bank
06.1994 - 09.1996
Walden University - Master of Science, Healthcare Administration
SUNY-Stony Brook University - Master of Science, Social Welfare
SUNY College At Old Westbury - Bachelor of Arts, Psychology

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Shantale Chery