Summary
Overview
Work History
Education
Skills
Timeline
Generic

Shaterica Grant

Miami,FL

Summary

Highly skilled Health Services Administrator with broad experience in healthcare management. Proven ability to improve operational efficiency, enhance patient care quality, and streamline workflow processes. Strengths include strategic planning, team leadership, and regulatory compliance. Previous work demonstrates impact through implementation of innovative healthcare solutions that led to improved overall performance metrics.

Overview

6
6
years of professional experience

Work History

Provider Engagement Coordinator

Elite Health
North Miami
06.2023 - 06.2024
  • Analyzed HEDIS reports from health plans to identify gaps in care and compliance
  • Responsible for contacting patients post hospitalization to ensure compliance with timely physician follow up appointments
  • Communicated with local pharmacies requesting medication refills for patient’s to stay compliant with their health plan medication adherence
  • Make outbound calls to patients to inform them of medication that needs to be picked up
  • Responsible for coordinating and overseeing Diabetic Eye Exam and Breast Cancer Screening events
  • For the medical office to help ensure patients yearly screenings were completed and gaps were closed.

Medical Records Administrator

01.2022 - 05.2023
  • Assisted in preparation and coordination of collected medical records by providers/ hospitals for annual/ ongoing HEDIS review
  • Schedule and coordinate virtual appointments for Chart Review based on office location, appointment time and volume of charts
  • Electronically download retrieved charts to laptop or to secure data storage devices.

United Healthcare Provider Service Advocate
11.2018 - 06.2020
  • Answered incoming phone calls from health care providers such as physician offices and clinics
  • Identified type of assistance needed such as benefit and eligibility, billing and payments, authorizations for treatment, and explanation of benefits, etc
  • Remained diligent on resolving issues providers might have encountered with claims
  • Reviewed claims in system to ensure the CPT coding and ICD 10 were accurate for prompt payment and approval
  • Completed the documentation necessary to track provider issues and facilitate the reporting of overall trends
  • Researched claims that were denied ensuring codes were correct/ Reviewed doctors’ notes when needed to resubmit claim for payment.

Education

Bachelors of Health Services - Administration

Florida International University
Miami, FL

Associate of Arts - Dietetics

Miami Dade College
Miami, FL

Skills

  • Microsoft Word, Excel, PowerPoint, and Outlook
  • Patient Safety
  • Regulatory knowledge
  • Organizational Development
  • Decision-Making
  • Critical Thinking
  • Medical Condition Coding Software
  • Excellent Communication
  • Active Listening
  • Teamwork and Collaboration
  • Self Motivation
  • Nutrition Research
  • Patient Education
  • HEDIS and STARS performance
  • HIPAA Compliance

Timeline

Provider Engagement Coordinator

Elite Health
06.2023 - 06.2024

Medical Records Administrator

01.2022 - 05.2023

United Healthcare Provider Service Advocate
11.2018 - 06.2020

Bachelors of Health Services - Administration

Florida International University

Associate of Arts - Dietetics

Miami Dade College

Similar Profiles

CREATE PROFILE
Shaterica Grant