Shauneea Warden
Pittsburgh,PA
Summary
Background in employee relations. Dedicated to reinforcing company policies for handling performance and behavioral issues. Focused on facilitating diverse relationships and collaboration between employees, consumers and the community by effectively motivating and strengthen relationships at all levels. Research, dispute resolution and solution development by increasing understanding of legal requirements. Hands-on leader with strengths in program management, process improvement and data analytics.
Overview
9
9
years of professional experience
Work History
Client and Employee Coordinator
Jewish Family and Community Services (JFCS)
03.2019 - Current
- Interview and screen individuals applying for registry, orienting them to agency and state policies by assessing their appropriateness
- Resolved employee conflicts through techniques that fostered mutual understanding and cooperation among team members
- Assists consumers and employees with problem-solving and a variety of issues related to service (e.g scheduling, conflicts with employees, etc.)
- Has shared responsibility for after-hours pager for responding to urgent employee needs in the evening and on weekends
- Provided constructive feedback to employees through regular performance evaluations, leading to enhanced productivity levels.
- Enhanced employee satisfaction by implementing effective communication and feedback systems within state guidelines.
- Maintains necessary documentation for all consumers and employees.
- Ensures complete and accurate documentation by all staff and by maintaining electronic and paper records and enforcing HIPPA regulations in an organized fashion
- Assisted in the recruitment process by screening resumes, conducting interviews, and providing recommendations for hiring decisions.
- Maintains the monthly process of making and sending invoices to our consumers
- Reviews the registry's yearly policy, procedures and plan of correction to ensure compliance,
- Evaluate and submit the Pennsylvania Department of Health's state licensure yearly as well as working directly to ensure guidelines.
- Coordinated cross-functional projects involving multiple departments for increased efficiency and effectiveness within the organization as well as the community consumers
- Devised hiring and recruitment policies for 150-caregiver company.
Benefits Verification Specialist
CVS Caremark
01.2019 - 03.2019
- Understanding insurance carriers and concepts including drug cards, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs.
- Developed training materials for newly hired Benefits Verification Specialists, enhancing team productivity levels.
- Conducted regular performance evaluations for junior staff members, offering constructive feedback and opportunities for growth.
- Ensured timely reimbursements by proactively identifying potential issues that could delay claim processing and addressing them before submission.
- Established positive relationships with insurance carriers, streamlining communication channels when clarifying policy details or negotiating terms on behalf of clients.
- Streamlined workflow for benefit verification team by implementing comprehensive data tracking system.
Benefits Specialist
AmerisourceBergen Services Corp/ Lash Group
10.2017 - 01.2019
- Collects and reviews all patient Insurance information needed to complete benefit verification process
- Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
- Verify patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider option according to Program specific (Verification process could include electronic validation of pharmacy coverage and medical eligibility)
- Help launch new fusion drug database project for patients with Parkinson's disease by creating new patient accounts, entering patient demographic information, provider-site relationships, prescriptions, copay cards, welcome kits, pharmacy benefits coverage and doing thorough benefits verification investigation.
- Assisted in resolving complex benefits issues, leading to increased employee satisfaction and retention rates.
Patient Access and Information Coordinator
UPMC ST. Margaret
05.2015 - 01.2016
- Interview and pre-register patients at the time of or prior to the visit date
- Input patient information into the computer to initiate a medical record, coding, and billing
- Obtains and updates demographic, next-of-kin, and insurance information, including referrals/authorizations on all patients as needed and signature of patient or family member for consent to treatment and financial responsibility following the Health Insurance Portability and Accountability Act (HIPAA) rules and regulations
- Confirm/Verify insurance benefits with the appropriate carrier via on-line verification systems or telephone inquiries
- Collect and record patient payments at time of service
- Schedule patient appointments in accordance with UPMC and department-specific guidelines
- Appropriately distribute/triage phone calls to other areas and/or clinical providers
- Assist with administrative duties in the office including but not limited to scanning of medical records and faxing.
- Managed incoming inquiries, directing them to appropriate personnel for prompt resolution and increased customer satisfaction.
Education
Bachelor's Degree - Health Information Management
University Of Pittsburgh
Pittsburgh, PA04.2014
Associates Degree - Liberal Arts and Science
Community College of Allegheny County
West Mifflin, PA05.2012
High School Diploma -
West Mifflin Area High School
West Mifflin, PA06.2009
High School Diploma -
Steel Center Area Vocational Technical School
West Mifflin, PA05.2009
Skills
- Effective Time Management
- Performance improvement strategies
- Case analysis
- Workplace Safety
- Project coordination, scheduling and development
- Advanced problem solving
- Risk & Audit Management
- Staff Training and Development
- Compliance Monitoring and Auditing Processes
Additional Information
ADDITIONAL REFERENCES, PROJECTS SKILLS, AND JOB EXPERIENCES CAN BE PROVIDED UPON REQUEST
Timeline
Client and Employee Coordinator
Jewish Family and Community Services (JFCS)
03.2019 - Current
Benefits Verification Specialist
CVS Caremark
01.2019 - 03.2019
Benefits Specialist
AmerisourceBergen Services Corp/ Lash Group
10.2017 - 01.2019
Patient Access and Information Coordinator
UPMC ST. Margaret
05.2015 - 01.2016
Bachelor's Degree - Health Information Management
University Of Pittsburgh
Associates Degree - Liberal Arts and Science
Community College of Allegheny County
High School Diploma -
West Mifflin Area High School
High School Diploma -
Steel Center Area Vocational Technical School
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