Shavon Milton
Ensemble Health Partners
Norcross,GA
6
years of professional experience
Accomplished medical claims processor with 15+ years of experience, seeking to transition into a new role that offers more physical activity and shift options. Pursuing a career with a stable company that will maximize my current strengths, provide team engagement experiences, and the possibility of advancing to management.
Work History
Accounts Receivable Representative
1 Year 7 Months- Follow-up on denied hospital claims and make necessary corrections for receiving insurance payments.
- Maintain knowledgeable of Ohio State Medicaid policies for processing government medical claims.
- Utilized various payor portals to search, review and reprocess denied medicaid claims.
- Collaborated with team members to work special projects for timely completion.
Senior Processing Executive
1 Year 1 Month- Reconcile complex patient medical claim with insurance payers, ensuring reimbursement for hospital services.
- Demonstrate adaptability to work other projects when required by workload demands or staffing shortages.
- Maintain daily productions of reconciling 40-55 professional and or hospital claims per day.
- Participate in team meetings to discuss progress, challenges, and opportunities for improvements.
Accounts Receivable Specialist
2 Years 2 Months- Researched and resolved denied and complex medical claims.
- Draft appeals for non-covered services based on clinical documentation and policy guidelines.
- Processed 40-45 claims per day to meet daily production goals.
- Contributed to departmental goals by consistently meeting individual performance metrics related to speed, accuracy, and customer satisfaction scores.
Professional Cleaning Staff Associate
3 Years- Professionally cleaned 4-6 residential and, or commercial properties per day.
- Bending, lifting, climbing and continuous physical activity.
- Complied with health and safety standards while lifting and using chemicals.
- Professionally handled confidential and delicate items.
- Flexible and on-call availability.
Education
No Degree - Commuications
High School Diploma
Skills
Software (Epic Care
Availity
WayStar
Gammis
and multiple payor portals)
Commercial & government claims processing guidelines
Microsoft Office applications
Detail-oriented & Investigative
Self-motivated & highly productive
Expert residential cleaner
Environment
Health & Safety knowledge
Timeline
Accounts Receivable Representative
Ensemble Health Partners
03.2025 - CurrentRead More
Senior Processing Executive
Cognizant Technology Solutions, CTS
06.2024 - 07.2025Read More
Accounts Receivable Specialist
EyeSouth Partners
03.2022 - 05.2024Read More
Professional Cleaning Staff Associate
Dash Services LLC
01.2020 - 01.2023Read More
University of Michigan
No Degree from Commuications
Read More
Beecher High School
High School Diploma
Read More