SHEE CHEATHAM
Woodbury
Summary
Proven expertise in insurance verification and prior authorization, with a forte in multitasking and maintaining patient confidentiality. Exceptional organizational acumen and data entry precision underpin a track record of enhancing workflow efficiency. Hardworking, highly motivated professional eager to lend combined knowledge and skills to enhance business performance. Operates well in both individual and team capacities, leveraging seasoned work ethic to quickly adapt to different processes and drive company objectives. Resourceful and results-driven with a passion for growth and efficiency to meet company needs and increase service value.
Overview
27
27
years of professional experience
Work History
Insurance Coordinator
Weisman Children's Rehab Hospital
03.2025 - Current
- Coordinated patient insurance verification processes to ensure timely approvals and minimize delays.
- Verified insurance and communicated coverage to staff and patients.
- Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.
- Obtained prior authorization and precertification for outpatient procedures.
- Reduced errors in policy documentation, meticulously reviewing and updating insurance records.
- Coordinated insurance verification processes, ensuring accurate coverage information for patient accounts.
Referral/Prior Authorization Specialist
AdvoCare
09.2023 - 02.2024
- Initiated contact with insurance companies when additional information is needed for prior authorization requests.
- Maintained up-to-date knowledge of insurance policies and procedures related to prior authorization requirements.
- Managed incoming calls from providers regarding status updates of pending authorizations.
- Evaluated patient's benefits eligibility using various databases and tools such as web portals, claims system.
- Demonstrated strong organizational skills by managing multiple tasks simultaneously while ensuring accuracy and quality of work.
- Verified patient demographics against submitted documentation prior authorization submission process.
Prior Authorization Specialist
Summit Health
09.2021 - 02.2023
- Obtaining Authorizations for patients in a timely manner
- Performed data entry accurately into computer systems while adhering to established deadlines.
- Communicated with others to obtain and verify eligibility information.
- Verified patient demographics against submitted documentation prior authorization submission process.
- Initiated contact with insurance companies when additional information is needed for prior authorization requests.
- Navigated through computer screens to complete and review documents and other forms.
Insurance Verification Specialist
Penn Medicine Pennsylvania Hospital
07.2018 - 04.2020
- Processes and completes the verbal verification of payment and ensures pre-certification requirements are met
- Ensured timely insurance verification for all scheduled appointments, preventing delays in treatment plans.
- Expedited insurance verification processes, ensuring prompt authorizations for necessary medical treatments or procedures.
- Assisted patients with insurance verification and billing inquiries, ensuring accurate processing and timely resolution.
- Expedited insurance verification processes by obtaining necessary information from patients, providers, and insurers.
- Reduced claim denials, ensuring accuracy in insurance verification and pre-authorization processes.
- Handled insurance verification tasks accurately and quickly, preventing delays in treatment authorization or billing issues later on.
Prior Authorization Specialist
Inspira Health
01.2017 - 07.2018
- Maintained up-to-date knowledge of insurance procedures related to prior authorization requirements
- Verified insurance information for patient admissions, ensuring compliance with hospital policies.
- Verified Insurance eligibility weekly also monthly
- Submitted reconsideration for Insurance denials
- Organized and set up peer to peers for Physicians
Prior Authorization Specialist
Cooper University Hospital
01.2014 - 03.2018
- Schedule patient appointments for Internal & Family Medicine, Cardiology, Pulmonary
- Verified insurance coverage and benefits for patient treatments
- Reduced claim denials by thoroughly reviewing patient eligibility and coverage details.
- Processed insurance verifications to ensure accurate patient coverage.
- Performed various administrative tasks by filing, copying and faxing documents.
Benefits Customer Service Specialist
Verizon, Xerox Corporation /HR Solutions, Inc
09.2012 - 11.2013
- Performed administrative duties such as data entry, order processing, billing inquiries, account maintenance.
- Streamlined processes to improve efficiency during peak times of open enrollment season.
- Assisted employees in navigating the online enrollment platform.
- Processed enrollments in a timely manner according to established deadlines.
- Reviewed insurance policy to determine coverage.
Customer Service Representative
French& Kline
01.2005 - 05.2007
- Opened new loan accounts for customers
- Verified customers employment history
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Documented and detailed calls and complaints using call center's CRM/software
- Maintained a thorough knowledge of products and services to provide accurate information to customers.
Customer Service Rep
Comcast Cable Communications
07.2001 - 08.2004
- Answered inbound calls for high volume call center
- Resolved customer inquiries efficiently, enhancing overall satisfaction and loyalty.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Investigated and resolved customer inquiries and complaints quickly.
- Delivered prompt service to prioritize customer needs.
- Identified and resolved discrepancies and errors in customer accounts.
Banking Associate
TD Bank
11.1998 - 12.2001
- Greeted customers upon arrival
- Assisted customers with opening new accounts while verifying their identity
- Performed account reconciliations and processed transactions accurately within established timeframes.
- Provided excellent customer service by responding to inquiries, resolving complaints, and educating clients on banking products and services.
Education
Certified Medical Assistant - Medical Assistant
Harris School of Business
Voorhees, NJ06-2015
Skills
- Scheduling management
- Coordinating patient referrals
- Knowledge of clinical terminology
- Efficient data input
- Insurance validation
- CPT coding expertise
- Confidentiality regulation compliance
- ICD-10 coding knowledge
- Effective multitasking
- Effective time allocation
- Prior authorization oversight
- Effective organizational skills
Timeline
Insurance Coordinator
Weisman Children's Rehab Hospital
03.2025 - Current
Referral/Prior Authorization Specialist
AdvoCare
09.2023 - 02.2024
Prior Authorization Specialist
Summit Health
09.2021 - 02.2023
Insurance Verification Specialist
Penn Medicine Pennsylvania Hospital
07.2018 - 04.2020
Prior Authorization Specialist
Inspira Health
01.2017 - 07.2018
Prior Authorization Specialist
Cooper University Hospital
01.2014 - 03.2018
Benefits Customer Service Specialist
Verizon, Xerox Corporation /HR Solutions, Inc
09.2012 - 11.2013
Customer Service Representative
French& Kline
01.2005 - 05.2007
Customer Service Rep
Comcast Cable Communications
07.2001 - 08.2004
Banking Associate
TD Bank
11.1998 - 12.2001
Certified Medical Assistant - Medical Assistant
Harris School of Business
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