Shewanna L. Mason
Florence,USA
Summary
Dedicated professional with expertise in customer service, time management, and trend analysis. Proven ability to troubleshoot issues and implement effective solutions. Strong communicator with a track record of building positive relationships and consistently exceeding performance goals. Detail-oriented with a focus on evaluating processes and enhancing operational efficiency across all levels.
Overview
22
22
years of professional experience
Work History
Sr. Quality Assurance Analyst
Blue Cross Blue Shield of SC
Florence, SC
12.2024 - Current
- Conducted focused quality audits across various operations functions to identify errors.
- Provided management with feedback on detected errors and ensured resolution.
- Monitored and evaluated implementation of corrective action plans for effectiveness.
- Documented analysis findings and prepared recommendations for new systems or procedures.
- Developed and implemented a quality control program based on identified targets.
- Compiled data and generated reports on quality performance for operations and training areas.
- Created desk procedures and training materials to standardize departmental processes.
- Assisted with special projects, including testing for new business implementations or system changes.
Career Coach
EmployReward Solutions (ERS)
Florence, South Carolina
07.2021 - Current
- Maintained current databases of participant and program information in electronic records system.
- Guided participants through development of personalized career plans.
- Improved outcomes by encouraging clients to fully utilize available workshops and other resources.
- Reinforced use of skills learned in orientation activities through regular client meetings and ongoing coaching sessions.
- Identified short- and long-term goals and helped clients strategize ways to accomplish objectives.
- Research new employment opportunities and help clients strategize for a successful job interview.
- Perform various services to ensure client success (i.e., mock interviews, education assistance, and career counseling).
Claims Customer Service Advocate II/Appeals Specialist
Blue Cross Blue Shield of South Carolina
Florence, SC
02.2013 - 06.2021
- Providing customer service to medical providers and patients by identifying incorrectly processed claims by completing adjustments and other reprocessing actions.
- Respond to routine correspondence and telephone inquiries pertaining to claims or appeals.
- Performs non-medical reviews and process redetermination letters ensuring timeliness and accuracy.
- Prepares unit reports, analyzes and interprets workload, and processes issues utilizing various software tools.
- Update letters and documents within the department when necessary.
- Gather and prepare documentation for legal inquiries and administrative requests.
Correctional Clerk/Officer
Florence County Detention Center
Effingham, SC
09.2004 - 02.2013
- Responsible for intake and release process/fingerprinting/pat searching.
- Checking inmate files and conducting bond hearing as a court officer.
- Scheduling appointments for inmates for medical, court, and visitation.
- Ensuring inmates including juveniles are kept safe, fed, and that their basic needs were met while detained in the facility.
- Answering radios/PA systems/phones making sure all calls are redirected to the appropriate receiver.
- Controlling the Central Control panel doors for officers/inmates to enter/exit housing units/answering alarms/liaison to outside agencies/keeps record for all movement for facility.
Education
Diploma - Medical Billing And Coding
Ultimate Medical Academy
Tampa, FL01-2025
Bachelor of Science - Healthcare Management
SOUTH UNIVERSITY
SAVANNAH, GASkills
- Recordkeeping and case reporting
- Crisis intervention
- Individual and career counseling
- Coverage determination
- Team leadership and mentoring
- Quality audits
- Customer service and communication
- Time management
Timeline
Sr. Quality Assurance Analyst
Blue Cross Blue Shield of SC
12.2024 - Current
Career Coach
EmployReward Solutions (ERS)
07.2021 - Current
Claims Customer Service Advocate II/Appeals Specialist
Blue Cross Blue Shield of South Carolina
02.2013 - 06.2021
Correctional Clerk/Officer
Florence County Detention Center
09.2004 - 02.2013
Diploma - Medical Billing And Coding
Ultimate Medical Academy
Bachelor of Science - Healthcare Management
SOUTH UNIVERSITY