Shuntea Scarbrough
Baton Rouge,LA
Summary
Highly motivated employee with a strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Skilled service-oriented Claims Adjuster with a creative approach to problem-solving. Proven track record in developing profitable and quality-focused processes. Deep knowledge of the medical claims industry and expertise in developing objectives and strategies to settle denial claims. Excellent skills in compiling, coding, categorizing, and auditing information for efficient claims processing.
Overview
3
3
years of professional experience
Work History
Oncology Claims Analyst 1
Our Lady of the Lake Regional Medical Center
11.2023 - Current
- Interacted with clients and employees, which helped cultivate positive working relationships.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Troubleshoots and resolves issues that impact revenue. Works collectively with FMOLHS denial management team to audit Medicare, Medicaid, and Insurance claims for accurate coding, charging, and modifier usage as requested by the FMOLHS
- Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial
Teacher
ParkView Bapitist Church
08.2023 - 11.2023
- Developed and implemented lesson plans based on curriculum objectives.
- Provided individualized instruction to meet the needs of all students.
- Maintained a safe and orderly learning environment for all students.
- Incorporated instructional best practices such as differentiated instruction into lesson plans.
Teacher
St. Patricks Episcopal Day School
09.2022 - 05.2023
- Provided individualized instruction to meet the needs of all students.
- Instructed students in academic subjects such as math, science, language arts, social studies, and history.
- Encouraged critical thinking skills and problem-solving strategies among students.
- Maintained a safe and orderly learning environment for all students.
Behavioral Health Technician
Baton Rouge General Hospital
11.2021 - 03.2022
- Observed patients' behaviors during recreational activities and outings.
- Encouraged positive interactions between other Behavioral Health Technicians and clients and patients.
- Documented behavioral incidents to keep accurate records.
- Documented patient behavior, interventions completed and patient response to interventions.
Education
High School Diploma -
Excelsior Christian Academy
07.2011
Skills
- Activity Monitoring
- Records Management
- Documentation Skills
- Behavior Management
- Claims analysis
- Dispute tracking
- Claims
- Skilled in Epic
- Claim Form Analysis
- Coverage Assessment
- Claims Processing
- File and Record Management
Timeline
Oncology Claims Analyst 1
Our Lady of the Lake Regional Medical Center
11.2023 - Current
Teacher
ParkView Bapitist Church
08.2023 - 11.2023
Teacher
St. Patricks Episcopal Day School
09.2022 - 05.2023
Behavioral Health Technician
Baton Rouge General Hospital
11.2021 - 03.2022
High School Diploma -
Excelsior Christian Academy
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