Shuntina Manuel
Greer,SC
Summary
Professional with background in customer service and administrative support. Proven ability to manage high-volume calls and resolve issues efficiently. Known for strong collaboration skills and focus on achieving results in dynamic environments. Dependable and adaptable to changing needs, with excellent communication and problem-solving abilities.
Overview
9
9
years of professional experience
Work History
Inbound Contact Representative 2
Humana, Work at Home
09.2023 - 11.2025
- The Inbound Contacts Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating members. Records details of inquiries, comments or complaints, transactions or interactions and takes action in accordance to it. Escalates unresolved and pending customer grievances. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
- Managed inbound customer inquiries, providing accurate information and resolving issues efficiently.
- Utilized CRM software to track interactions and ensure timely follow-up with clients.
Consumer Operations Supervisor
Humana, Work at Home
01.2021 - 09.2023
- Lead and support a team of member-facing associates who are focused on transforming the healthcare experience for our members; these associates will often report to other leaders and leadership through influence is required to be successful. Help associates navigate their onboarding and continued learning in the healthcare and customer service space. Provide an open, and supportive environment for associates. Develop relationships with you direct team as well as the clinicians within the care team and their leads to ensure a cohesive care team experience for our members. Communicate as needed with members’ medical providers and community resources. Collaborate with your team to support member inquiries through chat, email, and voice.
Consumer Service Operations 3
Humana, Work at Home
07.2020 - 01.2021
- The Consumer Service Operations Representative 3 may perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. Investigates and settles claims and customer service issues. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.
Physicians Billing Customer Service Rep
Prisma Health
Greenville, SC
01.2020 - 07.2020
- Provides accurate and timely submission of claims for Prisma Health to various payer sources based on timely filing guidelines. Ensures specialty accounts are followed up on in a timely manner with increased focus on aged and high dollar accounts. Follows up and pursues identified payer variances after comparing expected to actual reimbursement received. Responsible for working with other departments when issues arise such as missing payments, payer delays, and technical denials. Ensures payment amount(s) from insurance carriers are correct and posted to accounts. Reviews accounts after payment posting to determine if balance needs moved to secondary payer or patient liability. Knowledge of payers and provides support to other team members as needed. Demonstrates exceptional relationships with external payers and internal departments in accordance with Prisma Health Standards of Behavior and Compliance.
PBO Insurance Collector
Prisma Health
Greenville, SC
04.2019 - 01.2020
- Insurance Collectors are responsible for managing and recovering outstanding payments from insurance companies or clients. They ensure accurate billing, follow up on claims, and resolve discrepancies to secure timely payments. Junior roles focus on basic claim follow-ups and data entry, while senior and managerial roles involve overseeing collection strategies, handling complex cases, and leading teams.
Patient Service Representative
Heart to Heart Health Care
Greensboro, NC
10.2016 - 04.2019
- Work in the company as a liaison between the patients and healthcare providers. Greeting and checking in patients upon arrival, answering patient inquiries, either in person or over the phone, Scheduling and rescheduling patient appointments, Processing patient admissions and discharges, Collecting and verifying patient insurance information and handling billing, Coordinate with healthcare professionals to ensure seamless patient care, maintaining patient records accurately and ensuring patient confidentiality, Providing necessary assistance and information to patients regarding medical procedures, Handling patient complaints and concerns, ensuring patient satisfaction, Performing general administrative tasks such as filing, photocopying, and faxing documents.
Education
No Degree - Communications
Barber Scotia College
Concord, NC12-1995
High School Diploma - undefined
James B. Dudley High School
Greensboro, NC06-1993
Skills
- Customer Care
- Customer Service
- EPIC
- Medical Records
- Office Experience
- Medical Billing
- Communication Skills
- Leadership
- ICD-10
- Front Desk
- Medicare
- Goal oriented
- Empathy and patience
- Data entry proficiency
LANGUAGES
English
Highly proficient
Timeline
Inbound Contact Representative 2
Humana, Work at Home
09.2023 - 11.2025
Consumer Operations Supervisor
Humana, Work at Home
01.2021 - 09.2023
Consumer Service Operations 3
Humana, Work at Home
07.2020 - 01.2021
Physicians Billing Customer Service Rep
Prisma Health
01.2020 - 07.2020
PBO Insurance Collector
Prisma Health
04.2019 - 01.2020
Patient Service Representative
Heart to Heart Health Care
10.2016 - 04.2019
High School Diploma - undefined
James B. Dudley High School
No Degree - Communications
Barber Scotia College