Valerie Shephard
Columbus,GA
Summary
Reliable professional bringing over 20 years of experience in healthcare environments. Maintains positive relationships with case managers and providers. Remains polished and calm under extreme stress.
Overview
17
17
years of professional experience
Work History
Utilization Management Representative
Elevance Health Anthem BCBS
12.2020 - Current
- Evaluate medical guidelines and benefit coverage to determine appropriateness of services.
- Perform prior authorization review of services requiring notification.
- Perform admission reviews based for medical necessity based upon specification.
- Obtain authorizations from multiple insurance carriers for various levels of care.
- Follow all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Quickly respond to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
- Manage incoming calls.
Center Assistant
Enrichment Services Program, Inc.
11.2016 - 12.2020
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
- Managed filing system, entered data and completed other clerical tasks.
- Managed paper and electronic filing systems by routing various documents, taking messages and managing incoming and outgoing mail.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
- Completed forms, reports, logs and records to quickly handle all documentation for human resources.
- Composed and proofread memos, letters and reports to verify error-free communication.
Caregiver
Gwendolyn Wilkes Rainbow Center
09.2011 - 11.2016
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Built strong relationships with clients to deliver emotional support and companionship.
- Transported individuals to events and activities, medical appointments and shopping trips.
- Monitored client vital signs, administered medications and tracked behaviors to keep healthcare supervisor well-informed.
- Entertained, conversed and read aloud to keep patients mentally alert.
Administrative Assistant
Atlanta Youth Academy
08.2004 - 07.2010
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Executed record filing system to improve document organization and management.
- Scheduled office meetings and client appointments for staff teams.
- Supported efficient meetings by organizing spaces and materials, documenting discussions and distributing meeting notes.
Education
Bachelor of Science - Healthcare Management
University of Phoenix
Tempe, AZ02.2020
Associate of Arts - Health Administration
University of Phoenix
Tempe, AZ06.2010
Skills
- Obtaining Authorizations
- Determine Medical Necessity
- Physician Consultations
- Emotional Support
- Procedures Compliance
- Utilization Management
- Client Relationships
- Claims Service
- Patient Admission
- Microsoft Office
- Creative Thinking
- Problem Resolution
Timeline
Utilization Management Representative
Elevance Health Anthem BCBS
12.2020 - Current
Center Assistant
Enrichment Services Program, Inc.
11.2016 - 12.2020
Caregiver
Gwendolyn Wilkes Rainbow Center
09.2011 - 11.2016
Administrative Assistant
Atlanta Youth Academy
08.2004 - 07.2010
Bachelor of Science - Healthcare Management
University of Phoenix
Associate of Arts - Health Administration
University of Phoenix
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