SHANICE DUBOSE
Columbia
Summary
Highly skilled senior care coordinator with an unmatched customer service record and successful strategic development. Proven ability to lead teams, adapt to changing needs, and ensure seamless collaboration among healthcare providers. Develop strong working relationships with teams to boost performance and meet objectives. Recognized for exceptional leadership and results-driven approach.
Overview
14
14
years of professional experience
Work History
Senior Care Coordinator
Emcara Health
03.2019 - Current
- Revamped clinical operations standard process documents and job aides to maintain 100% compliance and participated in project management for care coordination
- Daily reporting of care coordination team performance statistics, by running and analyzing reports on activities and operations being carried out throughout the organization
- Planning and leading weekly team meetings
- Provide direct support for market campaigns and contracts and aiding support to care coordination director
- Analyze and dispersed reports for ineligible enrolled members by custom report building and development through Excel and Power BI
- Facilitated and developed training manuals and also conducted new hire training class for care coordinators
- Streamlined referral management and program enrollment for patient care and appointment scheduling
- Providing administrative support to clinical staff for patients with chronic care management program
Revenue Specialist
Enable Comp LLC
09.2022 - 06.2024
- Analyze, and evaluate as well, prepare correct VA claims either an initial bill packet or appeal letter to insurance companies to recoup payment for services rendered
- Increased revenue by identifying and resolving billing errors in a timely manner.
- Reached out to insurance companies to verify coverage.
- Maintained clear documentation of all activities related to unpaid claims or denied services.
- Successfully navigated complex insurance disputes, resulting in recovery of substantial amounts of previously denied claims.
Insurance Specialist
Verus Healthcare
07.2017 - 03.2019
- Verify patient's insurance eligibility and coverage, aided patients with general plan information, coverage, and benefits
- Request prior authorizations to multiple insurance providers for durable medical equipment for patients
- Followed up on denials, late payments, extensions and other special circumstances
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss
Healthcare Collector Specialist
Community Health Systems, CHS
09.2016 - 07.2017
- Placed 75 + or more outbound and received 50 inbound calls daily working with patients on their collection balances
- Processed Insurance payments performed daily maintenance for patient accounts and resolved billing inquiries
- Assessed delinquent accounts for possible collection actions
Customer Service Representative
Modis And Computer Science Corporation
12.2015 - 09.2016
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Answered high volume of calls per shift to meet fast-paced call center demands
- Documented and detailed calls and complaints using call center's CRM database
- Met customer call guidelines for service levels, handle time and productivity
Daycare Teacher
Knowledge Universe
05.2011 - 12.2015
- Promoted physical, academic and social development by implementing diverse classroom and outside activities
- Maintained well-controlled classrooms by clearly outlining standards and reinforcing positive behaviors
- Instructed children in health and personal habits, such as eating, resting and toileting
Education
Middle Tennessee State University
Murfreesboro, TNSkills
- Training and mentoring
- Team Building
- Staff Management
- Analyzing claims
- Customer Relations
- Claims investigation and research
- Referral Management
- Denial management
- Medical billing
Timeline
Revenue Specialist
Enable Comp LLC
09.2022 - 06.2024
Senior Care Coordinator
Emcara Health
03.2019 - Current
Insurance Specialist
Verus Healthcare
07.2017 - 03.2019
Healthcare Collector Specialist
Community Health Systems, CHS
09.2016 - 07.2017
Customer Service Representative
Modis And Computer Science Corporation
12.2015 - 09.2016
Daycare Teacher
Knowledge Universe
05.2011 - 12.2015
Middle Tennessee State University
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