Shantra R Phillips

**** ********** **** *******, ** 37115 615-***-**** acqhrl@r.postjobfree.com

Professional Experience: (Contract Only)

May 2015 - June 2015 Randstad/Cigna Healthspring

Accounting Senior Assistant (A/P Only)

Audits and reviews the files of contracted agents and agencies to ensure that all regulatory and compliance requirements have been met and evidence is on file.

Research of internal databases for all required documentation and reporting of missing documents to the contracting leadership team.

November 2014 - January 2015 Orchestrall Inc/Aramark

Quality Review/Audit Associate

Process invoices for client vendor sites for payment.

Research, track and resolve accounting issues.

Assists with monthly closing of finances.

December 2013 - March 2014 Mindlance, Inc. /Express-Scripts

Senior Prior Authorization Representative

Research payer benefit for Specialty Drugs ( Pulmonary Arterial Hypertension.

Review medical necessity and qualifications from Medical Doctor.

Reading CPT and HCPC coding to assist with effective submission of request

August 2012 - May 2013 Kelly Services/CGS

Medicare DME Appeals Analyst

Research Medicare claims for possible adjustment.

Review medical records and perform daily workload management.

Reading and understanding LCD guidelines and Policy articles

Remain knowledgeable on current changes in Medicare policies and procedures

Contact suppliers and adjudicate claims for proper payment.

August 2011- February 2012 AppleOne, Inc./Genworth Financial

Policy Holder Services Representative

Handling calls from policyholders and agents in the Medicare supplement field.

Listening, analyzing, and responding to customer inquiries. Providing information and issue resolution via email or phone calls.

November 2008 - January 2011 Aerotek, Inc./ CVS-Caremark/Windsor Health Group

Outbound Member Verifications Representative

Verify new Members and review Medicare Advantage benefits and coverage.

Conduct annual Health Assessments with existing Members to update medical needs, prescriptions and emergency contact information.

Care Reservist

Data entry of prescription refill requests for order processing.

Status checks of pending prescription refill requests.

Updating vital participant information to aid in the processing of future refill requests.

October 2005 -- April 2006 ACS, Inc./Cendant Travel

Escalations Travel Agent

Investigated and resolved customer concerns in collaboration with respective airline and hotel reservation departments.

Enhanced customer-satisfaction ratings by expediting refund and rescheduling requests from on-line travel clients.

Professional Experience: (Permanent)

January 2007 – July 2008 AT&T

Retention Sales Associate

Negotiated more efficient and cost effective pricing plans for customer retention.

Exceeded customer expectations when adding new services while maintaining costs.

Consistently provided excellent service while tactfully resolving sensitive customer issues.

May 2006 - January 2007 Emdeon

Software Support Representative

Reset passwords for client staff.

Resubmitted client information for daily reporting to medical clearinghouses.

Assisted clients with reporting issues caused by software errors and/or incorrect data input.

June 2004 - December 2004 Asurion Insurance Services

Technical Support Representative

Followed trouble-shooting guidelines for clients having problems with their wireless handsets.

Assisted clients in reprogramming and updating their wireless device software.

Processed requests for replacement wireless handsets for clients filing insurance claims.

November 2000 - June 2004 Sprint PCS, Inc.

Business Customer Retention Specialist

Offered and processed more cost efficient plan changes for clients considering cancellation of their wireless services.

Answered questions. Responded to concerns and resolved delicate situations with professionalism and sensitivity.

Education:

Middle Tennessee State University Murfreesboro, TN

Political Science.…Candidate for Bachelor’s degree December 2016

New Horizons Computer Learning Center Nashville, TN

CMAA & CBCS Certification June 2010

References:

Deb Bartlett Xtend Healthcare 615-***-****

Karen Bledsoe Mitsui 615-***-****

Troysetta Demonbreun Aramark 615-***-****

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