Shaunda Kenner

Ocala, FL *****

ad4xqr@r.postjobfree.com

+1-737-***-****

My objective is to find a career that will allow me to grow and increase my knowledge and skills Work Experience

Automotive Cashier/BDC/ Receptionist

Deluca Toyota - Ocala, FL

October 2023 to April 2024

Provided customer service to the general public in person, by telephone, and written correspondence through email. Scheduled appointments, assisted in answering telephones, handling complaints, answering questions regarding warranty and services. Screened calls, took messages, and routed calls to various departments for appropriate service needs. Cashier duties were posting payments and filing. Service Advisor/Receptionist/Business Development Consultant All New Gary Yeomans Ford of Ocala - Ocala, FL

September 2021 to September 2023

BDC duties-Provided customer service to the general public in person, by telephone, and written correspondence through email. Scheduled appointments, assisted in answering telephones, handling complaints, answering questions regarding warranty and services. Screened calls, took messages, and routed calls to various departments for appropriate service needs. Cashier duties were posting payments and filing.

Service Advisor-Served as the primary point of contact for all automotive service and repair matters. Addressed customers’ problems and arrange for appropriate service. Prioritize required services, and offer options

Set and manage the expectations of the service delivery for both the customers and mechanics. Continuously keep the customer updated on repair needs and completion times. Housekeeper / Homemaker / Companion/ HHA

Viceroy Health Services - Ocala, FL

March 2021 to August 2022

Homemaker and Companion Aide Home Care Companions provide service to individuals in their own homes and communities who need assistance caring for themselves because of old age, sickness, disability and/or other inflictions. Home care may include light housecleaning, laundry, meal preparation, transportation, companionship, respite and advice on such things as nutrition, cleanliness Customer Service and Collections Specialist

Getix health - Sugar Land, TX

January 2020 to February 2021

• Call Center-Medical Collections for Henry Ford Hospital

• Responding to telephone inquiries (inbound/outbound), utilizing standard procedures and scripts.

• Gathering information, performing research and resolving customer inquiries.

• Review medical claims and Explanation of Benefits

• Coordinate Benefits and medical insurance

• Communicate appropriate options for resolution in a timely manner.

• Inform customers/patients about services available, and assess their needs.

• Schedule work to ensure accurate phone coverage, prioritize calls and escalate as required.

• Assist in planning and implementing department goals and make recommendations to management to improve efficiency and effectiveness.

Collect monies owed on delinquent medical accounts in an expeditious manner to ensure account resolution. Assists patients by offering suggestions and information in regard to payment arrangements, and account disputes, also performs skip tracing and re-bills insurance companies when appropriate. Work independently, excellent customer service and communication skills, patience, flexibility and the assertiveness to achieve goals.

Appeals and Grievance Coordinator

Memorial Hermann Health System - Houston, TX

January 2018 to December 2019

Utilization Management

Review and process member and provider grievances and appeals within Federal, State and organizational regulations and policies and procedures. Serve as liaison between member, provider regulatory agencies, and internal staff Make outbound calls to providers for acquiring all required clinical documentation as specified. Collaborate with Customer Service and Business Management Services to address members/providers concerns and reach a resolution within a timely manner. Enter notifications, Providers status of an existing notification and determining if notification is required. Coordination of Benefits

Correspond with members and providers through Acknowledgement and Resolution letters in a timely manner.

Verify all patient medical information and obtain prior authorizations and predeterminations using provider NPI and Tax Identification numbers, ICD-10 codes, and CPT Codes to insurance companies for medical services.

Collaborate with the medical director and nurse to determine status of appeal. File Appeals, provide case status, and schedule peer to peer consultations. prepare for audits.

HIPAA Training and Certification

Pharmacy Technician Trainee

CVS Health - Pearland, TX

June 2016 to June 2018

• Under the supervision by the pharmacist, assist in the practice of pharmacy, in accordance with state, federal, and company policy.

• Performed duties as assigned by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered correctly, filling prescriptions by retrieving, counting and pouring pharmaceutical drugs, verifying medicine is correct, and checking for possible interactions. Assists pharmacists in scheduling and maintaining work flow.

• Responsible and accountable for registering all related sales on assigned cash register, collects and handles cash as required. Takes customer to OTC aisle when possible to assist in locating products.

• Handles telephone calls that do not require personal attention of the pharmacist, including those to physicians.

• Assists and supports Pharmacy Department on inventory management activities, such as, ordering, unpacking, checking and storing shipment of pharmaceuticals. Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods involving Rx drugs.

• Assist pharmacist in administering clinical services including the collection and proper labeling of blood/ urine samples from patients and other clinical services as required; assists pharmacy staff in coordination of clinical services, Walgreens healthcare clinics and external providers.

• Assists Pharmacy Manager and Staff Pharmacist in developing and maintaining good relationships with the local medical community, including physicians, nurses, and other health care providers, by medical provider detailing and outreach to health groups, retirement homes, nursing homes, and other forums for enhancing growth opportunities.

• Assists with ensuring the Pharmacy Department is stocked with adequate supplies, clean, neat and orderly in condition and appearance.

Account Manager- Neurology

Altus Infusion - Pearland, TX

January 2016 to June 2018

Manage doctor's patients insurance, authorizations, and account balances Serve as a liaison between the provider and insurance company. Verifying eligibility and benefits.

Obtain prior authorizations and predeterminations using provider NPI and Tax Identification numbers, ICD-10 codes, and CPT Codes to insurance companies for IV Infusion medications. Calculate and Collect Patient Copays

Coordination of Benefits

Providing prompt and courteous service to patients, clinics contacts, and other health care professionals in regards to reimbursement and patient assistance questions. Serve as a liaison between patient, medical staff and pharmaceutical reimbursement services, to properly execute program benefits; serving as an expert resource to the network in the research of reimbursement and patient assistance programs.

Gather Personal Health Information and medical information in order to apply and receive approval from the assistance programs.

Schedule and confirm appointments and go over benefits with patients. Create a daily collection sheet for the nurses to keep them informed on all details of the patient's insurance and copays for each patient's date of service. Daily use of computer systems, fax machines, and heavy phone systems. Perform all aspects of insurance verification for Commercial Insurance, Medicare and Medicaid. Explain and help patient to determine if they want to use In or Out of Network benefits. Update patient demographics and insurance changes in software.(AIMS) Senior Customer Service Representative

UnitedHealth Group - Sugar Land, TX

July 2013 to December 2015

Serviced 8 states for Medicare and Medicaid patient Primary Responsibilities:

Ensure quality customer service for internal and external customers Respond to incoming customer service requests, both verbal and written Identified and assesses customers' needs quickly and accurately

Solves problems systematically, using sound business judgment Partner with other billing and eligibility department representatives to resolve complex customer service inquiries.

Monitor delegated customer service issues to ensure timely and accurate resolution. Inform and educate new customers regarding billing / invoicing set up and billing and payment procedures.

Place outgoing phone calls to complete follow-up on customer service requests as necessary. Process member terminations (i.e. phone disenrollment) Establish and demonstrate competency in eligibility, billing and receivable systems and associated applications. Implements customer service strategies and recommends related improvements / enhancements

Consistently meet established productivity, schedule adherence, and quality standards. Proactively seek to further develop billing and accounts receivable competencies Education

Associate in Arts (AA) in Social and Behavioral Science Daytona State College - Ocala, FL

August 2005 to December 2007

Skills

• Customer Service (10+ years)

• Insurance Verification (10+ years)

• 10 key typing

• Medical Collection (10+ years)

• Utilization Management (2 years)

• ICD-10

• HIPAA

• Medical Terminology

• Managed Care (2 years)

• Documentation Review

• Microsoft Office (5 years)

• Attention To Details

• Communication skills

• Organizational skills

• Administrative experience

• Pharmacy Technician Apprentice Program (1 year)

• Pharmacy Tech Trainee (2 years)

Certifications and Licenses

Pharmacy Technician Trainee

May 2016 to May 2018

license# 255553 /Texas

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