SHELONDA LINDSEY

**** ********* **. (C) 214-***-**** adgkma@r.postjobfree.com

Skills

Microsoft Office

All versions of Microsoft Windows

Lotus 1-2-3 Word

Analyst

Excel

Lotus Notes

Communication Skills

Data Entry Skills

Telephone Skills

Right faxing

Marketing Skills/Digital Marketer

Web Management Systems/consumer facing web sites

Management Systems

Computer Support Specialist

IT skill

Customer services skills/Supervision Exp.

Project Management Skills

Claims

Quoting Health care benefits

Detailed oriented

Multi Tasker/can meet demanding deadlines/team player

Professional Summary

Developed ability to work in a fast-paced

atmosphere Maintained excellent customer

relations and developed customer rapport

Diplomatically resolved customer and providers

complaints on as-needed basis Ability to follow

instructions well and make decisions with no

supervision Effectively developed telephone

communication skills and consistently met quotas

Delegated responsibilities to employees to meet

company's expectations

Work history

Shared Health Coordinator Sep 2013 - Current

Blue Cross and Blue Shield of Texas Richardson, Texas, United States

This position is responsible for contacting members to inform and educate them on our medical

management programs; conducting research, performing data entry, responding to inquiries from

members and providers, and supporting the clinicians in the Medical Management department with

their provider and member activities, routing cases to nurses to be worked and approved, taking some

calls from providers about approved or denied cases. Setting up programs for clinicians. In and Out bound calling informing providers of approval for members.

Behavioral Health advocate 2 Sep 2013 – Nov 2016

Blue Cross and Blue Shield of Texas Richardson, Texas, United States

this position is responsible for working on the phone all day in a call center setting to assist members

and physicians by responding to telephone and written inquiries in a prompt, accurate and objective

manner. Duties include: conducting research’s and quoting Behavioral health benefits to providers,

and also precerting hospital stays, surgeries, LTAC, Hospice stays and skilled nursing stays; spends

approximately 90 of the scheduled time on the phone according to business need

credentialing support rep specialist Sep 2011 - March 2012

Blue Cross and Blue Shield of Texas Richardson, Texas, United States

this position reviews and source verifies all initial and re-credential provider applications for

designated health care professionals for the purpose of determining adherence to the Health Plan

Credentialing Policies. The Specialist communicates with all state, federal and other regulatory

agencies to obtain and/or validate information submitted by providers. The incumbent researches

and investigates all issues involved in the credentialing/re-credentialing process. This position prepares

findings and recommendations for the Medical Director to present to the Health Plan Credentialing

Committee. This position conducts follow-up on Credentialing Committee decisions and requests for

further investigation. Reviews, maintains and updates credentialing database as appropriate. Also

take and make inbound and outbound calls to Provider for the provider’s most updated information to

be able to except BCBS health INS.

Education

Have not completed: Business Management/Administration Current Student

Strayer University

9000 W Chester St. M Milwaukee, WI 53214

Have not completed: Business Admin have not completed

Collin County Community College 2800 E Spring Creek Pkwy

Objective

Highly self-motivated achiever driven to set and attain goals. Team player with strong interpersonal,

time management, and organization skills. Able to communicate effectively with various personality

types while exhibiting leadership, a professional attitude and appearance. Computer literate,

aggressive, persistent, and able to work well independently.

Contact this candidate