Shavonda Francis Evans

*** ********** **.

Canton, MS

adzocg@r.postjobfree.com -

601-***-****

Objective: A challenging position in a growth-oriented company, where my education, experience and creative skills will be utilized.

SKILLS

-Computer proficient in Microsoft Word Works, Window XP, Vista, Excel, Window 7, Spreadsheet, PowerPoint Keyboarding/typing 45wpm, Customer Focus, Communication, Team Work, Flexibility Strong Work Ethic Work well as a part of an interdisciplinary team member

-Dependable

-Efficient / detailed oriented

-Self-directed

-Excellent troubleshoot / problem solving skills

-Quick learner

EDUCATION

Associate of Arts

Hinds Community College December 2009

Interdisciplinary Studies

Bachelor of Science April 2012

Jackson State University

Interdisciplinary Studies

WORK EXPERIENCE

Department Veterans Affairs- October 2017-Present

Advanced Medical Support Assistant

Deborar Brooks Sander (Supervisor) 601-***-**** ext.56184

GS-06 Step 2 Annual Salary: $39,105.00 Average hours worked per week (40)

Provides clerical and administrative support to the Complex Mental Health Department and serves as the Advanced Medical Support Assistant for other clerical support staff with the service and lead administrative support for Complex Mental Health Department

Contact patients by mail and/or phone to scheduling appointments to assure that the most convenient date and time is offered to the patient.

Document appropriately in the patient’s medical record and mail appointment letters to patients as needed.

Uses VISTA and Computerized Patient Record System (CPRS) to access, enter, retrieve, and edit information in the medical center’s computer systems.

Generates a variety of reports, including, but not limited to, consult tracking, days in wait, clinic utilization and capacity.

Supports patient safety standards using the correct Veterans Affairs identification of all patients through the use of two forms of identification, the Veteran's name and full Social Security Number (SSN).

Screen/receive phone calls in a courteous and timely manner, determine the nature of requests and provide the information desired using privacy rules and established clinic processes.

Schedule appointments accurately and in a timely manner. All appointments will be made with the patient's input, either in person or by phone. This may require a high level of coordination to avoid patients having to make multiple trips to the medical center or clinic

Notifies his/her supervisor when clinic access is less than desirable or if an individual patient cannot be scheduled within mandated clinic timeframes.

Participate in, and may lead as appropriate, any process improvement groups to correct and reduce patient complaints.

Develops, examines, adjusts, reconsiders, recommends settlement of various types of claims, receives and processes requests for authorization of healthcare services, supplies and benefits.

Through consultation and advisory, the incumbent provides customers with advantages and disadvantages to various benefit options and discusses various alternatives.

Redevelops claims for reprocessing, ensuring that all required information and documents are present and complete to facilitate payment of claims.

Explains and advises the basis for payment decisions and reasons for disallowance.

Advises, counsels, and reviews applications for benefits for assigned health benefit programs administered by the OCC.

Serves as a field representative to VAMCs and Veterans Integrated Service Networks (VISNs) for assigned health benefit programs administered by the OCC.

Replies may be prepared using standard formats and language, or in very complex cases, specific language and/or formats may be necessary to appropriately address the issues.

Customer Service Representative- April 2016- April 2017

Disabled Veteran Solutions - Ridgeland, MS

Claretha Crockett (supervisor) 601-***-****

Annual Salary $26,500.00 Average hours worked per week (40)

Answer incoming calls

Assist in updating information on child support cases

Send messages to Caseworkers to resolve client’s issues

Provide accurate information on payments and other child support issues

CUSTOMER Service Representative- October 2014 to April 2015

Xerox -Madison, MS

Claretha Crockett (supervisor) 601-***-****

Annual Salary $26,500.00 Average hours worked per week (40)

Using a computerized system, responds to customer inquiries in a call center environment.

May perform one or more of the following responds to telephone inquiries and complaints using standard scripts and procedures.

Gathers information, researches/resolves inquiries and logs customer calls.

Informs customers about services available and assesses customer needs.

Collects, compiles, and/or track data and program information in support of revenue.

Prepare executes, and/or tracks revenue program specific information.

Provides answers to customer service regarding accounts receivable, means and co-payment test, and health insurance related issues.

Customer Account Executive- June 2008 February 2014

Comcast - Madison, MS

Elizabeth Harper (supervisor) 601-***-****

Annual Salary $26,500.00 Average hours worked per week (40)

Handle large volume of incoming telephone calls, cover full range customer services in a prompt and professional manner, and obtaining all information for resolution of transaction.

Resolve technical problems and answer inquires by telephone in support of internal and external customer computer hardware, software, network, and telecommunication systems.

Maintain and update reference materials needed to provide quality service.

Ability to troubleshoot advance product inquires on Comcast network e-mail, operating system, connectivity issues, products features wireless, and basic internet configuration.

Resolve technical problems and answer inquires by telephone in support of internal and external customer computer hardware, software, network, and telecommunication systems.

Maintain and update reference materials needed to provide quality service.

Ability to troubleshoot advance product inquires on Comcast network e-mail, operating system, connectivity issues, products feature wireless, and basic internet configuration.

Biller/Collector Specialist

University MS Medical Center - Jackson, MS - November 1999 to June 2008

Angela Thomas (supervisor) 601-***-****

Annual Salary $27,500.00 Average hours worked per week (40)

Customer Service, billing and follow-up Medicare, Medicaid, Blue-Cross, Commercial, HMO from EPIC System, data entry, reviewing coding, HCPC, ICD-9, call company verify insurance, update new information from patient, 10-key calculator, spreadsheets, and troubleshooting.

Responsible for claims filing in DAR system, ub-94, correct denied claims in remote system, follow-up on unpaid claims; incoming calls update insurance, worked unbilled report, customer service, medical records for appeals and filed second insurance hardcopy.

Independently processes medical, dental and/or hospital claims for assigned plans requiring minimal supervision. Provides customer service, including providing information to hospitals, physicians and participants regarding eligibility, benefits and claims status.

Maintain current knowledge of assigned Plans and effectively apply knowledge in the payment of claims, customer service, and all other job functions.

Provided administrative support and human resources operations. Transcribed routine pre-coded and identifiable alphanumerical data from source document. Process tasks such as data entry and scanning as well as performing data entry of materials from source documents to a computer database. Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.

Administrative Assistant/Human Resource Specialist – January 2001-May 2004

Canton Municipal Utilities – Canton, MS

Connie Henderson (supervisor) 601-***-****

Annual Salary $ 22,500.00 Average hours worked per week (40)

Performs complex administrative activities including managing special projects, composing letters and reports, preparing/editing presentations, creating and updating. collection, verification and weekly check distribution throughout the facility.

Answer incoming telephone calls and direct call traffic to the proper person utilizing a Cisco Unity phone system with computerized transfer abilities. Work closely with the clients, guests, and staff to ensure seamless day-to-day operations as the first line of contact with clients, visitors and attorneys.

Developing job descriptions.

Discussing needs and qualifications with employers.

Claims Examiner/Biller

GA Carmichael Clinic - May 1999 to January 2001

Montrice Wilson (supervisor) 601-***-****

Annual Salary $19,500.00 Average hours worked per week (40)

Compiled and recorded medical charts, reports and correspondence, using typewriter and word processor. scheduling appointments, entering patient information in system, entering charges, ordering supplies, generating encounters, verifying income, insurance,

Medicaid and Medicare billing, ICD-9 Coding, medical records, filing, excellent customer service skills, computer literate, detailed oriented, maintaining records, correspondence and files, distributes mail, manages charges and return.

Answered telephone and scheduled appointments post and accepted payments on accounts. Performed secretarial duties, utilizing knowledge of medical terminology and hospital, clinic and laboratory procedures.

Processes complex general liability claims by investigating and gathering information to determine the exposure on the claim and/or auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.

Responsible for litigation process on litigated claims.

Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.

Reports large claims to excess carrier(s).

Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.

Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.

Communicates claim action/processing with insured, client, and agent or broker when appropriate.

Assesses liability and resolves claims within evaluation.

Negotiates settlement of claims within designated authority.

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

Prepares necessary state fillings within statutory limits.

Manages the litigation process; ensures timely and cost-effective claims resolution.

Coordinates vendor referrals for additional investigation and/or litigation management.

Customer Care Associate

State Farm Insurance Company- May 2005- June 2008

Latoshia Goodrich-Supervisor 769-***-****

Annual Salary $20,650.00 Average Hours work per week (40)

Performs clerical duties, including data entry, filing paper documents, email, calendar management, and word processing

Obtain copies of checks and make file copies to address formal complaints

Orders equipment and provide minimal technical support

Primarily work various lists and spreadsheets; sending out acknowledgement letters

Processes, sorts, indexes, and routes incoming and outgoing communications related to claim operations

Collects, organizes, and maintains standard information for files, forms, records, and report

Receives, screens, and routes telephone calls and other electronic correspondence

Provides back-up for any support function in the office

Completes all necessary forms, logs documents into the system, and routes them to the appropriate parties

Customer-centric employee: Conveying a calm, caring attitude, you’ll provide best-in-class service to customers while processing new claims and “First Notice of Loss” forms (the initial report made following a loss, theft or damage to an insured asset)

Collaborative partner: Working with internal and external partners, you’ll support policyholders while their claims are being processed

Efficient worker: In our fast-paced environment, you’ll handle customers’ needs—quickly, effectively and in a friendly, caring manner—to meet our Claims Service Center goals

Problem solver: No day is predictable; you’ll utilize out-of-the-box, creative thinking to resolve a wide variety of claims challenges and customer issues

Clear communicator: You’ll provide policyholders with the information they need by clearly setting expectations and outlining next step

Reference Upon Request

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