Shannisha Griffin
Bogalusa
Summary
Experienced in evaluating claims for accuracy and compliance. Utilizes strong organizational skills and attention to detail to process claims efficiently. Track record of effectively communicating with clients and stakeholders to resolve claims disputes. Professional with a strong background in claims management, prepared to make a significant impact. Skilled in assessing and processing claims accurately, resolving complex issues, and ensuring customer satisfaction. Effective team collaborator, with a focus on achieving results and adapting to changing needs. Known for analytical thinking, communication skills, and attention to detail.
Overview
9
9
years of professional experience
Work History
Claims Representative
Conduent
2022.03 - 2025.03
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines.
- Conducted detailed assessments of claims documents for accuracy and completeness.
- Served as a subject matter expert on specialized claims, providing support to team members.
- Conducted investigations into suspicious claims, reducing fraud.
- Reviewed and updated claim processing guidelines to align with industry standards.
- Handled Medicare claims with accuracy and compliance, reducing errors and denials.
Customer Billing Representative
TTEC
2019.04 - 2022.01
- Delivered exceptional customer service by promptly responding to inquiries from internal and external stakeholders.
- Assisted patients in understanding their insurance benefits and financial assistance programs.
- Maintained strict adherence to HIPAA guidelines to protect confidential information.
- Reduced claim denials by reviewing medical documentation and ensuring accurate coding.
- Collaborated with healthcare providers to reconcile discrepancies for timely claim submission.
- Collected payments and applied them to patient accounts.
- Posted payments and collections regularly.
- Verified patient insurance eligibility and resolved denied claims with providers.
- Processed Medicare-related claims, ensuring compliance with federal guidelines.
Customer Service Representative
General Dynamics
2016.08 - 2019.11
- Assisted customers with inquiries, account updates, and service requests with professionalism and accuracy.
- Handled high-volume inbound calls while maintaining quality performance standards.
- Provided troubleshooting support and resolved customer concerns, improving satisfaction.
- Documented customer interactions in company systems, ensuring accuracy and compliance.
- Collaborated with team members to meet and exceed performance goals in a call center environment.
- Handled Medicare claims, supporting patients with coverage questions and claim status updates.
Education
High School Diploma -
Bogalusa High School
Bogalusa, LA2012-05
Skills
- Claims management
- Medicare claims
- Customer service
- communication
- Analytical thinking
- HIPAA compliance
- Problem solving
- Health insurance knowledge
- Time management
Timeline
Claims Representative
Conduent
2022.03 - 2025.03
Customer Billing Representative
TTEC
2019.04 - 2022.01
Customer Service Representative
General Dynamics
2016.08 - 2019.11
High School Diploma -
Bogalusa High School